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MRCP > Nephrology > Flashcards

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
Q

2 examples of alpha one blockers

A

Tamsulosin, alfuzosin, silodosin.
-Sin

26
Q

2 examples of 5 alpha reductase

A

Finesteride, Dutaseteride.
- IDE (5 alpha)
- Sin (One alpha)

27
Q

Which one alpha blocker is more selective. Causing less hypotension?

A

Tamsulosin, Alfuzosin and Silodosin.
While terazosin and Doxazosin are less selective causing more hypotension

28
Q
A
29
Q

Malaria associated with which type of glomerulonephritis?

A

Membranous. Don’t forget also about gold and penicallamine

30
Q

Result of IF of renal biopsy for patient with lupus nephritis will shows?

A

Full house immunoglobulin

31
Q

Chromosome involved in ADPCKD?

A

Chromosome 16 is type 1 (most common)
Chromosome 4 in type 2 (less common)

32
Q

Mention 4 types of amyloidosis

A

1) AL: Primary amyloid
2) AA: Secondary amyloid
3) B3M: Dyalisis associated
4) Senile amyloid: in elderly. Secondary to transtherytin

33
Q

Causes of retroperitoneal fibrosis

A

methysergide
Riedel thyroiditis
Sarcoidosis

34
Q

Splitting of laminate densa in EM (renal biopsy). Diagnosis? Mode of inheritance?

A

Alport syndrome
X-linked recessive

35
Q

Most common cardiac manifestation in ADPCKD?

A

Mitral valve prolapse. Seen in 25 % of patients.

36
Q

What is the mechanism of polyuria in patient with alcohol excess?

A

Inhibition of ADH in post.Pit

37
Q

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?

A

Thin basement membrane disease.
AD condition, usually benign.
Mutation in type IV collagen

38
Q

What are the features of HIV associated nephropathy?

A
  • Large kidney
  • Normotension
  • High BUN and Cr
  • FSGS
  • Massive proteinuria
39
Q

Good prognostic factors for IgA nephropathy

A

Frank hematuria

40
Q

Which nephrotic syndrome associated with loss of subcutanous fat in the face?

A

Membranoproliferative type II: Occur secondary to activation of alternative complement system + factor H deficiency
Type I Associated with: Cryglobenemia and HCV

41
Q

Which diuretic prevent calcium stone formation?

A

Thiazide diuretics.
While Loop diuretics like lasix + C.A inhibitors promote Ca stone formation.

42
Q

Which diuretic prevent calcium stone formation?

A

Thiazide diuretics.
While Loop diuretics like lasix + C.A inhibitors promote Ca stone formation.

43
Q

F

A
44
Q

Painful skin lesion in patient with CKD, surrounded by black Eschar

A

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
Q

The only semi-opaque stone in imaging?

A

Cystine stone.
Radio-lucent:
- Xanthine and urate.

46
Q

Beryllium and cadmium increase the risk of?

A

Renal stones.

47
Q

Which chromosome involve in ARPCKD?

A

Ch4: type II ADPCKD
Ch6: ARPCKD
Ch 16: Type I ADPCKD

48
Q

IgA nephropathy biopsy findings?

A
  • mesengial hypercellularity with positive IFA for IgA and C3
49
Q

IgA nephropathy biopsy findings?

A
  • mesengial hypercellularity with positive IFA for IgA and C3
50
Q
A

Initially: increase the secretion of LH, FSH.&raquo_space; Then&raquo_space; Increase T and E&raquo_space; will increase the tumor size
Eventually: high T and E will inhibit GnRH. Full story in the picture.

51
Q

Which medication should be administered in patient taking Goserelin as a treatment for prostate cancer?

A

Androgen blockers. Like Cyprotenone acetate. This will prevent the disease flare which causes urinary retention and spinal cord compression

52
Q

Which medication for BPH causes decrease in PSA and prostate smooth muscle size?

A

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
Q

Celiac disease associated with which type of nephrotic syndrome?

A

IgA nephropathy.
Others associated with IgA Nephropathy:
- Cirrhosis.
- HSP

54
Q

What can prevent Ca Oxalate stone?

A

1) Cholestramine.
2) Pyridoxine.

55
Q

Most common skin cancer associated with immunosuppressive agents?

A

Most common is basal.
Second most common is squamous cell carcinoma.

56
Q

Most common skin cancer associated with immunosuppressive agents?

A

Most common is basal.
Second most common is squamous cell carcinoma.

57
Q

Bicalutamide MOA?

A

Androgen receptor blocker

58
Q

Bicalutamide MOA?

A

Androgen receptor blocker

59
Q

Channel involved in liddle syndrome?

A

ENaC Channel

60
Q

Channel involved in liddle syndrome?

A

ENaC Channel

61
Q

Two differences between Bartter and Gitelmen?

A

1) Very low Mg in Gitelmen
2) Hypercalciuria in Bartter.

62
Q

>

A

MRCP (6 decks)

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