Nephrology

Question 1

How do you manage hyperphosphataemia in CKD?

Answer 1

Dietary changes (reduce chocolate and nuts)
Start sevelamar to bind to excess phosphate

Question 2

What should you do if a patient has haematuria with no clear cause?

Answer 2

Urology referral

Consider 2ww

Question 3

Formula to calculate anion gap

Answer 3

Na+K -Cl -HCO3

Question 4

Features of acute interstitial nephritis

Answer 4

Fever
Rash
Arthralgia 
Eosinophilia 
HTN 

Presents a bit like an allergic picture (IgE, raised urinary WCC)

Question 5

Drug causes of AIN

Answer 5

Penicillin
NSAIDs
Diuretics

Question 6

Histology of AIN

Answer 6

Marked interstitial oedema and interstitial infiltrate in the connective tissue between renal tubules

Question 7

Signs of sepsis

Answer 7

Pyrexia
Hypotension
Tachycardia

Question 8

HIV in terms of nephrology can cause…

Answer 8

Big kidneys

Question 9

Causes of enlarged kidney

Answer 9

SHAPE

Scleroderma
HIV nephropathy
Amyloidosis
Polycystic kidneys
Endocrinology (diabetes)

Question 10

Which infection is likely in peritoneal dialysis?

Answer 10

Staphylococcus.epidermis

Question 11

Anaemic CKD, which drug might you give?

Answer 11

Erythropoietin

Question 12

Why might a patient not respond to erythropoetin?

Answer 12

Cpncurrent iron deficiency anaemia

Question 13

Signs of iron deficiency

Answer 13

Microcytic anaemia
Pencil cells on blood film
Koilonychia 
Angular stomatitis
Red sore tongue (glossitis)

Question 14

How much potassium can you infuse per hour?

Answer 14

10mmol

Question 15

Which cancers are patients on long term immunosuppressants most at risk of?

Answer 15

Skin cancer

e.g. squamous carcinoma