Nephrology Flashcards
Imaging for atypical UTI in an unwell baby
Acute ultrasound before discharge
OP MCUG and DMSA
Type of renal stone in Proteus infection
Struvite or triple stones
Type of renal stone in CF patient
Calcium
Type of renal stone in Lesch-Nyhan syndrome
Uric acid
Type of renal stone in Crohns disease
Calcium oxalate
Causes of metabolic alkalosis with volume contraction (normal or low BP)
Diuretics Vomiting/laxatives Bartter syndrome Cystic fibrosis Postnephrotic syndrome diuresis
Causes of metabolic alkalosis with volume expansion (high BP)
Primary hyperaldosteronism Renal artery stenosis Pseudohyperaldosteronism Renin producing tumour Adrenal carcinoma Liquorice
What happens in renal osteodystrohpy?
Decreased renal excretion of phosphate Reciprocal hypocalcaemia Osteomalacia Secondary hyperparathyroidism Then causes bone resorption and osteoporosis Decreased 1,25-dihydroxycholecalciferol High ALP Acidosis as kidneys can't excrete H+
Grade I vesico-ureteric reflux
Into the ureter only on micturition
Grade II vesico-ureteric reflux
Into the ureter, pelvis and calyces without dilatation on micturition
Grade III vesico-ureteric reflux
Into the pelvis and calyces, but with mild dilatation
Grade IV vesico-ureteric reflux
Moderate dilatation of the ureter, renal pelvis and obliteration of the sharp angle of fornices on micturition
Grade V vesico-ureteric reflux
Gross dilatation and tortuosity with no papillary impression viable in calyces
Treatment for hypertensive emergencies
IV labetalol
Sodium nitroprusside
Sublingual nifedipine
Difference in urinalysis between Fanconi’s syndrome and nephrocalcinosis?
In nephrocalcinosis, the urine is not acidified
Presentation of Gitelman syndrome
Hypokalaemia Metabolic alkalosis Hypomagnesaemia Hypocalciuria Normal blood pressure
Presentation of Liddle syndrome
Hypokalaemia Metabolic alkalosis Hypertension Hypernatraemia Low to normal aldosterone levels
Best investigation for pyelonephritis
DMSA
Best investigation for obstructive renal disease
Diuretic scintigraphy
Best investigation for horseshoe kidney
Intravenous urography
Treatment for Bartter’s syndrome
Sodium supplements
Potassium supplements
Indometacin 2mg/kg/day
Presentation of acute glomerulonephritis
Sudden onset haematuria Proteinuria Renal impairment Hypertension Oedema
Features of distal renal tubular acidosis?
Hyperchloraemia
Hypokalaemia
Metabolic acidosis
Renal stones
Suspect if there is localised posterolateral scrotal tenderness and the scrotum is red and swollen
Epididymo-orchitis
Best investigation for obstruction
MAG3 scan
Best investigation for renal scarring
DMSA
Treatment for oxalosis
Liver and kidney transplantation
Causes of low complement nephritis
Post infectious glomerulonephritis SLE Cryoglobulinaemia Shunt nephritis Membranoproliferative glomerulonephritis Infective endocarditis
Causes of normal complement nephritis
HSP Goodpastures PAN Wegener's IgA nephropathy
Biochemical features of Fanconi syndrome
Proximal RTA
Impaired reabsorption of glucose, bicarb, phosphate, potassium, sodium, and water
Clinical features of Fanconi syndrome
Failure to thrive Vomiting Polyuria Polydipsia Hypokalaemia Hypophosphataemic rickets
Causes of Fanconi syndrome
Cystinosis Lowe syndrome Wilson disease Tyrosinaemia Galactosaemia Hereditary fructose intolerance Toxicity to heavy metal e.g. lead
Likely diagnoses if nephrotic syndrome not responding to prednisolone?
Focal segmental glomerular sclerosis
Mesangio-capillary glomerulonephritis
Side effects of ciclosporin
Renal toxicity Hepatotoxicity Hypertrichosis Tremor Gingival hypertrophy Hypertension
What is cystinuria?
Disorder of intestinal absorption and renal tubular reabsorption of the dibasic amino acids ornithine, arginine, lysin and cystine
Complications of cystinuria?
Haematuria
Obstructive uropathy
Chronic renal failure
Type of renal stones with chemotherapy/TLS
Uric acid stones
Type of renal stones with renal tubular acidosis
Calcium stones
What constitutes relapse of nephrotic syndrome?
3+ protein or more on dipstick for 3 or more days
Features of nephronophthisis
Progressive symmetrical destruction of tubules and glomeruli Polyuria + polydipsia Isosthenuria Chronic renal failure NO hypertension or proteinuria
Features of cystinosis
Polyuria + polydipsia Growth retardation Hypophosphataemic rickets Fair hair and skin Cystine in cornea causes photophobia, retinitis pigmentosa and blindness
Features of Alports
Microscopic or gross haematuria
Symptoms of chronic renal failure
X-linked
Develop CRF by 2nd or 3rd decade
