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Misc. Notes Year 2 > Passmed Renal > Flashcards

Passmed Renal Flashcards

1
Q

What is the treatment for nephrogenic diabetes insipidus

A 
Thiazide diuretics 
(paradoxically decreases the volume of urine)
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2
Q

Which renal stones are radio-lucent

A

Urate & Xanthine stones

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3
Q

Which cancer is associated with textiles, plastic, rubber and dye

A

Transitional cell carcinoma

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4
Q

What is Wilm’s tumour and who is it most common in

A

Nephroblastoma

Commonest in children

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5
Q

Does an angiomyolipoma cause proteinuria

A

No typically causes haematuria

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6
Q

What should you think of in someone with bilateral Angiomyolipoma

A

Tuberous Sclerosis

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7
Q

Where do angiomyolipoma’s tend to metastasise to

A

Nowhere benign tumour

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8
Q

Which calculi are associated with Proteus

A

Struvite Calculi

Staghorn Calculi

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9
Q

What smell is Proteus associated with

A

Burnt Chocolate

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10
Q

What is a struvite stone made from

A

Magnesium Ammonium Phosphate

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11
Q

Which cancer is the Gleason score used for

A

Prostate cancer

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12
Q

What is the lowest Gleason score which indicates malignancy

A

6

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13
Q

What is the most common infecting organism for someone on peritoneal dialysis and why

A

Staph Epidermidis

Foreign body

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14
Q

How does Spironolactone cause gynecomastia

A

Inhibits testosterone binding to androgen receptors on cells of breast tissue

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15
Q

If someone on spironolactone is complaining of gynecomastia, what drug can they be offered instead

A

Eplerenone

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16
Q

What is the first step of management in someone with hyperkalaemia

A

Cardiac monitoring via ECG

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17
Q

What changes on an ECG are associated with hyperkalaemia

A

Tall tented T waves
Broad QRS
flattened/absent p waves

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18
Q

If changes consistent with hyperkalaemia are seen on ECG, what is the next step of management

A

IV 10mls of 10% caclium gluconate

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19
Q

What is the role of calcium gluconate in hyperkalaemia management

A

DOES NOT AFFECT POTASSIUM LEVELS

Used to stabilise myocardium to prevent arrhythmias

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20
Q

What can be given to drive the potassium back into cells, in the management of hyperkalaemia

A

10 units of actrapid insulin

10mg of nebulised salbutamol

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21
Q

When managing hyperkalaemia, what must be given with insulin and why

A

50mls of 50% dextrose

to prevent hypoglycaemia

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22
Q

What can be given for the long-term management of hyperkalaemia

A

Calcium resonium –> prevents GI absorption

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23
Q

Why is Erythropoietin given in chronic kidney disease

A

To improve exercise tolerance

DOES NOT AFFECT RENAL FUNCTION

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24
Q

In the case of a suspected AKI, how can post-renal and pre-renal causes be isolated

A

The presence of protein in urine dipstick suggests that the problem is renal

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25
In the case of a suspected AKI, what does a high WCC indicate
Indicates an inflammatory process | goes against tubular necrosis
26
What drugs can cause interstitial nephritis
Penicillins | NSAIDS
27
What is the most common cause of nephrotic syndrome in kids
Minimal change glomerulonephritis
28
What is the most common cause of nephrotic syndrome in adults
Focal Segmental Glomerulosclerosis
29
What does muddy brown casts suggest
Acute tubular necrosis
30
Which type of AKI can lead to tubular necrosis if left untreated
Pre-renal
31
How can you differentiate between tubular necrosis and pre-renal AKI
Tubular necrosis will present with high urine sodium (think of the tubules dying and so unable to reabsorb the sodium) Pre-renal AKI will present with low urine sodium because the tubules are holding onto the sodium to compensate for hypo-perfusion
32
What is the 1st line treatment of renal colic pain
IM Diclofenac 75mg
33
In AKI, all NSAID's should be stopped to prevent further kidney injury. What is the one exception to this
Cardioprotective dose of Aspirin
34
Which scrotal pathology may be related to infertility
Varicocele | dilation of scrotal venous plexus
35
What is the commonest cause of death in patients with chronic kidney disease who are on haemodialysis
Ischaemic Heart Disease
36
What must a patient abstain from and how long for before a PSA test
Ejaculation and vigorous exercise | for 48 hours
37
What should you think of if a patient on haemodialysis presents with drowsiness but normal blood and clear lung fields
Dialysis Disequilibrium syndrome | cerebral oedema
38
What is the most common renal malignancy and give 2 names for it
Renal Adenocarcinoma | Grawitz tumour
39
What is the next step for a patient with overflow incontinence and elevated PSA levels
TRUS-guided biopsy of the prostate
40
What is 1st line treatment for benign prostatic hyperplasia
Alpha blocker (Tamsulosin)
41
What are some side effects of alpha-blockers
Postural hypotension | Dizziness
42
Renal transplantation leaves you at higher risk of developing which cancer
Squamous cell carcinoma of the skin
43
What is the mode of transmission of Alport syndrome
X-linked dominant
44
What is the defect in Alport syndrome
A defect in the formation of type 4 collagen - abnormal GBM
45
Which gene is mutated in Alport syndrome
COL4A5
46
When does Alport syndrome present
In childhood
47
Name one renal and one extra-renal symptom of Alport syndrome
Haematuria + bilateral sensorineural hearing loss
48
What should you monitor following acute urinary retention and why
Serum creatinine | to look for signs of post-renal AKI
49
Which two genes can be mutated in adult polycystic kidney disease
PKD1 gene on chromosome 16 | PKD2 gene on chromosome 4
50
What is the gold standard screening test for adult polycystic kidney disease
Ultrasound abdomen
51
Schistosomiasis increases the risk of which malignancy
Squamous cell carcinoma of the bladder
52
What is the most common type of renal stone
Calcium oxalate
53
What is the gold standard investigation for renal stones
CT KUB
54
What is a hydrocele
Collection of serous fluid in the tunica vaginalis
55
What does the testicle feel like in the presence of a hydrocele
Non-palpable
56
Is a hydrocele painful and does it transilluminate
Non-tender and fully transilluminates
57
Contrast is well known to cause nephropathy so what should you do in order to prevent this in a CKD patient requiring a contrast CT
0.9% NaCl saline before and after the procedure
58
If a patient presents with a scrotal mass which you are unable to get above on examination, what should you think of
Direct inguinal hernia
59
What are the three main differentials for frank haematuria
Cancer Stones Infection
60
How can you rule out infection and stones in someone with frank haematuria
If there is a lack of lower urinary tract symptoms
61
Why does Nephrotic syndrome predispose you to venous thromboembolism
Loss of Anti-Thrombin III
62
Which side do varicocele's tend to present on
Almost always on the left
63
What is the nutcracker angle and what is the clinical relevance
Compression of the renal vein can occur at the angle between the abdominal aorta and the superior mesenteric vein
64
How can a renal cell carcinoma present as a varicocele
Entrapment of the renal vein at the nutcracker angle, leading to dilation of the scrotal venous plexus
65
What is plasma and urine osmolality like in diabetes insipidus
DI is characterised by low urine osmolality and high plasma osmolality
66
How do you work out anion gap
(Na+K) - (HCO3 + Cl)
67
Give an example of a state when the anion gap is increased
Diabetic ketacidosis
68
What are the 4 hallmarks of the Nephritic syndrome
Haematuria Proteinuria Hypertension Oliguria
69
What 4 things are included in the MDRD4 equation and what is it used for
estimate GFR | Creatinine, Age, Gender, Ethnicity
70
What is the triad associated with renal cell carcinoma
Haematuria, Loin pain, Abdominal mass
71
What is the most common viral infection in transplant patients
Cytomegalovirus
72
Which drugs are transplant patients prescribed post-op
MMF (Mycophenolate) Tacrolimus Prednisolone

Misc. Notes Year 2 (30 decks)

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