Nephrology

Question 1

Acute interstitial nephritis:

M/C and other Causes:

Answer 1

Drugs: ANTIBIOTICS
penicillin
rifampicin
NSAIDs
allopurinol
furosemide

systemic disease: SLE, sarcoidosis, and Sjogren’s syndrome
infection: staphylococci

Accounts for 25% of drug-induced AKI

Question 2

Features which suggests CKD over AKI

Answer 2

Hypocalcaemia

Renal US: In CKD patient’s have small kidneys (larger in diabetic nephropathy)

Question 3

Should NSAIDs be stopped in AKI

Answer 3

Yes, unless if aspirin at cardiac dose (75mg)

Question 4

AKI staging: Cr level and UO

Stage 1
Stage 2
Stage 3

Answer 4

Stage 1: Increase in creatinine to 1.5-1.9 times baseline, or
Increase in creatinine by ≥26.5 µmol/L, or
Reduction in urine output to <0.5 mL/kg/hour for ≥ 6 hours

Stage 2: Increase in creatinine to 2.0 to 2.9 times baseline, or
Reduction in urine output to <0.5 mL/kg/hour for ≥12 hours

Stage 3: Increase in creatinine to ≥ 3.0 times baseline, or
Increase in creatinine to ≥353.6 µmol/L or
Reduction in urine output to <0.3 mL/kg/hour for ≥24 hours, or
The initiation of kidney replacement therapy, or,
In patients <18 years, decrease in eGFR to <35 mL/min/1.73 m2

Question 5

Alport’s syndrome symptoms:

Answer 5

microscopic haematuria
progressive renal failure
Bilateral sensorineural deafness
Lenticonus
retinitis pigmentosa

Question 6

ADPKD features:
Extra-renal features:

Answer 6

hypertension
recurrent UTIs
flank pain
haematuria
palpable kidneys
renal impairment
renal stones

Liver cysts (m/c manifesatation)
Berry Aneurysms
CV system
Cysts in other organs.

Question 7

Anion gap: How to calculate
Normal gap?

Answer 7

(sodium + potassium) - (bicarbonate + chloride)

A normal anion gap is 8-14 mmol/L

Question 8

CKD staging:

Answer 8

CKD staging
1 Greater than 90 ml/min, with some sign of kidney damage on other tests (if all the kidney tests* are normal, there is no CKD)

2 60-90 ml/min with some sign of kidney damage (if kidney tests* are normal, there is no CKD)
3a 45-59 ml/min, a moderate reduction in kidney function

3b 30-44 ml/min, a moderate reduction in kidney function

4 15-29 ml/min, a severe reduction in kidney function

5 Less than 15 ml/min, established kidney failure - dialysis or a kidney transplant may be needed

Question 9

Diabetes insipidus:
Divided into:
Treatment for each:

Answer 9

Cranial vs nephrogenic

Nephrogenic: Thiazides and low salt/protein diet
Central: Desmopressin

Question 10

Metabolic disturbance seen when large volumes of saline are used:

Answer 10

Hyperchloraemic metabolic acidosis

Question 11

ECG changes assoc. w/ hyperkalaemia

Answer 11

Peaked / tall-tented T waves
Loss of P waves
Broad QRS complexes
Sinusoidal wave pattern