Nephrology

Question 1

What is the anion gap formula?

Answer 1

(Na+K)-(Cl+HCO3)

Question 2

What is a common cause of HUS?

Answer 2

E coli 0157:H7

Question 3

What can happen if you use 0.9% Sodium Chloride in large volumes?

Answer 3

risk of hyperchloraemic metabolic acidosis

Question 4

Dietary advice of CKD patients?

Answer 4

Low protein
Low phosphate
Low sodium
Low potassium

Question 5

What cancer risk is increased due to renal transplant?

Answer 5

Squamous cell cancer of the skin

Question 5

What are some causes of a raised anion gap?

Answer 5

1) lactate:
- shock
- sepsis
- hypoxia
- metormin
2) ketones:
- diabetic ketoacidosis
- alcohol
3) urate: renal failure
4) acid poisoning: salicylates, methanol

Question 6

What acid-base balance does vomiting result in?

Answer 6

Hypochloraemic, hypokalaemia metabolic alkalosis

Question 7

What acid-base balance does diarrhoea result in?

Answer 7

hyperchloraemic metabolic acidosis

Question 8

Daily glucose requirement in fluids?

Answer 8

50-100g/day

Question 9

Treatment of IgA nephropathy?

Answer 9

1) minimal proteinuria or isolated haematuria with normal GFR then nothing
2) If persistent proteinuria ir slightly reduced GFR- ACEi
3) If active disease not responding to ACEi- immunosuppression with corticosteroids

Question 10

What is the most common causative organism of peritonitis in patients of Continuous Ambulatory Peritoneal Dialysis (CAPD)?

Answer 10

Staphylococcus epidermidis

Question 11

What is the management of peritonitis due to CAPD?

Answer 11

1) vancomycin (or teicoplanin) + ceftazidime added to dialysis fluid
2) OR vancomycin added to dialysis fluid + ciprofloxacin by mouth

Question 12

What do kidneys look like on the ultrasound of someone with chronic diabetic nephropathy?

Answer 12

large/normal sized kidneys

WHEREAS in CKD they are bilaterally small

Question 13

What do kidneys look like on the ultrasound of someone with chronic kidney disease?

Answer 13

Bilateral small kidneys

Question 14

What are the variables included in Modification of Diet in Renal Disease Equation

Answer 14

eGFR variables -
(CAGE)
Creatinine
Age
Gender
Ethnicity

Question 15

What is a hyperacute transplant rejection normally due to?

Answer 15

Hyperacute transplant rejection is caused by pre-existing antibodies against ABO or HLA antigens

Question 16

What is the treatment of PCKD?

Answer 16

Tolvaptan
If:
- CKD 2, 3
Rapidly progressing disease

Question 16

When should ACE inhibitors be stopped in CKD?

Answer 16

1) decrease in eGFR of up to 25%
2) a rise in creatinine of up to 30%

Question 17

What are the key features of HUS?

Answer 17

1) AKI
2) Microangiopathic haemolytic anaemia
3) Thrombocytopenia

NOTE: think child following diarrhoeal illness (E. coli)