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Medicine Year 3 > Nephrology > Flashcards

Nephrology Flashcards

1
Q

How long does it take an AV fistula to mature

A

6-8 weeks

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2
Q

Phosphate in CKD

A

Decreases

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3
Q

Nephrotic syndrome and reduced antithrombin III increases the risk of

A

VTE

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4
Q

Imaging for polycystic kidney

A

Ultrasound

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5
Q

4 things associated with polycystic kidney

A

Cerebral aneurysm
Liver and ovarian cysts (HEPATOMEGALY)
Diverticulosis

(liver cysts are most common)

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6
Q

Cause of secondary hyperparathyroidism

A

CKD induced

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7
Q

Risk of secondary hyperparathyroid

A

Fragility fractures

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8
Q

Thyroxine in nephrotic syndrome

A

Reduced

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9
Q

Example of nephrotic

A

Membranous glomerulonephritis

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10
Q

Cause of chronic hypocalcaemia

A

Chronic kidney disease

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11
Q

What are the genetics of alport syndrome

A

X linked

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12
Q

4 features of alports syndrome

A

Microhaematuria
Renal failure
Sensorineral deafness
Eye: retinitis pigmosa and lenticonus (splitting of the lamina densa)

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13
Q

What cancer does a renal transplant increase the risk of

A

Skin SCC

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14
Q

Which type of renal failure gives an increased serum urine: creatinine ratio

A

Pre renal

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15
Q

Can anaemia cause a murmur

A

Yes

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16
Q

Feature and cause of secondary aldosteronism

A

Increased renin

Renal artery stenosis

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17
Q

What condition is anti GBM found in

A

Goodpastures

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18
Q

2 associations with goodpastures

A

Haemoptysis

AKI (protein/blood)

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19
Q

Treatment of DKA

A

Fixed rate insulin infusion

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20
Q

Antidote for opioid

A

Naloxone

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21
Q

Antidote for benzo

A

Flumezenil

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22
Q

3 features of an aspirin overdose

A

N+V, tinnitus, headache

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23
Q

Treatment of an aspirin overdose

A

IV sodium bicarb

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24
Q

Metabolic disturbance in vomiting and diarrhoea

A

Vomiting: alkalosis
Diarrhoea: acidosis

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25
Q

What is polycystic kidney disease associated with

A

Subarachnoid haemorrhage

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26
Q

To diagnose CKD on eGFR

A

You need 2 results

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27
Q

3 features of minimal change glomerulonephritis

A

Oedema
Proteinuria
Reduced albumin

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28
Q

treatment of minimal change glomerulonephritis

A

Prednisolone

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29
Q

Urine finding in acute tubular necrosis

A

Muddy brown casts

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30
Q

Side effect of spironolactone

A

Gynaecomastia

switch to eplerenone

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31
Q

What medication should you stop in AKI

A

ACEi

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32
Q

What will iron deficiency anaemia fail to respond to

A

EPO

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33
Q

Urine finding in interstitial nephritis

A 
White cell casts
IgE eosinophils (allergic)
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34
Q

what will acute tubular necrosis give a poor response to

A

a fluid challenge

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35
Q

would you biopsy minimal change?

A

only if the steroid response is poor

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36
Q

treatment of CKD mineral bone disease

A

Correct phosphate

reduce phosphate in diet and give phosphate binder

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37
Q

urine change in pre-renal disease

A

Increased osmolarity of urine

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38
Q

two findings in membranous glomerulopnephritis

A

Basement membrane has thick epithelial spikes

Positive PLA2

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39
Q

What does myoglobinurina lead to

A

Tubular cell necrosis

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40
Q

What would you give before CT to redcue the contrast risk

A

IV NaCL (0.9%)

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41
Q

Treatment of pulmonary oedema in AKI

A

Haemodialysis

42
Q

Investigation for polycystic kidneys

A

Ultrasound

43
Q

3 diagnostic features of fibromuscular dysplasia

A

Sting of beads
AKI after ACEi
Young female

44
Q

Most common cause of death if CKD on haemodialysis

45
Q

4 side effects of erythropoietin

A 
HTN
Flu
Pure red blood cell aplasia
Encephalopathy
Skin rash
46
Q

5 features of amyloidosis

A 
Weakness
Breathlessness
Reduced renal function
Proteinuria
Hepatosplenomegaly
47
Q

4 features of acute interstitial nephritis

A

Sterile pyuria
White cell casts
fever and rash
Post ABx

48
Q

Treatment of high potassium

A

Calcium resonium REMOVES potassium

Insulin SHIFTS potassium

49
Q

Mesenteric infarct

A

METABOLIC ACIDOSIS

50
Q

AKI Stage 1

A

↑ creatinine 1.5-1.9 times, or

↓ urine output <0.5 mL/kg/hr for ≥ 6 hours

51
Q

AKI Stage 2

A

↑ creatinine 2-2.9 times, or

↓ urine output <0.5 mL/kg/hr for ≥ 12 hours

52
Q

AKI Stage 3

A

↑ creatinine 3 times, or

↓ urine output <0.5 mL/kg/hr for ≥ 24 hours

53
Q

Diabetes insipidus bloods

A

high plasma osmolality and a low urine osmolality

54
Q

Medication to treat ascites

A

Spironolactone

55
Q

Diagnosing an AKI

A

↑ creatinine > 26µmol/L in 48 hours
↑ creatinine > 50% in 7 days
↓ urine output < 0.5ml/kg/hr for more than 6 hours

56
Q

Haemolytic uraemic syndrome - blood cells

A

Fragmented

57
Q

What is the most important antigen to match on renal transplant

58
Q

How does autosomal dominant polycystic kidney disease present

A

Abdominal pain and early satiety

59
Q

Method of access for haemodialysis

A

Arteriovenous fistulas

60
Q

What will happen to urinary sodium in acute tubular necrosis (renal AKI)

A

Raised urinary sodium

61
Q

Role of calcium gluconate in hyperkalaemia

A

Stabilises the myocardium

It does NOT change electrolyte levels

62
Q

triad of renal cell carcinoma

A

flank pain, flank mass and haematuria

63
Q

Testicular mass like ‘a bag of worms’

A

Varicocele

64
Q

How does bladder cancer present

A

Painless haematuria

65
Q

Severe hyperkalaemia with ECG changes

A

IV calcium gluconate AND

insulin/dextrose infusion

66
Q

No blood in urine

67
Q

Most common cause of nephrotic syndrome in children and adults

A

Children: Minimal change
Adult: Focal segmental or membranous glomerulopathy

68
Q

Acute graft failure (renal)

A

Asymptomatic

Rising creatinine, pyuria and proteinuria

69
Q

Nephrotic syndrome is associated with a hypercoagulable state due to loss of antithrombin III via the kidneys

70
Q

Most common cause of acute interstitial nephritis

A

Antibiotic use

71
Q

Screening for polycystic kidney disease

A

Ultrasound

72
Q

ABG in salicylate poisoning

A

Raised anion gap metabolic acidosis

73
Q

fever, arthralgia and lethargy with haemoptysis and dyspnoea

A

Goodpasture - positive ANCA

Granulomatosis with polyangiitis - negative ANCA, positive antiGBM

74
Q

Chronic kidney disease with ACR below 30

75
Q

Outcome of minimal change nephropathy

A

Good response to steroids but can have later recurrent episodes

76
Q

Which medications should be stopped in AKI

A

Aminoglycosides, ACE inhibitors/ ARBs, diuretics, and NSAIDs that are not at cardioprotective doses

77
Q

Medication which can cause interstitial nephritis

78
Q

Cause of vitamin D deficiency in polycystic kidneys

A

Secondary hyperparathyroidism

79
Q

Dehydration or rhabdomyolysis in an elderly patient with AKI

A

Dehydration: pre-renal so raised urea:creatinine ratio
Rhabdomyolysis: shows on urine dip

80
Q

eGFR is inaccurate in people with large muscle mass

81
Q

Renal impairment in Henoch-Schonlein

A

Full recovery

82
Q

Lithium is a recognised cause of nephrogenic diabetes insipidus (polyuria)

83
Q

Which nephrotic syndrome is associated with malignancy

A

Membranous nephropathy

84
Q

What should all patients with CKD be prescribed

85
Q

Difference between post strep glomerulonephritis and IgA nephropathy

A

Post strep: 1-2 weeks after URTI

IgA: 1-2 days after URTI

86
Q

Diabetes insipidus osmolarity

A

High plasma osmolarity and low urine osmolarity

87
Q

Contraindication to peritoneal dialysis

88
Q

Pharmacological treatment for x-linked nephrogenic diabetes insipidus

A

Chlorothiazide

89
Q

Pharmacological treatment of cranial diabetes insipidus

A

Desmopressin

90
Q

Alport syndrome

A

Renal failure
Leioyomas
Seisioneural hearing loss

91
Q

Confusion, reduced urine with dark urine with increased muscle use

A

Acute tubular necrosis

92
Q

unexplained visible haematuria without UTI

A

urgent 2ww for urological cancer

93
Q

Systemic lupus erythematosus with proteinuria on urinalysis

A

Lupus nephritis

94
Q

Most common cause of peritonitis secondary to peritoneal dialysis

A

Staph epidermidis

95
Q

anion gap in DKA

96
Q

Diagnosis of haemachromatosis

A

Serum ferriitn

97
Q

Chronic HIV-associated nephropathy will have large/normal sized kidneys on ultrasound whereas most patients with chronic kidney disease have bilateral small kidneys

98
Q

Patients with chronic kidney disease should be started on an ACE inhibitor if they have an ACR > 30 mg/mmol

99
Q

Exercise can cause haematuria

100
Q

Penicillin can cause acute interstitial nephritis

101
Q

Patient with CKD taking calcium-based binders can have problems including hypercalcaemia and vascular calcification

Medicine Year 3 (8 decks)

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