Passmed Flashcards
In patients on regular steroid medication what do you need to watch out for if the patient develops a fever?
Need to watch out for adrenal insufficiency causing hyperkalaemic metabolic acidosis
How does transitional cell carcinoma of the bladder typically present?
Around 80% present with painless, visible haematuria
What is Wilms’ nephroblastoma?
Wilms’ nephroblastoma is one of the most common childhood malignancies. It typically presents in children under 5 years of age, with a median age of 3 years old.
Features
abdominal mass (most common presenting feature)
flank pain
painless haematuria
After a sore throat 2 weeks ago a patient develops Oligouria and proteinuria, what is the likely diagnosis?
Post-streptococcal glomerulonephritis
A child presents with oedema and frothy urine, urine dip shows negative blood but lots of protein. How should they be managed?
Oral prenisolone and urgent outpatient referral
This is classic nephrotic syndrome and it is likely to be minimal change disease in childhood that almost always responds to steroids
In acute kidney injury what is a large group of medications that should be withheld?
ACE inhibitors as they are nephrotoxic
What kidney conditions arise a few days after an URTI and a few weeks after?
PSGN develops 1-2 weeks after URTI. IgA nephropathy develops 1-2 days after URTI
What are the ECG changes seen with hyperkalaemia?
diminished P wave amplitude, increased T wave amplitude, PR prolongation and widened QRS complex.
How do urea and creatinine blood results present in a patient with dehydration rather than AKI?
The rise in blood urea will be proportionally higher than the rise in creatinine
How do kidneys in chronic kidney disease appear on ultrasound?
They will appear small bilaterally
Why does rhabdomyolysis cause AKI?
The myoglobin released is nephrotoxic
What is the treatment of aspirin overdose?
mixed respiratory alkalosis and metabolic acidosis
Activated charcoal if found early to reduce absorption
Causes a metabolic acidosis so treat with IV sodium bicarb as this enhances elimination of aspirin
Haemodialysis
What level of hyperkalaemia requires treatment?
Greater than 6.5 or if there are ECG changes
How is central diabetes insipidus treated?
With an ADH analogue such as vasopressin
How is nephrogenic diabetes insipidus treated?
This is treated paradoxically with a thiazide diuretic such as Chlorothiazide as this causes more sodium excretion that causes decreased plasma osmolality
