Nephrology Flashcards
What are the features of plasmodium malariae membranous glomerulonephritis?
Nephrotic syndrome
Travel/work in African fish farm
Chronic malaria: treated with chloroquine
What happens in Gitelman syndrome?
Mutation in thiazide sensitive NaCl transporter
Hypokalemic metabolic alkalosis
Inv: Urinary chloride excretion increased
Rx: Potassium and Magnesium supplements/potassium sparing diuretics
What is seen on kidney biopsy in sarcoidosis?
Granulomatous tubulo-interstitial nephritis
What gene mutation is seen in Liddle syndrome?
Enac gain of function mutation
What are the features of Gitelman syndrome?
hypokalemic metabolic alkalosis
HTN
Hypomagnesemia
Hypocalciuria (not in Bartter’s)
What is the investigation of choice for hydronephrosis?
US renal tract
One of the causes of cyclosporine toxicity causing renal injury?
Co- prescription with Diltiazem
Features of rhabdomyolysis?
hyperkalemia
hypocalcemia
hyperphosphatemia
What is associated with pure red cell aplasia?
EPO treatment for CKD
What can carpal tunnel syndrome be associated with?
Beta 2 microglobulin deposition
What is the active form of Vitamin D?
Alphacalcidol
Sarcoidosis renal presentation
Granulomatous tubulo-interstitial nephritis
Polyuria, nocturia due to hypercalcemia
What is the inactive form of Vitamin D?
Ergocalciferol
Which drug causes retroperitoneal fibrosis causing AKI/hydronephrosis?
Beta blockers
How is Alport syndrome mainly inherited?
X linked dominant
In addition to IV fluids, what should you give for rhabdomyolysis?
Sodium bicarbonate (if bicarbonate <30)
What does DM nephropathy cause?
Nodular sclerosis of glomeruli and diffuse mesangial expansion
What is nephrogenic systemic fibrosis?
When CKD patients are exposed to gadolinium for MRI imaging
Adult nephrotic syndrome- most common cause?
Young adult: Membranous
Old adult: Focal segmental glomerulosclerosis (esp black)
Xanthogranulomatous pyelonephritis
Fever, weight loss, loin pain
Seen in DM, immuno-compromised and obstructive uropathy
M/C organism: Proteus
Treated with nephrectomy (medical management not enough)
Renal tubular acidosis type 4
Hyperkalemia
Metabolic acidosis
Seen in DM, SLE etc
Precipitated by: ACE inhibitors, beta blockers, NSAIDs
Treated with Fludrocortisone
Cholesterol embolism
AKI
Livedo reticularis
EOSINOPHILIA
Seen after stenting procedures
Or after initiation of warfarin
Acute tubular necrosis
Prolonged hypotension
Ischaemia of renal tubules
Inability to concentrate urine
Low plasma sodium
High urine Na but low osmol and large output
Rx: fluid replacement
Acute interstitial nephritis
EOSINOPHILIA
Drug induced
Which type of GN is most likely to recur post renal transplant?
Membrano-proliferative
What is important before starting EPO in CKD?
Iron stores must be replenished before starting EPO
What endocrine association can CKD have?
Hyperprolactinemia; amenorrhoea
Recurrent cystine stones despite alkalinisation?
Penicillamine
CKD anaemia management
EPO with Hb target 110 after iron replenishment
Ferritin >100
TSAT >20%
<10% hypochromic cells
What is post renal transplant Alport syndrome associated with?
Anti GBM disease
Difference between ACE inhibitor induced and RTA after Ramipril?
If >30% rise in creatinine –> RTA
What is Atazanavir (HAART) associated with?
Crystal nephropathy
Increased plasma concentration due to Co-trimoxazole
Rx: Hydration
What are the subtle features of ADPKD?
Back pain
Raised Hb (Raised EPO)
Liver cysts
First line for pyelonephritis?
Oral Cefalexin
How often do you repeat US for ADPKD?
Once after 20 years of age if neg before
Indications for urgent cadaveric renal transplant
Lack of dialysis access
Severe psychological problems
Hypotension or other complications from haemodialysis
Uraemic poly neuropathy
Treatment of Liddle’s syndrome?
Amiloride/ potassium sparing diuretics
PSGN v/s IgA nephropathy
Low complements in PSGN
And present after weeks
How do you confirm pulmonary haemorrhage
Raised KCO
Low Hb
Nodular changes and cavitation on CXR
How do you treat Goodpastures?
Steroids and plasma exchange
Flash pulmonary edema
Young: Fibromuscular dysplasia
Old: Renal artery stenosis
Renal artery stenosis biochemistry
High renin
High aldosterone
Low potassium
High normal sodium
Familial Mediterranean fever
Confirmed on renal biopsy
Mimics acute abdomen
Risk of analgesic nephropathy because of NSAID use for pain
AA amyloid deposition kidney disease M/C
