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NEPHROLOGY Flashcards

1
Q

VBG in salicylate poisoning?

A

raised anion gap
metabolic acidosis

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2
Q

what is good pastures/anti glomerular basement memberane syndrome

CFs

Management

A

small vessel vasculitis
causes:
- pulmonary haemorrhages
- rapid glomerulonephritis

Ix; anti glomerular basement membrane antibodies against type 4 collagen
Management:
- plasma exchange (plasmaphoresis)
- Steroids
- Cyclophosphamide

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3
Q

Ix anti glomerular basement membrane disease

A

Linear IgG deposits along basement membrane

Pulmonary haemorrhages- causing raised transfer factor

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4
Q

what can membranoproliferative glomerulonephritis present as? (3)

A
  1. nephrotic syndrome
  2. haematuria
  3. proteinuria
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5
Q

3 types of membranoproliferative glomerulonephritis

A

Type 1= 90% cases
EMM- tram track
cause: cryoglobulinaemia, hepatitis C

type 2=
dense deposits
causes:
partial lipodystrophy factor H deficiency#

Type 3
causes: hepatitis B and C

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6
Q

What type of metabolic abnormality does diarrhoea most commonly cause

A

normal anion gap metabolic acidosis

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7
Q

how to calculate anion gap

A

(Na+ + K+) - (Cl- + HCO-3).

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8
Q

Post-streptococcal glomerulonephritis onset timeline
and caused by what organism

and appearance on immunofloresence

A

Post-streptococcal glomerulonephritis typically occurs 7-14 days following a group A beta-haemolytic Streptococcus infection
usually strep pyogenes

GRANULAR appearance

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9
Q

difference between IgA nephropathy and post strep GAS glomerulonephritis

A

post strep glomerulonephritis= 1-2 weeks and proteinuria

IgA nephropathy=1-2 days
and macroscopic haematuria

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10
Q

What type of metabolic abnormality does acetazolamide most commonly cause?

A

normal anion gap metabolic acidosis

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11
Q

what is cystinuria
#i heritance pattern

CFs
management

A

autosomal recessive

Features
recurrent renal stones
are classically yellow and crystalline, appearing semi-opaque on x-ray

Management
hydration
D-penicillamine
urinary alkalinization

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12
Q

what is cystinuria
inheritance pattern

CFs
management

A

autosomal recessive (exception to MR DS)
recurrent renal stones. defect in the membrane transport of cystine, ornithine, lysin, arginine . COLA!!!!

Features
recurrent renal stones
are classically yellow and crystalline, appearing semi-opaque on x-ray

Management
hydration
D-penicillamine
urinary alkalinization

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13
Q

cyanide-nitroprusside test

A

test for cystinuria

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14
Q

first choice investigation for reflux nephropathy

A

Micturating cystography

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15
Q

what type of immunogloblin responsible for graft rejection

A

IgG

and DR

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16
Q

how to distinguish between nephrogenic DI and cranial DI

A

administer nasal desmopressin

nephrogenic DI: no response.

cranial DI:

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17
Q

alport syndrome inheritance

A

X linked dominant
defect in type 4 collagen

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18
Q

CFs alport syndrome

A

usually young boys
microscopic haemiaturia
renal progressive failure
BIL Sensorineural hearning loss
retinal pigmentosa

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19
Q

what does renal biopsy and EMM show in alport syndrome;

A

SPLITTING OF LAMINA DENSA

X LINKED DOMINANT

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20
Q

WHAT IS a staghorn calculus made of

A

Magnesium ammonium phosphate, (also known as struvite),

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21
Q

congo red staining

A

amyloidoisis

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22
Q

renal complication of SLE and the 6 types

A

lupus nephritis
I normal kidney
II: mesangial glomerulonephritis
III: focal segmental glomerulonephritis
IV: diffuse proliferative glomerulonephritis
V: diffuse membranous
VI: sclerosing glomerulonephritis

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23
Q

most severe and and COMMON and dangerous type of SLE renal involvement

A

type 4- diffuse proliferative glomerulonephritis

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24
Q

mneumonic for 6 types of SLE nephritis

A

Normal Angels Focus on Diffusing Profits to Members of Sceciety

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25
what is calciphylaxis
area of black necrotic tissue that may form bullae, ulcerate, and leave a hard, firm eschar deposition of calcium deposits in intimal arterioles
26
most common bacteria for peritonitis infection during peritoneal dialysis
staph epidermis
27
is strep epidermis coagulase positive or negatvie
coagulase NEGATVE
28
treatment for peritonitis from peritoneal dialysis
vancomycin (or teicoplanin) + ceftazidime a
29
which type of glomerulonephritis associated with wegeners granulomatosis(ANCA)
rapidly progressive glomerulonephritis
30
most common type of glomerulonephritis in adults and its Tx
membranous glomerulonephritis Tx ACEi and immunisuppression with corticosteroids eg pred
31
anti phospholipase A2 associated with which type of glomerulonephritis
membranous glomerulonephritis 'The basement membrane is thickened with subepithelial electron dense deposits, creating a 'spike and dome' appearance.'
32
causes of renal papillary necrosis
- severe acute pyelonephritis - diabetic nephropathy - obstructive nepropathy - NSAIDs - sickle cell anaemia
33
what type of cancer is associated with Polycythaemia secondary to erythropoietin secretion
renal cell cancer
34
minimal change disease light microscopy findings?
normal findings
35
fanconi syndrome CFs (3 main)
type 2 (proximal) renal tubular acidosis, rickets/osteomalacia, polyuria Type 2 (proximal) renal tubular acidosis polyuria aminoaciduria glycosuria phosphaturia osteomalacia
36
acute tubular necrosis
Urine osmolality < 350 mOsm/kg
37
Autosomal dominant polycystic kidney disease type 2 is caused by a gene mutation on which chromosome?
Chromosome 4 Huntington's disease autosomal dominant polycystic kidney disease type 2
38
diffuse proliferative glomerulonephritis on light microscopy
wire loop appearance
39
which type of antibiotic can cause acute interstitial nephritis CFs
penicillin/ antibiotics CFs triad of eosinophilia rash fever + STERILE PYURIA, WHITE CELL CASTS
40
Autosomal dominant polycystic kidney disease type 1 caused by which chromosome
chromosome 16
41
What type of cancer is most associated with schistosomiasis?
SCC of bladder
42
nephrogenic DI gene mutation causes of nephrogenic DI- electrolytes
avpr2 aquaporin 2 Hypercalcaemia Hypo kalemia Genetic lithium sickle cell
43
polycystic kidney disease cardic problem
mitral valve prolapse
44
Disorders associated with glomerulonephritis and low serum complement levels
-post-streptococcal glomerulonephritis -subacute bacterial endocarditis -systemic lupus erythematosus -mesangiocapillary glomerulonephritis
45
post renal transplant RUQ pain and fever diagnosis l=most likely
CMV
46
bicalutamide MOA
androgen receptor blocker
47
foot processes on EMM
minimal change syndrome on electron microscopy
48
Tx minimal change syndrome
80% treated by prednisolone corticosteroid\ 20% steroid resistant- treat with cyclophos[hamide
49
tolvaptan MOA and used for?
vasopressin receptor 2 antagonist PCKD
50
nephrotic syndrome CFs associated bleeding problem causes Tx
CFs HOP Hypoalbuminaemia Oedema Proteinuria ass'd with antithrombin 3 deficiency minimal change GN membranous GN Focal segmental GN Amyloidosis Diabetes MINI MEMBERS FOCUS ON AMYS DIABETES Tx- ACEi
51
nephritic syndrome CFs causes
CFs haematuria, HTN Causes: IgA Alports Rapid progressive GN
52
Renal vascular disease: CFs Ix gold standard Tx
CFs Flash pulmonary oedema- string of beads HTN Chronic renal failure Ix of choice for Renal vascular disease= MR angiography Tx= balloon angioplasty
53
HUS triad of cfs causes Ix tx
Triad of: thrombocytopenia microangiopathic haemolytic anaemia AKI Cause : usually secondary to Ecoli infection , pneumococcal infec, HIV, SLE Ix FBC- thrombocytopaenia low Hb , negative coombs test U+E= AKI stool culture Mx= supportive no need Abx plasma exchange for PTS WITH NO DIARRHOEA
54
how to remember if renal stones are x ray opaque or not
all the ones that are OOOOOpaque contain an o (phosphate (incl stag horn struvite), oxalate), radiolucent don't have O (urate and xanthine) remember that cystine are semi-opaque (the c looks like half an o)
55
mutation in the gene that encodes the aquaporin 2 channel causes/????
causes DI
56
how long does it take an V fistula develop
6-8 weeks
57
MOA bicalutamide used in prostate ca
Bicalutamide is an androgen recept blocker
58
how can APCKD affect the heart
Mitral valve prolapse
59
what medication out of tamsulosin or finasteride will DECREASE PSA (give false negative)
finasteride= 5ht REDUCtase will REDUCE psa
60
Which one of the following types of glomerulonephritis is most characteristically associated with streptococcal infection in children?
diffuse proliferative
61
d
62
causes of cranial DI
brain injury, pit adenoma, craniopharymgioma histocytiosis sarcoidosis haemachromotasis post brain surgery
63
what happens if you give too much 0.9% nacl VBG wise
hyperchloraemic met acid`
64
high calcium and renal stones to reduce stones what decreases oxalate stones
thiazide- hypercalcium cholestyramine= oxalate stones
65
common electryolyte complication of plasma exchange
hypocalcemia
66
how can alcohol bingeing affect ADH
Alcohol bingeing can lead to ADH suppression in the posterior pituitary gland subsequently leading to polyuria
67
how does ADH suppression affect urine
polyuria
68
Proteus mirabilis infection predisposes to ??type of kidney stone
STRUVITE staghorn
69
how does calcium resonium decrease k
increases excretion
70
spironolactone, aldosterone antag MOA
Inhibition of the mineralocorticoid receptor in the cortical collecting ducts
71
function of erythropoetin injections in CKD
improve exercise tolerance - does NOT improve renal function
72
amyloid biopsy findings
Congo red stain shows apple-green birefringence under polarised light
73
when does contrast nephropathy happen- time frame to develop
2-3 days
74
what is it important to co prescribe for 3 weeks when starting gosrelin
cyproterone acetate= steroid anti androgen gosrelin= gnrh agonist
75
eGFR= what does the calculation depend on and what affects and invalidates gfr calc
CAGE creatinine, age, gender, ethnicity invalidates: pregnancy, large muscle mass, red meat in 12 hrs
76
fibromuscular dysplasia
type of renal vascular disease risk factors smoker, young female poorly controlled HTN assymmetric kidneys FLASH PULM OEDEMA
77
pre renal uraemia vs ATN
Pre-renal uraemia ; Anything related to excretion is low (low urine sodium, low Fractional sodium excretion, low Fractional urea excretion) Anything in a ratio is high (Serum urea:creatinine ratio, Urine:plasma osmolality, Urine:plasma urea)
78
HOW TO differentiaite between the 2 types of amyloidosis AA AND AL
AA, A for autoimmune such as RA and SLE AL for light chains (associated with WM, MM etc)
79
how long till finasteride starts takin effect
up to 6 months
80
heroin use risk factor for which type of renal condition
Heroin is a known cause of focal segmental glomerulosclerosis.
81
normal anion gap
A normal anion gap is 8-14 mmol/L
82
Causes of a normal anion gap or hyperchloraemic metabolic acidosiis
Causes of a normal anion gap or hyperchloraemic metabolic acidosis gastrointestinal bicarbonate loss: diarrhoea, ureterosigmoidostomy, fistula renal tubular acidosis drugs: e.g. acetazolamide ammonium chloride injection Addison's disease
83
Raised anion gap causes
Raised anion gap lactate: shock sepsis hypoxia ketones: diabetic ketoacidosis alcohol urate: renal failure acid poisoning: salicylates, methanol
84
how does gentamicin cause nephrotoxicity
proximal tubular dysfunction
85
what is c3 nephritic factor
anti C3BBBB antibody
86
HLA matching process
DR A B DR > B > A
87
normal anion gap
10-18
88
normal anion gap met acid causes
AAA GR Addisons Acetazolomide Ammonim chloride injection GI loss (diarrhoea, ureterosigmoidostomy, fistrula) Renal Tubular acidosis
89
what causes pseudoparathyroidism
target cell insensitivity to parathyroid hormone (PTH) due to a mutation in a G-protein
90
insulin stress test used for ?
diagnose hypopituitarism
91
paroxysmal nocturnal haematuria
acquired conditio n CD55 AND CD59 CFs haematuria - dark urine in the morning pancytopenia can develop aplastic anaemia thrombosis haemolytic anaemia Ix = flow cytometry first line also could do hams test
92
HTN and asymmetrical kidneys = bIL small kidneys=?
renal artery stenosis Bil small kidneys= renal papillary necrosis
93
HIV nephropathy
massive proteinuria large kidneys focal segmental glomerulosclerosis elevated urea and creatinine normotension
94
types of rapidly progressive GN
polyangitis and granulomatosis= wegners nazis had moustaches gave them recurrent sinusitis Anti basement membrane disease (good pastures)
95
recurrent UTIs in childhood= ?
vesicoureteric reflux
96
how does polycystic kidney disease affevt heart
MITRAL VALVE PROLAPSE

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