Nephrology Flashcards
Which kidney normally sits higher in the abdomen?
Left
Which renal vein drains the ipsilateral kidney, adrenal and gonadal veins?
Left
At which vertebral level do the renal veins drain into the IVC?
L2
What are the features of hypokalaemia?
Elevated BP, arrhythmias, muscle weakness, myalgia, cramps, flaccid paralysis, hyporeflexia
ECG: flattened/inverted T-waves, U-waves, ST depression, wide PR interval
What are the 3 most osmotically active solutes?
Na+, K+, glucose
What is the danger in rapidly increasing sodium levels in a patient with hypovolaemic hyponatraemia?
Osmotic demyelination
central pontine myelinosis
What medications can cause hyperkalaemia?
Beta blockers
Digitalis (overdose)
What conditions cause increased cellular release of potassium?
Haemolysis Rhabdomyolysis Insulin deficiency Hyperosmolar states (e.g. hyperglycaemia) Metabolic acidosis Tumour lysis syndrome Medications (beta blockers, digitalis)
What are the ECG changes seen in hyperkalaemia?
Peaked T waves
Small or absent P waves
Prolonged PR inteval
Widened QRS, merging with T wave (sine wave)
What are the ECG changes seen in hypokalaemia?
U wave
Flattened / inverted T waves
ST depression
Prolonged QT interval
What physiological factors or medications cause increased cellular uptake of K+ and this hypokalaemia?
Insulin
Alkalosis
Beta-2 agonists
What are the absolute indications for urine MCS in a patient presenting with a symptomatic UTI?
Pregnant women
Men
Treatment failure
Recurrent infections
What pathologies is polycystic kidney disease associated with?
Berry aneurysms (10%) Hepatic and pancreatic cysts (33%) Cardiac valve disease Diverticulsos Hernias Seminal vesicle cysts
What are Kimmelsteil-Wilson lesions associated with?
Diabetic Nephropathy
List 5 common causes of nephrotic syndrome.
Diabetic nephropathy Hypertensive nephropathy Focal segmental glomerulosclerosis Minimal change disease (children) Membranous glomerulonephritis Connective tissue / autoimmune: SLE, sarcoidosis, etc.
What are the most common causes of nephritic syndrome?
IgA nephropathy
Post-infectious glomerulonephritis (group A strep)
What are the features of neprhotic syndrome?
Massive proteinuria (>3.5g/day)
Hypoalbuminaemia
Hyperlipidaemia
Dependent oedema
What are the features of nephritic syndrome?
Haematuria
Proteinuria (<3.5g/day)
Hypertension
Uraemia
What is usually the initial investigation of choice to investigate renal tract disease?
Noncontrast helical CT
Which cells secrete renin?
Granular cells (part of juxtaglomerular apparatus)
What is the function of macula densa cells?
To detect an increase in sodium levels to stimulate renin release from granular cells
Which cells secrete erythropoietin?
Interstitial fibroblasts of the kidney
