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4th Year Exam > Nephrology ILOs > Flashcards

Nephrology ILOs Flashcards

1
Q

Define UTI, including complicated and uncomplicated

A

Uncomplicated occurs with structurally and functionally normal tissue, complicated occurs in the presence of underlying pathology

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2
Q

Give 3 causative organisms of UTIs

A

E. coli
Klebsiella
Enterococcus

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3
Q

Give 4 symptoms of a UTI

A

Dysuria
Urgency
Suprapubic pain
Pyrexia

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4
Q

Give 2 investigations and 2 treatments for UTIs

A

Urinalysis + culture

ABX + IV fluid

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5
Q

Define pyelonephritis and give 3 signs and symptoms

A

Severe infectious inflammatory disease of kidney

  • Flank pain
  • Costovertebral angle tenderness
  • Fever
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6
Q

Give 2 management options for pyelonephritis

A

ABX

Supportive care

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7
Q

Give 3 risks of pyelonephritis

A
  • UTI
  • Diabetes
  • Stress incontinence
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8
Q

Define AKI and give one pre-renal, renal and post-renal cause

A

Acute decline in kidney function leading to raised creatinine and/or decreased urine output

  1. Hypovolaemia
  2. Drugs
  3. Renal stones
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9
Q

Give 3 signs of an AKI

A
  • Hypotension
  • Reduced urine output
  • Symptoms of pulmonary oedema
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10
Q

Give 3 investigations for an AKI

A
  • U&Es ( increased creatinine, high K, metabolic acidosis)
  • Blood culture for cause
  • Urine culture
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11
Q

Give 3 management options for an AKI

A
  • Fluid resuscitation
  • Medication review and stop nephrotoxins
  • Vasopressor support if still hypovolaemic
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12
Q

What is one life-threatening complication of an AKI which needs immediate correction?

A

Hyperkalaemia

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13
Q

Give 3 causes of CKD

A
  • Diabetes
  • Hypertension
  • Polycystic kidney disease
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14
Q

Outline the pathology of CKD

A

Increased intra-glomerular pressure and increased angiotensin II production lead to collagen synthesis and renal scarring

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15
Q

Outline the stages of CKD

A

1: eGFR >90
2: eGFR = 60-89
3a: eGFR = 45-59
3b: eGFR = 30-44
4: eGFR = 15-29
5: eGFR <15

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16
Q

What 2 things may be seen on urinalysis in CKD?

A

Haematuria

Proteinuria

17
Q

Give 4 management options of CKD

A
  • ACEI/ARB
  • Statin
  • Glycaemic control
  • Dialysis
18
Q

Give 5 indications for renal replacement therapy

A
  1. Medically resistant hyperkalaemia
  2. Medically resistant pulmonary oedema
  3. Medically resistant acidosis
  4. Uraemic pericarditis
  5. Uraemic encephalopathy
19
Q

Give 3 symptoms of uremia

A

Anorexia
Itch
Restless legs

20
Q

At what eGFR does dialysis typically occur?

A

5-10 but most start when eGFR =7

21
Q

Outline the 2 forms of dialysis

A

Haemodialysis: removes solute by diffusion and fluid by hydrostatic pressure

Peritoneal: peritoneum functions as filter

22
Q

Give 2 pros and 2 cons of renal transplant

A

Pros: no dialysis, better life expectancy

Cons: immunosuppressive medication, increased infection

23
Q

At what eGFR does glomerulonephritis occur and give 2 symptoms

A

eGFR <15

Visible haematuria
Synpharingitis (sore throat then Coca Cola urine)

24
Q

Give 3 investigations for glomerulonephritis

A
  • U and E’s
  • Urine dip for blood
  • Immunology, myeloma and HbA1c screen
25
Q

Outline the 3 components of nephrotic syndrome

A
  1. 3.5g proteinuria per 24hr
  2. Serum albumin <30
  3. Oedema
26
Q

Outline the 3 components of nephritic syndrome

A
  1. Hypertension
  2. Blood and protein in urine
  3. Declining kidney function
27
Q

How does IgA nephropathy occur and what drug is used in it’s management?

A

IgA deposited in mesangial cells which disrupts filtration barrier

ACEI

28
Q

What is membranous glomerulonephropathy?

A

Occurs in adults presenting with nephrotic syndrome

29
Q

What occurs in minimal change disease I?

A

In children, podocytes fuse together

30
Q

What occurs in minimal change disease II?

A

Acutely normal/reduced eGFR

31
Q

Give 4 features of PKD

A
  • Hypertension
  • Impaired renal function
  • Loin pain
  • Haematuria
32
Q

Which chromosomal gene mutations are implicated in PKD 1 and PKD 2 respectively?

A

16 and 4

33
Q

Outline the pathophysiology of PKD

A
  • Cysts gradually enlarge and normal tissue replaced

- Kidney volume increases and GFR decreases

34
Q

Give 2 management options of PKD

A

Manage BP

Tolvaptan: vasopressin V2 receptor antagonist

35
Q

What happens when a patient suffers from vesicle-ureteric reflux?

A

Retrograde passage of urine from bladder to upper tract = scarring

36
Q

How does renovascular disease cause renal pathology?

A

Narrow renal arteries cause perfusion to fall = inflammation and fibrosis

37
Q

What is amyloidosis and what are the two types?

A

Deposition of insoluble protein material in extracellular space

AA: systemic
AL: immunoglobulin due to haem. condition e.g. MM

38
Q

How does SLE cause renal damage and what is the treatment?

A

Immune complexes activate complement (C4) causing renal damage

Tx: immunosuppression

4th Year Exam (20 decks)

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