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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
Q

In the case of a suspected AKI, what does a high WCC indicate

A

Indicates an inflammatory process

goes against tubular necrosis

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26
Q

What drugs can cause interstitial nephritis

A

Penicillins

NSAIDS

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27
Q

What is the most common cause of nephrotic syndrome in kids

A

Minimal change glomerulonephritis

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28
Q

What is the most common cause of nephrotic syndrome in adults

A

Focal Segmental Glomerulosclerosis

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29
Q

What does muddy brown casts suggest

A

Acute tubular necrosis

30
Q

Which type of AKI can lead to tubular necrosis if left untreated

A

Pre-renal

31
Q

How can you differentiate between tubular necrosis and pre-renal AKI

A

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
Q

What is the 1st line treatment of renal colic pain

A

IM Diclofenac 75mg

33
Q

In AKI, all NSAID’s should be stopped to prevent further kidney injury. What is the one exception to this

A

Cardioprotective dose of Aspirin

34
Q

Which scrotal pathology may be related to infertility

A

Varicocele

dilation of scrotal venous plexus

35
Q

What is the commonest cause of death in patients with chronic kidney disease who are on haemodialysis

A

Ischaemic Heart Disease

36
Q

What must a patient abstain from and how long for before a PSA test

A

Ejaculation and vigorous exercise

for 48 hours

37
Q

What should you think of if a patient on haemodialysis presents with drowsiness but normal blood and clear lung fields

A

Dialysis Disequilibrium syndrome

cerebral oedema

38
Q

What is the most common renal malignancy and give 2 names for it

A

Renal Adenocarcinoma

Grawitz tumour

39
Q

What is the next step for a patient with overflow incontinence and elevated PSA levels

A

TRUS-guided biopsy of the prostate

40
Q

What is 1st line treatment for benign prostatic hyperplasia

A

Alpha blocker (Tamsulosin)

41
Q

What are some side effects of alpha-blockers

A

Postural hypotension

Dizziness

42
Q

Renal transplantation leaves you at higher risk of developing which cancer

A

Squamous cell carcinoma of the skin

43
Q

What is the mode of transmission of Alport syndrome

A

X-linked dominant

44
Q

What is the defect in Alport syndrome

A

A defect in the formation of type 4 collagen - abnormal GBM

45
Q

Which gene is mutated in Alport syndrome

A

COL4A5

46
Q

When does Alport syndrome present

A

In childhood

47
Q

Name one renal and one extra-renal symptom of Alport syndrome

A

Haematuria + bilateral sensorineural hearing loss

48
Q

What should you monitor following acute urinary retention and why

A

Serum creatinine

to look for signs of post-renal AKI

49
Q

Which two genes can be mutated in adult polycystic kidney disease

A

PKD1 gene on chromosome 16

PKD2 gene on chromosome 4

50
Q

What is the gold standard screening test for adult polycystic kidney disease

A

Ultrasound abdomen

51
Q

Schistosomiasis increases the risk of which malignancy

A

Squamous cell carcinoma of the bladder

52
Q

What is the most common type of renal stone

A

Calcium oxalate

53
Q

What is the gold standard investigation for renal stones

A

CT KUB

54
Q

What is a hydrocele

A

Collection of serous fluid in the tunica vaginalis

55
Q

What does the testicle feel like in the presence of a hydrocele

A

Non-palpable

56
Q

Is a hydrocele painful and does it transilluminate

A

Non-tender and fully transilluminates

57
Q

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

A

0.9% NaCl saline before and after the procedure

58
Q

If a patient presents with a scrotal mass which you are unable to get above on examination, what should you think of

A

Direct inguinal hernia

59
Q

What are the three main differentials for frank haematuria

A

Cancer
Stones
Infection

60
Q

How can you rule out infection and stones in someone with frank haematuria

A

If there is a lack of lower urinary tract symptoms

61
Q

Why does Nephrotic syndrome predispose you to venous thromboembolism

A

Loss of Anti-Thrombin III

62
Q

Which side do varicocele’s tend to present on

A

Almost always on the left

63
Q

What is the nutcracker angle and what is the clinical relevance

A

Compression of the renal vein can occur at the angle between the abdominal aorta and the superior mesenteric vein

64
Q

How can a renal cell carcinoma present as a varicocele

A

Entrapment of the renal vein at the nutcracker angle, leading to dilation of the scrotal venous plexus

65
Q

What is plasma and urine osmolality like in diabetes insipidus

A

DI is characterised by low urine osmolality and high plasma osmolality

66
Q

How do you work out anion gap

A

(Na+K) - (HCO3 + Cl)

67
Q

Give an example of a state when the anion gap is increased

A

Diabetic ketacidosis

68
Q

What are the 4 hallmarks of the Nephritic syndrome

A

Haematuria
Proteinuria
Hypertension
Oliguria

69
Q

What 4 things are included in the MDRD4 equation and what is it used for

A

estimate GFR

Creatinine, Age, Gender, Ethnicity

70
Q

What is the triad associated with renal cell carcinoma

A

Haematuria, Loin pain, Abdominal mass

71
Q

What is the most common viral infection in transplant patients

A

Cytomegalovirus

72
Q

Which drugs are transplant patients prescribed post-op

A

MMF (Mycophenolate)
Tacrolimus
Prednisolone

Misc. Notes Year 2 (30 decks)

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