Nephrology

Question 1

Microscopic – can be a normal finding in women who are menstruating

Answer 1

Microscopic haematuria can be a normal finding in women who are menstruating

Question 2

Hyaline casts
consist of Tamm-Horsfall protein (secreted by – tubule)
seen in normal urine, after –, during fever or with –diuretics

Acute tubular necrosis
— casts in urine

Prerenal uraemia
— urinary sediment

Red cell casts
– syndrome

Answer 2

Hyaline casts
consist of Tamm-Horsfall protein (secreted by distal convoluted tubule)
seen in normal urine, after exercise, during fever or with loop diuretics

Acute tubular necrosis
brown granular casts in urine

Prerenal uraemia
‘bland’ urinary sediment

Red cell casts
nephritic syndrome

Question 3

The maximum recommended rate of potassium infusion via a peripheral line is – mmol/hour, whereas rates above – mmol/hour require cardiac monitoring

0.9% saline
if large volumes are used there is an increased risk of hyper— — acidosis

Hartmann’s
contains – and therefore should not be used in patients with –

Answer 3

The maximum recommended rate of potassium infusion via a peripheral line is 10 mmol/hour, whereas rates above 20 mmol/hour require cardiac monitoring

Question 4

NSAIDs should be stopped in AKI except – at cardio-protective dose

Answer 4

NSAIDs should be stopped in AKI except aspirin at cardio-protective dose

Question 5

Detect acute kidney injury, in line with the (p)RIFLE, AKIN or KDIGO definitions, by using any of the following criteria:

a rise in – of 26 micromol/litre or greater within 48 hours

a 50% or greater rise in — known or presumed to have occurred within the past 7 days
a fall in — to less than 0.5 ml/kg/hour for more than 6 hours in adults and more than

Answer 5

Detect acute kidney injury, in line with the (p)RIFLE, AKIN or KDIGO definitions, by using any of the following criteria:
a rise in serum creatinine of 26 micromol/litre or greater within 48 hours
a 50% or greater rise in serum creatinine known or presumed to have occurred within the past 7 days
a fall in urine output to less than 0.5 ml/kg/hour for more than 6 hours in adults and more than

Question 6

Should be stopped in AKI as may worsen renal function

• N-
• A-
• A-
• A-
• D-

Answer 6

Should be stopped in AKI as may worsen renal function

Question 7

There is no role for antibiotics in the treatment of haemolytic uraemic syndrome unless indicted my preceding –

Answer 7

There is no role for antibiotics in the treatment of haemolytic uraemic syndrome unless indicted my preceding diarrhoeal infection

Question 8

Haemolytic uraemic syndrome is generally seen in young children and produces a triad of:

Answer 8

Haemolytic uraemic syndrome is generally seen in young children and produces a triad of:
acute kidney injury
microangiopathic haemolytic anaemia
thrombocytopenia

Question 9

Systemic lupus erythematosus with proteinuria on urinalysis - consider –

Answer 9

Systemic lupus erythematosus with proteinuria on urinalysis - consider lupus nephritis

Question 10

— is a rare but serious complication of haemodialysis

Answer 10

Dialysis disequilibrium syndrome is a rare but serious complication of haemodialysis

Question 11

Membranous glomerulonephritis histology:
— thickening on light microscopy
subepithelial — on sliver stain
positive immunohistochemistry for –

Answer 11

Membranous glomerulonephritis histology:
basement membrane thickening on light microscopy
subepithelial spikes on sliver stain
positive immunohistochemistry for PLA2

Question 12

Microalbuminuria is the first indicator of—nephropathy.

Management includes blood pressure and proteinuria control with an ACE-inhibitor or ARB

Answer 12

Microalbuminuria is the first indicator of diabetic nephropathy. Management includes blood pressure and proteinuria control with an ACE-inhibitor or ARB

Question 13

Persistent – and negative urine culture is seen in renal TB

Answer 13

Persistent pyuria and negative urine culture is seen in renal TB

Question 14

Low total thyroxine levels may be seen in –syndrome

Answer 14

Low total thyroxine levels may be seen in nephrotic syndrome

Question 15

The time taken for an arteriovenous fistula to develop is –

Answer 15

The time taken for an arteriovenous fistula to develop is 6 to 8 weeks

Question 16

Lithium is a recognised cause of nephrogenic –

Answer 16

Lithium is a recognised cause of nephrogenic diabetes insipidus

Question 17

Henoch-Schonlein purpura classically presents with

-- pain, 
a--, 
h-- and a 
purpuric rash over the -- and 
--- surfaces of arms and legs

Answer 17

Henoch-Schonlein purpura classically presents with abdominal pain, arthritis, haematuria and a purpuric rash over the buttocks and extensor surfaces of arms and legs

Question 18

Amyloidosis is a cause of –

Answer 18

Amyloidosis is a cause of hepatosplenomegaly

Question 19

ADPKD is associated with — (rupture can cause SAH)

Answer 19

ADPKD is associated with berry aneurysms (rupture can cause SAH)

Question 20

CKD stage GFR range

1 Greater than –ml/min, with some sign of kidney damage on other tests (if all the kidney tests* are normal, there is no CKD)
2 – ml/min with some sign of kidney damage (if kidney tests* are normal, there is no CKD)
3a – ml/min, a moderate reduction in kidney function
3b – ml/min, a moderate reduction in kidney function
4 – ml/min, a severe reduction in kidney function
5 Less than – ml/min, established kidney failure - dialysis or a kidney transplant may be needed

Answer 20

CKD stage GFR range
1 Greater than 90 ml/min, with some sign of kidney damage on other tests (if all the kidney tests* are normal, there is no CKD)
2 60-90 ml/min with some sign of kidney damage (if kidney tests* are normal, there is no CKD)
3a 45-59 ml/min, a moderate reduction in kidney function
3b 30-44 ml/min, a moderate reduction in kidney function
4 15-29 ml/min, a severe reduction in kidney function
5 Less than 15 ml/min, established kidney failure - dialysis or a kidney transplant may be needed