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Sophie’s Flash Cards > Nephrology > Flashcards

Nephrology Flashcards

1
Q

What is the most common mechanism for primary hyperuricaemia
A. Increase cell turnover
B. Increased GIT absorption
C. Inherited defects in adenosine triphosphate metabolism
D. Reduced renal uric acid excretion

A

D

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2
Q

First change occur in diabetic nephropathy

A

Increased GFR

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3
Q

50F with RA with intermittent use of DMARDs. She has been poorly compliant with treatment. She now presents with progressive proteinuria with 24h > 4g and hyaline casts. Serum alb 30, normotensive 120/80. Serum Cr 60. Most likely cause of proteinuria
A. IgA GN
B. Membranous nephropathy
C. Anti-GBM disease
D. Secondary amyloidosis

A

D

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4
Q

71M with HTN, COPD and previous CABG. P/w 3/7 history of anuria and dyspnea. Taking ramipril. atorvastatin, amlodipine, clopidogrel and aspirin, amoxicillin, pantoprazole and inhaled steroid. BP 200/105, ECG shows previous anterior MI. Renal US shows a 6cm R kidney and 11cm L kidney. No urine noted. Cr 600
A. AIN
B. Renal thromboembolism
C. Renal dissection
D. Pyelonephritis

A

B

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5
Q

Strong indicator for renal biopsy
65M with T2DM and proteinuria (urine ACR 250g/mol Cr)
A. Positive ANCA Abs specific for MPO
B. Persistent microscopic haematuria
C. Positive ANA 1:1640
D. Increase in Cr from 90 to 170 over 2 months

A

A - look for inflammatory changes

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6
Q

S/E sirolimus

A

Pneumonitis, mouth ulcers, proteinuria

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7
Q

Flash pulmonary oedema, EUC worse on ACEI, asymmetrical kidney

A

Suspect RAS - do MR angiography

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8
Q

Binds to FK binding protein located in T cells and ultimate the gene transcription of IL-2

A

Tacrolimus

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9
Q

Least likely to cause leukopenia in the post transplant period
Bactrim, Valcyte (CMV prophylaxis), Thymoglobulin, MF, Tac

A

Tac

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10
Q

Papillary necrosis - causes

A
  • Chronic analgesia use
  • Sickle cell disease
  • TB
  • Acute pyelonephritis
  • DM
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11
Q

Fanconi syndrome - causes

A
  • Cystinosis (most common cause in children)
  • Sjogren
  • MM
  • Nephrotic syndrome
  • Wilson’s disease
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12
Q

Fanconi syndrome - manifestations

A
  • Type 2 (proximal) RTA
  • Polyuria
  • Aminoaciduria
  • Glycosuria
  • Phosphaturia
  • Osteomalacia
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13
Q

Risk factor of calciphylaxis

A
  • HyperCa
  • HyperPO4
  • HyperPTH
  • Warfarin
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14
Q

Management of Ca stone

A
  • High fluid
  • Low animal protein, low salt diet
  • Thiazide diuretics
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15
Q

Genetics of ADPKD

A

ADPKD type 1 (PKD 1, chromosome 16, 85%)
ADPKD type 2 (PKD 2, chromosome 4, 15%)

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16
Q

Mechanism of tolvaptan

A

Vasopressin receptor 2 antagonist
- found on basolateral membrane of the principal cells in the collecting ducts of the kidney
- Reduce water absorption and increases aquaresis without sodium loss

17
Q

Least likely seen in HSP
- Abdo pain
- renal failure
- Polyarthritis
- Thrombocytopenia
- Purpuric rash over buttocks

A

Thrombocytopenia

18
Q

Extra renal features of ADPKD

A
  • Hepatic cysts 70% (hepatomegaly)
  • Diverticulosis
  • Intracranial aneurysms
  • CV: MVP, mitral/tricuspid incompetence, aortic root dilatation, aortic dissection
  • Cysts in other organs: ovary, pancreas, thyroid, oesophagus
19
Q

Pre-renal uraemia vs ATN

A
  • Prerenal uraemia: hold on to Na to preserve volume
  • <1% Fractional sodium excretion, <35% fractional urea excretion, Urine Na < 20mmol
20
Q

Side effects of finasteride (5 alpha-reductase inhibitor) for BPH

A

Erectile dysfunction, reduced libido, ejaculation problems, gynaecomastia
MOA block conversion of testosterone to dihydrotestosterone (DHT) - induce BPH

21
Q

Nephrogenic DI

A

Low urine osmolality post water deprivation and failure to respond to desmopressin

22
Q

Factors increase pulmonary haemorrhage in GBM disease

A
  • Smoking
  • Lower resp tract infection
  • Pulmonary oedema
  • Inhalation of hydrocarbons
  • Young males
23
Q

Genetic mutation in nephrogenic DI

A
  • More common form: affecting vasopressin (ADH) receptor
  • Less common form: mutation in the gene that encodes the aquaporin 2 channel
24
Q

Which one not a RF for renal stone
A. RTA
B. Cadmium
C. HyperPTH
D. Dehydration
E. Cystinosis

A

E. it is cystinuria not cystinosis

25
Q

Electrolyte derangement causing nephrogenic DI

A
  • HyperCa or hypoK
26
Q

AutoAbs for membranous glomerulonephritis

A

Anti-phospholipase A2

27
Q

Which least a/w retroperitoneal fibrosis
A. Riedel’s thyroiditis
B. Previous radiotherapy
C. Inflammatory abdominal aortic aneurysm
D. Methysergide
E. Sulphonamides

A

E.

28
Q

Renal biopsy of membranous glomerulonephritis

A

EM - the basement membrane is thickened with subepithelial electron dense deposits. This creates a “spike and dome”appearance

29
Q

Cystinuria

A

Autosomal recessive
Recurrent stones (yellow, crystalline, semi-opaque)
Dx with cyanide-nitroprusside test

30
Q

HypoK + high plasma aldosterone + high plasma renin

A

Bilateral renal artery stenosis
If low renin -> primary hyperaldosteronism

31
Q

Alport syndrome - genetics

A

X-linked dominant, defect in gene codes for type IV collagen -> abnormal GBM

32
Q

Alport syndrome - clinical

A
  • Microscopic haematuria
  • Progressive renal failure
  • Bilateral sensorineural deafness
  • Lenticonus: protrusion of the lens surface into the anterior chamber
  • Retinitis pigmentosa
  • Renal biopsy: splitting of lamina densa seen on EM
33
Q

Not a feature of HIv-associated nephropathy
- Small kidneys
- Normotension
- Elevated urea and Cr
- Proteinuria
- FSGS

A

A: normally normal or large kidney

34
Q

Most likely cause of death in CKD on HD

A
  • IHD

Sophie’s Flash Cards (9 decks)

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