Nephrology Flashcards
What is the anion gap formula?
(Na+K)-(Cl+HCO3)
What is a common cause of HUS?
E coli 0157:H7
What can happen if you use 0.9% Sodium Chloride in large volumes?
risk of hyperchloraemic metabolic acidosis
Dietary advice of CKD patients?
Low protein
Low phosphate
Low sodium
Low potassium
What cancer risk is increased due to renal transplant?
Squamous cell cancer of the skin
What are some causes of a raised anion gap?
1) lactate:
2) ketones:
3) urate: renal failure
4) acid poisoning: salicylates, methanol
What acid-base balance does vomiting result in?
Hypochloraemic, hypokalaemia metabolic alkalosis
What acid-base balance does diarrhoea result in?
hyperchloraemic metabolic acidosis
Daily glucose requirement in fluids?
50-100g/day
What is the treatment of IgA nephropathy?
1) minimal proteinuria or isolated haematuria with normal GFR then nothing
2) If persistent proteinuria or slightly reduced GFR-> ACEi
3) If active disease not responding to ACEi-> immunosuppression with corticosteroids
What is the most common causative organism of peritonitis in patients of Continuous Ambulatory Peritoneal Dialysis (CAPD)?
Staphylococcus epidermidis
What is the management of peritonitis due to CAPD?
1) vancomycin (or teicoplanin) + ceftazidime added to dialysis fluid
2) OR vancomycin added to dialysis fluid + ciprofloxacin by mouth
What do kidneys look like on the ultrasound of someone with chronic kidney disease?
Bilateral small kidneys
What are the variables included in Modification of Diet in Renal Disease Equation
eGFR variables -
(CAGE)
Creatinine
Age
Gender
Ethnicity
What is a hyperacute transplant rejection normally due to?
Hyperacute transplant rejection is caused by pre-existing antibodies against ABO or HLA antigens
What is the treatment of PCKD?
Tolvaptan
If:
- CKD 2, 3
Rapidly progressing disease
When should ACE inhibitors be stopped in CKD?
1) decrease in eGFR of up to 25%
2) a rise in creatinine of up to 30%
What are the key features of HUS?
1) AKI
2) Microangiopathic haemolytic anaemia
3) Thrombocytopenia
NOTE: think child following diarrhoeal illness (E. coli)
What are the causes of cranial diabetes insipidus?
1) idiopathic
2) post head injury
3) pituitary surgery
3) craniopharyngiomas
4) infiltrative (histiocytosis X or
sarcoidosis)
5) haemochromatosis
6) DIDMOAD is the association of cranial Diabetes Insipidus, Diabetes Mellitus, Optic Atrophy and Deafness (also known as Wolfram’s syndrome)
What are the causes of nephrogenic diabetes insipidus?
1) genetic:
2)electrolytes (hypercalcaemia or
hypokalaemia)
3)lithium
4) demeclocycline
5) tubulo-interstitial disease: obstruction, sickle-cell, pyelonephritis
What is the management of diabetes insipidus?
nephrogenic:
- thiazides
- low salt/protein diet
Central:
desmopressin
What is the management of HUS?
treatment is supportive e.g. Fluids, blood transfusion and dialysis if required
What is the management of rhabdomyolysis?
1) IV fluids to maintain good urine output
2) urinary alkalinization is sometimes used
What are some causes of raised lactate anion gap?
- shock
- sepsis
- hypoxia
- metormin
What are some causes of raised ketone anion gap?
- DKA
- Alcohol
What are some causes of acid poisoning raised anion gap?
methanol or salicylate
What are causes of urate raised anion gap?
renal failure
