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Phase 3 > Nephrology (Week 14) > Flashcards

Nephrology (Week 14) Flashcards

1
Q

Name three functions of the kidney

A
  • Waste excretion
  • Control solutes and fluid status
  • Endocrine function
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2
Q

What kidney function test is commonly done in diabetes patients?

A

Albumin: creatinine ratio

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3
Q

What eGFR defines stage 2 kidney disease?

A

60-89

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4
Q

What stage of kidney disease does an eGFR of 15-29 represent?

A

Stage 4

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5
Q

What eGFR is related to stage 5 renal disease

A

eGFR <15

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6
Q

What kind of kidney disease is eGFR measurement not suitable in?

A

Acute Kidney Injury

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7
Q

What is urea?

A

A tissue breakdown product

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8
Q

What % of GFR has to be lost before serum creatinine drops?

A

50%

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9
Q

What is the function of mesangial cells?

A

Control the matrix between capillaries

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10
Q

In a kidney biopsy, what site is a sample taken from?

A

The cortex of the left kidney

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11
Q

Name 3 symptoms of glomerulonephritis

A
  1. Visible haematuria
  2. Nephrotic syndrome
  3. Nephritic syndrome
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12
Q

Name the three main features of nephrotic syndrome

A
  1. 3.5 proteinuria per 24hr
  2. Serum albumin <30
  3. Oedema
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13
Q

Name the three main features of nephritic syndrome

A
  1. Hypertension
  2. Blood and protein in urine
  3. Declining kidney function
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14
Q

Define IgA nephropathy

A

Deposition of IgA in mesangial cells which disrupts the filtration barrier

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15
Q

Which antibody is present in 70% of patients with membranous glomerulonephritis?

A

Anti-phospholipase A2 receptor antibody

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16
Q

What anatomical change happens in the nephron in type I minimal change disease?

A

Podocytes fuse together

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17
Q

What is the treatment for type II minimal change disease?

A

High dose steroid

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18
Q

Name three types of management for renovascular disease

A
  1. BP control (NOT ACEI/ARB)
  2. Statin
  3. Angioplasty (if rapidly deteriorating renal failure)
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19
Q

What does blood and protein in the urine indicate?

A

That the pathology is probably of glomerular origin

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20
Q

What is vesico-ureteric reflux?

A

Retrograde passage of urine from bladder to upper urinary tract

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21
Q

Name three common causative organisms in pyelonephritis

A

E coli
Klebsiella
Pseudomonas

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22
Q

Name three symptoms of Upper UTIs

A

Rigors
Vomiting
Abdominal pain

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23
Q

Name three symptoms of lower UTIs

A

Dysuria
Frequency
Haematuria

24
Q

Which two genetic mutations can be seen in adult polycystic kidney disease?

A 
PKD 1 (85% of cases)
PKD 2 (15% of cases)
25
Q

Briefly describe the pathophysiology of ADPKD

A

Cysts gradually enlarge in the kidneys and normal tissue is replaced

26
Q

What is the diagnostic criteria for a 30-59 for polycystic kidney disease?

A

2 cysts in each kidney

27
Q

Define AKI

A

Decline in renal excretory function over hours of days with rise in serum urea and creatinine

28
Q

What urine output is classed as oliguria?

A

<400ml or 500ml per 24hr in adults

29
Q

Name 2 pre-renal causes of AKI

A

Hypovolaemia

Diarrhoea

30
Q

Name 2 renal causes of AKI

A

GN

Drugs

31
Q

Name 1 post-renal cause of AKI

A

Kidney stones

32
Q

How do NSAIDs affect the afferent arteriole of the glomerulus?

A

They inhibit prostaglandins which normally dilate the afferent arteriole

33
Q

What level of potassium is classed as a medical emergency?

A

K >6.5

34
Q

What treatments would be given to correct hyperkalemia?

A

Calcium Resonium (decrease gut absorption)

Insulin + dextrose (encourage K+ to move into cells)

35
Q

Name three causes of CKD

A

Diabetic nephropathy
Renovascular disease
ADPKD

36
Q

Name 2 signs of advanced CKD

A

Pericardial rub

Peripheral oedema

37
Q

Name the 5 indications for RRT

A
  1. Medically resistant hyperkalaemia
  2. Medically resistant pulmonary oedema
  3. Medically resistant acidosis
  4. Uraemic pericarditis
  5. Uraemic encephalopathy
38
Q

What is the average eGFR when dialysis would be commenced?

A

7ml/min

39
Q

How would you treat a UTI in pregnancy?

A

7-10 days of Amoxicillin and Cefalexin

40
Q

What organisms typically cause epididymitis?

A

Gram negatives e.g. enterococci and staphylococci

41
Q

What is Fournier’s gangrene?

A

A form of necrotising fasciitis affecting the external genitalia

42
Q

Which three points in the ureters are narrower than the rest?

A

Ureteropelvic junction
Crossing iliac artery
Ureterovesical junction

43
Q

Which type of kidney stones are produced in patients who have an inherited predisposition to excrete certain amino acids?

A

Cysteine stones

44
Q

Why are females less likely to develop kidney stones?

A

Because they have higher levels of citrate which are inhibitory of stone formation

45
Q

List the ‘Sepsis 6’

A

TAKE:

  • blood cultures
  • measure lactate
  • measure urine output

GIVE:

  • O2 to keep sats >94%
  • Fluid challenge
  • IV antibiotics
46
Q

What are staghorn calculi?

A

Branched stones in the renal pelvis

47
Q

What is active surveillance in prostate cancer?

A

Patient’s fit to be cured with a life expectancy over 10 years

48
Q

List three risks of bladder cancer

A

Smoking
Male
Caucasian

49
Q

What does TURBT mean?

A

Transurethral resection of bladder tumour

50
Q

What is the classical triad of renal cancer?

A

Mass
Pain
Haematuria

51
Q

Name 3 useful tumour markers in testicular cancer

A

Alpha-fetoprotein
Beta hCG
LDH

52
Q

Which 3 types of HPV virus have been implicated in penile cancer?

A

HPV 16, 18, 21

53
Q

What is diurnal urinary frequency?

A

Tubular function affected so most urine is passed at night

54
Q

What test is the best measure of kidney function in the acute setting?

A

Urine volume

55
Q

Which three tests are the most important in renal disease patients in general?

A

Urine dipstick
U and E’s
Kidney ultrasound

56
Q

Name 3 features of hyperkalaemia on ECG

A

Tall tented T waves
P wave absence
Abnormal QRS complex

Phase 3 (15 decks)

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