Nephrology

Question 1

Most common cause of intrarenal AKI?

Answer 1

Acute tubular necrosis

Question 2

Presentation of tests for acute tubular necrosis

Answer 2

Raised urinary sodium
Low urine osmolarity
poor response to fluid challenge

Question 3

How does minimal change disease present?

Answer 3

Nephrotic syndrome

Question 4

Most likely cause of nephrotic syndrome in children/young adults?

Answer 4

Nephrotic syndrome in children / young adults - minimal change glomerulonephritis

Question 5

How do you screen relatives of PKD patients?

Answer 5

USS abdo

Question 6

Renal diet?

Answer 6

Low protein
Low phosphate
Low sodium
Low potassium

Question 7

Treatment of minimal change disease?

Answer 7

Pred

Question 8

AKI stages?

Answer 8

Stage 1
Increase in creatinine to 1.5-1.9 times baseline, or
Increase in creatinine by ≥26.5 µmol/L, or
Reduction in urine output to <0.5 mL/kg/hour for ≥ 6 hours

Stage 2
Increase in creatinine to 2.0 to 2.9 times baseline, or
Reduction in urine output to <0.5 mL/kg/hour for ≥12 hours

Stage 3
Increase in creatinine to ≥ 3.0 times baseline, or
Increase in creatinine to ≥353.6 µmol/L or
Reduction in urine output to <0.3 mL/kg/hour for ≥24 hours, or The initiation of kidney replacement therapy, or,
In patients <18 years, decrease in eGFR to <35 mL/min/1.73 m2

Question 9

Stages of CKD?

Answer 9

1 Greater than 90 ml/min, with some sign of kidney damage on other tests (if all the kidney tests* are normal, there is no CKD)

2 60-90 ml/min with some sign of kidney damage (if kidney tests* are normal, there is no CKD)

3a 45-59 ml/min, a moderate reduction in kidney function

3b 30-44 ml/min, a moderate reduction in kidney function

4 15-29 ml/min, a severe reduction in kidney function

5 Less than 15 ml/min, established kidney failure - dialysis or a kidney transplant may be needed

Question 10

What variables used in eGFR equation?

Answer 10

serum creatinine
age
gender
ethnicity

Question 11

Nephritic syndrome classic triad?

Answer 11

haematuria, oliguria, and hypertension

Question 12

Presentation of IgA nephropathy?

Answer 12

young male, recurrent episodes of macroscopic haematuria

typically associated with a recent respiratory tract infection

nephrotic range proteinuria is rare

renal failure is unusual and seen in a minority of patients

Question 13

Difference in post strep nephropathy and IgA nephropathy?

Answer 13

Post strep - 1-2 weeks after URTI and proteinuria

IgA - classically young males, 1-2 days after URTI

Question 14

What electrolytes can be affected in rhabdo?

Answer 14

Calcium can be low (because the myoglobin binds calcium) and phosphate can be high (due to release from myocytes) in rhabdomyolysis.