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Daisy Finals Revision > Nephrology > Flashcards

Nephrology Flashcards

1
Q

what are the causes of cranial DI?

A
  • idiopathic
  • post head injury
  • pituitary surgery
  • craniopharyngiomas
  • infiltrative histiocytosis X/sarcoidosis
  • haemochromatosis
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2
Q

what are the causes of nephrogenic DI?

A
  • genetic
  • electrolytes (hypercalcaemia, hypokalaemia)
  • lithium - desensitises kidney’s ability to respond to ADH in the collecting ducts
  • demeclocycline
  • tubulo-interstitial disease: obstruction, sickle-cell, pyelonephritis
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3
Q

investigations for DI?

A
  • high plasma osmolality, low urine osmolality
  • urine osmolal >700mOsm/kg excludes DI
  • water deprivation test
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4
Q

what is the management of nephrogenic DI?

A
  • thiazides
  • low salt/protein diet
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5
Q

what is membranous glomerulonephritis?

A

presents with nephrotic syndrome or proteinuria
commonest type of glomerulonephritis in adults
3rd most common cause of ESRF

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6
Q

what are the causes of membranous glomerulonephritis?

A

idiopathic
infections - hep B, malaria, syphilis
malignancy - prostate, lung, lymphoma, leukaemia
drugs - gold, penicillamine, NSAIDs
autoimmune disease

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7
Q

what is seen on renal biopsy in membranous glomerulonephritis?

A

spike and dome appearance - BM thickened with subepithelial electron dense deposits

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8
Q

what is the management for membranous glomerulonephritis?

A

ACE-i or ARB
immunosuppression
consider anticoag

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9
Q

what is the triad of HUS?

A

acute kidney injury
microangiopathic haemolytic anaemia
thrombocytopenia
-> usually post diarrhoeal illness

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10
Q

what is the management for proteinuria in CKD? (ACR >30)

A

ace inhibitor eg ramipril

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10
Q

what are the indications for haemodialysis in AKI?

A

hyperkalaemia
pulmonary oedema
acidosis
uraemia

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10
Q

how does minimal change disease present?

A

nephrotic syndrome
normotension
highly selective proteinuria
renal biopsy - EM shows fusion of podocytes and effacement of foot processes

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10
Q

how does IgA nephropathy present?

A

macroscopic haematuria in young people following an URTI

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11
Q

how is anaemia managed in CKD?

A
  1. correct iron deficiency
  2. start erythropoiesis-stimulating agents
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11
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A
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12
Q
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13
Q

What are the severe manifestations of uraemia?

A

Pericarditis
Encephalopathy

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14
Q

How is potassium removed from the body after the initial tx for hyperkalaemia?

A

Calcium resonium
Enemas more effective than oral

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15
Q

How does renal cell carcinoma present?

A

Triad - flank pain, flank mass and haematuria

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16
Q

What are varicoceles sometimes associated with?

A

Renal cell carcinomas

17
Q

What medication should be used to prevent recurrent hyperkalaemia?

A

Calcium resonium

18
Q

Which medications may be stopped in AKI (depending on circumstances)?

A

MELD - MEtformin, Lithium, Digoxin

19
Q

Which medications should definitely be stopped in AKI?

A

NADA: NSAIDs, ACEI/ARBs, Diuretics (except some exceptions), aminoglycosides (eg gent)

20
Q

What is the most common viral infection in solid organ transplant recipients?

A

Cytomegalovirus

21
Q

When should aspirin be stopped in AKI?

A

When they’re on the 300mg analgesic dose not the 75mg prophylactic dose

22
Q

What are the causes of minimal change disease?

A

Drugs - NSAIDs, rifampicin
Hodgkins lymphoma, thymoma
Infectious mononucleosis

23
Q

What is 1st and 2nd line management for minimal change disease?

A
  1. Prednisolone
  2. Cyclophosphamide in steroid-resistant cases
24
Q

What do hyaline casts on urinalysis suggest?

A

Normal, after exercise, during fever or with loop diuretics

25
Q

What do brown granular casts suggest on urinalysis?

A

Acute tubular necrosis

26
Q

What is seen on urinalysis in pre renal uraemia?

A

Bland urinary sediment

27
Q

When are red cell casts seen?

A

Nephritic syndrome

28
Q

What is the best investigation for ADPKD?

A

Ultrasound

29
Q

What are the variables for calculating eGFR?

A

CAGE
Creatinine
Age
Gender
Ethnicity

30
Q

What renal condition is associated with HIV?

A

HIVAN - causes collapsing focal segmental glomerulosclerosis - presents as a nephrotic syndrome

31
Q

Which organism is most likely to cause peritonitis secondary to peritoneal dialysis?

A

Staph epiermidis (or other coagulase-negative staph)

32
Q

What investigation is performed in diabetics to assess for diabetic nephropathy?

A

ACR early morning specimen

33
Q

pulmonary haemorrhage, rapidly progressive glomerulonephritis

A

goodpasture’s syndrome/anti-GBM disease

34
Q

findings on renal biopsy in anti-GBM?

A

linear IgG deposits along the basement membrane

35
Q

management for hyperacute transplant rejection?

A

removal of the transplant

36
Q

features of acute interstitial nephritis?

A

fever, rash, arthralgia
eosinophilia
mild renal impairment
hypertension

37
Q

what is seen on urine microscopy in acute interstitial nephritis?

A

white cell casts

38
Q

IgA nephropathy presentation?

A

URTI preceding presentation by a couple of DAYS
macroscopic haematuria

39
Q

post-strep glomerulonephritis presentation?

A

develops 1-2 WEEKS after URTI
haematuria + proteinuria
low complement

40
Q

screening test for adult PKD?

A

USS

41
Q

renal failure, sensorineural hearing loss and ocular abnormalities in a child?

A

alport syndrome

42
Q

management for minimal change disease?

A

prednisolone

43
Q

drug causes of polyuria?

A

lithium
diuretics, caffeine, alcohol

44
Q

most likely organism in peritonitis secondary to Peritoneal Dialysis?

A

staphylococcus epidermis

45
Q

what is dialysis disequilibrium syndrome?

A

unclear mechanism
post dialysis
cerebral oedema

46
Q

formula for calculating the anion gap?

A

sodium and potassium minus chloride and bicarb
(Na + K+) - (Cl + HCO3)

47
Q

clinical features of acute interstitial nephritis?

A

triad of rash, fever and eosinophilia

48
Q
A

Daisy Finals Revision (25 decks)

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