Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

BPT Written > Nephrology > Flashcards

Nephrology Flashcards

1
Q

Autosomal Dominant Polycystic Kidney Disease (ADPKD) sonographic criteria (in individuals with family history of PCKD)

A

Age 15-39 - 3 or more cysts, unilateral or bilateral
Age 40-59 - 2 or more cysts in each kidney
Age 60 or older - 4 or more cysts in each kidney

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Most common malignancy after renal transplant

A 
Melanoma and non-melanomatous skin cancer
Lymphoma
Kidney
Ureter / bladder
Colorectal
Lung
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Absolute indications to commence dialysis

A

Uremic pericarditis or pleuritis

Uremic encephalopathy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Common indications to commence dialysis

A

Declining nutritional status (anorexia, weight loss, nausea)
Persistent or difficult to treat volume overload
Fatigue and malaise
Mild cognitive impairment
Refractory acidosis, hyperkalemia, hyperphosphataemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Type 1 renal tubular acidosis (RTA) - investigations

A 
Normal anion gap metabolic acidosis
Urine pH more than 5.5
Urine anion gap positive
Hypokalemia
Hypercalcaemia
Renal calculi
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Type 1 renal tubular acidosis (RTA) - causes

A

Distal tubular defect with reduced H+ secretion.

  • Autoimmune - SLE, Sjogrens, RA
  • Drugs - amphotericin B, lithium, PPI, NSAID
  • Chronic hepatitis
  • Sickle cell anaemia
  • Obstructive uropathy
  • Thyroid disorders
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Type 2 renal tubular acidosis (RTA) - investigations

A

Normal anion gap metabolic acidosis (milder than type 1)
Urine pH more than 5.5 - if treated with alkali therapy
Urine pH less than 5.3 - if untreated

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Type 2 renal tubular acidosis (RTA) - causes

A

Proximal tubular defect with failure to reabsorb HCO3.

  • Fanconi’s syndrome
  • Multiple myeloma
  • Amyloidosis
  • Interstitial nephritis
  • Heavy metal poisoning
  • Antivirals - tenofovir
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Type 3 renal tubular acidosis (RTA) - causes

A

Mixed features of both distal and proximal RTA.

- Inherited carbonic anhydrase (CA) II deficiency - rare autosomal recessive disorder

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Type 4 renal tubular acidosis (RTA) - investigations

A

Normal anion gap metabolic acidosis
Urine pH less than 5.5
Urine anion gap positive
Hyperkalemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Type 4 renal tubular acidosis (RTA) - causes

A

Aldosterone deficiency or distal tubule resistance to aldosterone.

  • Diabetic nephropathy
  • Drugs - NSAID, ACEi, ARB, spironolactone, tacrolimus
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Mechanism of renal failure in gentamicin toxicity

A

Acute tubular necrosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Mechanism of renal failure in multiple myeloma

A 
Cast nephropathy (41%)
Amyloidosis (30%)
Monoclonal Ig deposition disease (19%)
Interstitial nephritis (10%)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Mechanism of action - frusemide

A

Location - Thick ascending limb of loop of Henle
Channel - Na-K-2Cl carrier on tubular lumen
Action - competes for Cl site, reduces reabsorption (including Mg)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Mechanism of action - hydrochlorothiazide

A

Location - distal tubule connecting segment
Channel - Na-Cl cotransporter
Action - compete for Cl site, reduce reabsorption, (increases Ca reabsorption)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Mechanism of action - spironolactone

A

Location - cortical collecting tubule
Channel - aldosterone sensitive Na channel
Action - compete and inhibit mineralcorticoid receptor

17
Q

Mechanism of action - acetazolamide

A

Location - proximal tubule

Action - inhibits carbonic anhydrase, reduces HCO3, Na, Cl reabsorption

18
Q

Mechanism of renal bone disease

A
  • Increased phosphate - due to low PO4 filtrate load
  • Secondary hyperparathyroidism
  • Decreased calcium
  • Decreased calcitriol (1,25 dihydroxy vitamin D)
19
Q

Mechanism of minimal change disease

A
  • Podocyte injury

- Immune mediated

20
Q

Mechanism of membranous glomerulonephritis

A
  • Anti PLA2-R (phospholipase A2 receptor antibodies) on podocytes
21
Q

Mechanism of membranoproliferative glomerulonephritis

A
  • Immune complex OR complement mediated (less common)
  • Proliferation of glomerular cells
  • Systemic inflammatory cell influx
22
Q

Mechanism of focal sclerosing glomerulonephritis

A
  • Similar to minimal change

- Podocyte injury due to circulating factors

23
Q

Mechanism of IgA nephropathy

A
  • Mesangial deposition of IgA
  • Mesangial cell proliferation
  • Complement activation
24
Q

Liddle’s syndrome

A
  • Abnormality in ENaC channel (acted on by spironolactone)
  • Collecting duct
  • Hypokalemia
  • Hypertension
  • Metabolic alkalosis
25
Q

Gitelman syndrome

A
  • Abnormality of NaCl transporter (acted on by thiazides)
  • Distal tubule
  • Hypokalemia
  • Hypocalciuria
  • Hypomagnesaemia
  • Metabolic alkalosis
  • Normal blood pressure
26
Q

Bartter syndrome

A
  • Abnormality of NaCl transporter (acted on by frusemide)
  • Loop of Henle
  • Hypokalemia
  • Metabolic alkalosis
  • Prostaglandin E elevated
  • Normal blood pressure
27
Q

Renal transplant - immunosuppressants safe for pregnancy

A
  • Prednisolone - aim <15mg/day
  • Azathioprine - doesn’t cross placenta
  • Tacrolimus - lower placental levels
28
Q

Drugs cleared by haemodialysis

A 
Barbiturates
Lithium
Alcohol
Salicylate
Theophylline

BPT Written (20 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions