Nephrology

Question 1

, stroke, raised HB, B/L renal masses, heamturia? female sound cyst in scan?

Answer 1

hepatic cysts common in Female. ADPKD

Question 2

horse rider common urethral injury?

Answer 2

blunt trauma to perineum - anterior urethral injury. distal to the membraneous

Question 3

urethral injury most common with pelvic #/ RTA?

Answer 3

posterior (near prostatic urethra. in the membranous

Question 4

GN: most common 48 hrs post URTI

Answer 4

IGA nephropathy.

Question 5

2-3 weeks post URTI GN?

Answer 5

PSGN. anti-streptolysin antibodies

Question 6

rash, abdo pain, child, joint pain, GI bleed, similar histological findings to IGA nephropathy?

Answer 6

HSP

Question 7

GN: asthma, GI, cardiac involvement?

Answer 7

Churg strauss syndrome/ oesiophillic granulomatous with polyangiitis. p anca

Question 8

nephritis with sinusuitis, nasal discharge with blood, joint pain in knees, ankles, weight loss

Answer 8

wegener’s granulomatosis, (granulomatosis with polyangiitis)

Question 9

nephritis with pulmonary haemorrhages?

Answer 9

Goodpasetur’s syndrome

Question 10

nephritis, young boy, sensorineuronal HL

Answer 10

X linked alport’s syndrome

Question 11

most common cx of nephrotic syndrome in adults?

Answer 11

focal segmental glomerulosclerosis

Question 12

most common renal lesion from SLE?

Answer 12

diffuse proliferative glomerulonephritis

Question 13

unexplained WL, fatigue, oedaema, resistent to diuretics?

Answer 13

nephrotic syndrome secondary to amyloidisis

Question 14

CX of bladder cancer?

Tx?

Answer 14

cyclophosphamide, pioglitazone, schistosomiasis

TX: BCG vaccine, muscle invasive - chemo and cystectomy

Question 15

chronic NSAID use, sudden flank pain?

Answer 15

do USS renal to obstruction from sloughed papilla

Question 16

danube river, yellow palms and soles, HTN, renal failure?

Answer 16

balkan neuropathy

Question 17

sterile pyruia cx?

Answer 17

appendicitis, treated UTI, renal stones, prostatis, chlamydia, PKD, interstitial cystitis

Question 18

f RA, with B/L renal masses, HTN, oedaema?

on congo red stain?

Answer 18

amyloidosis -shines green.

Question 19

Amyloidosis associated with?

Answer 19

RA, crohns, JIA, still’s, OM, TB, RCC,

Question 20

blood/ pus in urine, unexplained infertility, repeated UTIs?

Answer 20

genitourinary TB

Question 21

testicular lump, reducable with rpessure in deep inguinal ring?

Answer 21

inguinal hernia

Question 22

testicular lump fluctuant swelling separate from rest, milky fluid

Answer 22

spermatocele

Question 23

where is cryptoorchidism more likely?

Answer 23

right testes. complete surgery by 12-18 months age. refer at 3 months

Question 24

chronic sx of pelvic pain, incontinencne, lakc of gynae sx, dx of exlcusion?

Answer 24

interstitial cystitis (bladder pain syndrome)

Question 25

women <30YO, resistent HTN, took ace, worsened kidney function, flash pulmonary eodaema ?

Answer 25

renal artery stenosis

Question 26

raised ESR, CRP, B/L hydronephrosis ureters drawing together at midline in XR, CT para-aortic mass?

Answer 26

retroperitoneal fibrosis cx: cancers, autoimmune disorders, BB, methyl dopa, methysergide

Question 27

BPH tx meds?

Answer 27

alpha 1 antagonists:smooth muscle relaxer in bladder tamsulosin, terazosin 5 alpha reductase inhibitors - finesteride

Question 28

RF for testicular Ca?

Answer 28

klinfelters, young parent age, undescended, breech, infantile hernia.

Question 29

Child, renal failure, frontal bossing, urine with po4. glucose, AA, frontal bossing, rickets?

Answer 29

Fanconi's syndrome

Question 30

60YO man multiple myeloma patchy caclification on kidneys on XR? other causes?

Answer 30

nephrocalcinosis (cx by high Ca) other cx: malignancy,

Question 31

CI of nitrofurantoin?

Answer 31

G6PD and acute porphyria

Question 32

foods to avoid with kidney stones?

Answer 32

rhubarb, strawberry, spinach, beets, chocolate, reduce tea,

Question 33

what may hydroceles in adutls be secondary to?

Answer 33

orchitis, epidiydmitis, TB, torsion, testicular tumours, trauma, post renal transplant, post radiation therapy

Question 34

painless enlarged scrotum superior and anterior to testes?

Answer 34

hydroceles - testes may not always be felt. transilluminates

Question 35

painless enlarges scrotum, lump superior and posterior to testes?

Answer 35

spermatocel

Question 36

left side testicle, after puberty, bag of worms swelling?

Answer 36

varicocele - AF reduced function and infertility

Question 37

before PSA test whaat to warn people?

Answer 37

no UTI, no ejaculation 48 hrs, no vigorous exercise, no prostate biopsy in 6 weeks

Question 38

High PSA values? CX?

Answer 38

50-59 YO 3+ 60-69 YO 4+ 70+ 5+ CX: age, cancer, catheter, retention, prostatitis, TURP, BPH,

Question 39

post stabbing, transfusion, oliguria, urine Na is 70

Answer 39

ATN

Question 40

post op patient with urine sodium of 7 and oliguria?

Answer 40

dehydration cause- pre renal sodium is <20

Question 41

Post TURP colicky abdo pain, no urine passed and palpable bladder?

Answer 41

clot retention- bladder washout

Question 42

AKI with Oliguria, explain ix?cx

Answer 42

no pain/ = , AKI or AKI on CKD, do U+Es, do USS, - if no dilation/ structural/ obstructive cx, then it is pre-renal or renal cx (ATN) .then can do urine Na, osmol, creatinine, fractional sodium excretion,

Question 43

Pre-renal oliguria vs ATN?

Answer 43

ATN: urine sodium 40+, osmol <350, urea <150, urine plasma osmol <1:1. poor response to fluid challenge fractional urea excvretion:35%+, brown granular casts pre-renal: urine Na <20, osmol 500+, urine:plasma osmol 1.5+, good response to fluid challenge

Question 44

AD PKD AF conditions? Hb?

Answer 44

RCC, colonic diverticula, mitral valve prolapse, berry anerurysm, hepatic cysts in women hb - increase EPO

Question 45

brown urine cx?

Answer 45

fava beans, nitrofuantoin, myoglobulin,levodopa, metronidazole,

Question 46

Oe/ of urethral injury?

Answer 46

abnormally high riding prostate, blood/ bruiding perineum, scrotal haematoma

Question 47

crohns/ diverticulitis hx, bubbles in urine stream, fowel smelling, brown discoloured

Answer 47

pneumaturia: (vesicocolic fistula). growth: e.coli common. CTAP and cystoscopy

Question 48

urine dipstick increased specific gravity?

Answer 48

dehydration, RAS, HF, SIADH,proteinura

Question 49

decreased urine dipstick specific gravity cs?

Answer 49

excessive fluid, renal failure, peylonephritis, diabetes insipidus

Question 50

common uti cx women?

Answer 50

klibsiella, e coli, stpah saprophyticus (sexually active), candida, enterococci, enterobacter, proteus

Question 51

Na 175, urine osmol is 160 (low) and high serum osmol with B/G bipolar disorder and was NBM?

Answer 51

Neprogenic diabetes insipidus. after fluid deprivation and ADH (desmopressin), the osmol is still low <300. nbm - masked, likely cause was lithium for BPD. tx thiazide diuretics - inhibit NACL reabsorption in DCT

Question 52

cx of nephrogenic DI? acquired/ congenital?

Answer 52

acquired- lithium, demeclocycline, hypercalcaemia, CKD

Question 53

common cx of sterile pyruia? global scale? in uk? in people over 45YO?

Answer 53

sterile pyuria? presence of leukocytes without active infection global - TB/ shistosomiasis uk - partially tx uti/ sTI 45+ - renal/ bladder tumours

Question 54

haematuria, flank mass and left sided varicocele? past q

Answer 54

renal cancer

Question 55

UTI tx abx?

Answer 55

nitro (if GFR is 45+/ CI G6PD) 3 days/ trimethoprim (if not pregnant). if no improvmeent in 48 hrs penicillin/ fosfomycin 3g single sachet

Question 56

peylonephritis tx? non pregnant/ cather/ men

Answer 56

cefalexin 7-10 days if culture pos- co-amox/trimeth/ciproflox pregnant not needing admission - cefalexin