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Nephrology Flashcards

1
Q

What is the preferred modality to screen for PCKD?

A

Renal US

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2
Q

What is the diagnostic criteria for APCKD?

A

1) Age < 30: Two cysts.
2) Age > 60: Four cysts bilateral
3) Between 30 and 60: two cysts (should be bilateral)
- Note:
For less than 30 years old: two cysts is enough weather bilateral or unilateral

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3
Q

Management option for ADPCKD?

A

Tolvaptan (vasopressin 2 blockers)

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4
Q

Three main differences between PSGN and IgA nephropathy

A

IgA:
1) Present in males. 2) Presence of C3 3) 1-2 days post URTI
PSGN:
1) Proteinuria 2) Low complement. 3) 1-2 weeks post URTI
# Both can have hematuria

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5
Q

What are the good prognostic factors for IgA nephropathy?

A

Frank hematuria

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6
Q

What are the good prognostic factors for IgA nephropathy?

A

Frank hematuria

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7
Q

Poor prognostic factors for IgA nephropathy?

A

1) Hypertension 2) Proteinuria > 2 g per day 3) Male gender 4) ACE Genotype DD 5) DLP

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8
Q

Patient with ESRD, HTN, Afib on warfarin presented with painful skin lesion on the right shin, red and sorrounded by necrosis. Diagnosis?

A

Calciphlaxis

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9
Q

What type of stone cannot be seen in KUB (Radio-lucent)?

A

Urate + Xanthine

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10
Q

Management of ureter stone 8 mm

A

1) Shock wave
2) Alpha blocker (smooth muscle relaxant) only used if the stone in distal ureter + less than 10 mm

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11
Q

Diagnostic tool for pregnant women with suspected renal stone?

A

US. Sn 45 % Sp 90 % Used in children and pregnancy only.
Otherwise, CT KUB is the diagnostic tool

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12
Q

Indications for urgent referral for hematuria?

A

1) Age > 45 with visible hematuria + persistent after treating UTI.
2) Age > 60 With non-visible hematuria + dysuria or high WBC

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13
Q

Causes of transient non-visible hematuria

A

1) Exercise. 2) UTI. 3) Sexual intercourse. 4) Mensturation

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14
Q

Causes of transient non-visible hematuria

A

1) Exercise. 2) UTI. 3) Sexual intercourse. 4) Mensturation

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15
Q

Patient recently diagnosed with renal cell carcinoma. Presented with abdominal pain, hepatomegaly, high ALP And GGT. No jaundice or ascites. Diagnosis?

A

Stauffer syndrome

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16
Q

What electrolyte disturbance causes DI?

A

Hypercalcemia and hypokalemia

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17
Q

B-HCG seen in which type of cancer?

A

Seminoma (testicular cancer). Seen only in 20 %

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18
Q

LDH seen in which type of testicular cancer?

A

40 % of testicular cancer. Very non-specific

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19
Q

What type of skin cancer is associated with immunosuppressive agenst?

A

Squamous cell cancer. Tend to ulcerate, and seen in sun-exposed areas.

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20
Q

Causes of low complement GN

A

1) Infective endocarditis.
2) Post-infectious GN
3) Lupus nephritis.
4) Mesingiocapillary GN

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21
Q

What is the management option for HIV associated nephropathy?

A

Check adherence to ART
Most common type: FSGS
They usually present with nephrotic syndrome and normotension

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22
Q

What are the complications of PLEX?

A
  • Metabolic alkalosis.
  • Hypocalcemia.
  • Removal of coagulation factors and Immunoglobulins.
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23
Q

The most common mutation in DI?

A

ADH receptor
Other less common: Aquaporin-2 channel

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24
Q

Medical management options for BPH

A

1) Alpha one blocker
2) 5 Alpha reductase

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25
2 examples of alpha one blockers
Tamsulosin, alfuzosin, silodosin. -Sin
26
2 examples of 5 alpha reductase
Finesteride, Dutaseteride. - IDE (5 alpha) - Sin (One alpha)
27
Which one alpha blocker is more selective. Causing less hypotension?
Tamsulosin, Alfuzosin and Silodosin. While terazosin and Doxazosin are less selective causing more hypotension
28
29
Malaria associated with which type of glomerulonephritis?
Membranous. Don’t forget also about gold and penicallamine
30
Result of IF of renal biopsy for patient with lupus nephritis will shows?
Full house immunoglobulin
31
Chromosome involved in ADPCKD?
Chromosome 16 is type 1 (most common) Chromosome 4 in type 2 (less common)
32
Mention 4 types of amyloidosis
1) AL: Primary amyloid 2) AA: Secondary amyloid 3) B3M: Dyalisis associated 4) Senile amyloid: in elderly. Secondary to transtherytin
33
Causes of retroperitoneal fibrosis
methysergide Riedel thyroiditis Sarcoidosis
34
Splitting of laminate densa in EM (renal biopsy). Diagnosis? Mode of inheritance?
Alport syndrome X-linked recessive
35
Most common cardiac manifestation in ADPCKD?
Mitral valve prolapse. Seen in 25 % of patients.
36
What is the mechanism of polyuria in patient with alcohol excess?
Inhibition of ADH in post.Pit
37
Young patient with incidental finding of microscopic hematuria. Family history + for same condition Normal renal US Normal Cr level No protein No flank pain. Diagnosis?
Thin basement membrane disease. AD condition, usually benign. Mutation in type IV collagen
38
What are the features of HIV associated nephropathy?
- Large kidney - Normotension - High BUN and Cr - FSGS - Massive proteinuria
39
Good prognostic factors for IgA nephropathy
Frank hematuria
40
Which nephrotic syndrome associated with loss of subcutanous fat in the face?
Membranoproliferative type II: Occur secondary to activation of alternative complement system + factor H deficiency Type I Associated with: Cryglobenemia and HCV
41
Which diuretic prevent calcium stone formation?
Thiazide diuretics. While Loop diuretics like lasix + C.A inhibitors promote Ca stone formation.
42
Which diuretic prevent calcium stone formation?
Thiazide diuretics. While Loop diuretics like lasix + C.A inhibitors promote Ca stone formation.
43
F
44
Painful skin lesion in patient with CKD, surrounded by black Eschar
Calciphylaxis. Q- pyoderma gangrenosum VS calcyphylaxis? - Usually pyoderma is surrounded by violosous color around it not black eschar. Q- Calcyphlaxis VS arterial ulcer? - Arterial ulcer puched out lesion on lateral aspects of the leg or the digits. + Clinical scenario
45
The only semi-opaque stone in imaging?
Cystine stone. Radio-lucent: - Xanthine and urate.
46
Beryllium and cadmium increase the risk of?
Renal stones.
47
Which chromosome involve in ARPCKD?
Ch4: type II ADPCKD Ch6: ARPCKD Ch 16: Type I ADPCKD
48
IgA nephropathy biopsy findings?
- mesengial hypercellularity with positive IFA for IgA and C3
49
IgA nephropathy biopsy findings?
- mesengial hypercellularity with positive IFA for IgA and C3
50
What is the mechanism of GnRH analogue used in prostate cancer? -
Initially: increase the secretion of LH, FSH. >> Then >> Increase T and E >> will increase the tumor size Eventually: high T and E will inhibit GnRH. Full story in the picture.
51
Which medication should be administered in patient taking Goserelin as a treatment for prostate cancer?
Androgen blockers. Like Cyprotenone acetate. This will prevent the disease flare which causes urinary retention and spinal cord compression
52
Which medication for BPH causes decrease in PSA and prostate smooth muscle size?
5 alpha reductase inhibitors. Like Finesteride and Dutasteride. Note: Alpha-1 blocker SE: hypotension, dry mouth and depression. Ex: Doxazosin, Tamsulosin. 5 alpha SE: Ejaculatory dysfunction.
53
Celiac disease associated with which type of nephrotic syndrome?
IgA nephropathy. Others associated with IgA Nephropathy: - Cirrhosis. - HSP
54
What can prevent Ca Oxalate stone?
1) Cholestramine. 2) Pyridoxine.
55
Most common skin cancer associated with immunosuppressive agents?
Most common is basal. Second most common is squamous cell carcinoma.
56
Most common skin cancer associated with immunosuppressive agents?
Most common is basal. Second most common is squamous cell carcinoma.
57
Bicalutamide MOA?
Androgen receptor blocker
58
Bicalutamide MOA?
Androgen receptor blocker
59
Channel involved in liddle syndrome?
ENaC Channel
60
Channel involved in liddle syndrome?
ENaC Channel
61
Two differences between Bartter and Gitelmen?
1) Very low Mg in Gitelmen 2) Hypercalciuria in Bartter.
62
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