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Sheff 3b > Passmed renal > Flashcards

Passmed renal Flashcards

1
Q

How does muscle breakdown cause renal failure (eg after long time on floor after fall)

A

Rhabdomyolysis -Myoglobinuria -> tubular cell necrosis

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2
Q

How do drugs cause renal faulure

A

induce apoptosis

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3
Q

Maintenance fluids for adult ?

Maintenance K?

A

25-30ml/kg/day

1mmol/kg/day

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4
Q

Organism for HUS ?

Name 1 non infectivee cause

A

E coli

tumours
pregnancy
ciclosporin, the Pill
systemic lupus erythematosu

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5
Q

HUS triad

A

acute renal failure

microangiopathic haemolytic anaemia

thrombocytopenia

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6
Q

What if

renal failure, sensorineural hearing loss and ocular abnormalities develop in a child

A

Alport syndrome

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7
Q

What will exam q often give if need to calculate anion gap?

how do you do it?

A

Cl

=(Na + K) - (Cl + HCO3)

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8
Q

Acidosis with normal anion gap =? name 2 causes

A

= hyperchloraemic metabolic acidosis

gastrointestinal bicarbonate loss: diarrhoea, ureterosigmoidostomy, fistula

renal tubular acidosis

drugs: e.g. acetazolamide
ammonium chloride injection

Addison’s disease

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9
Q

young female patients who develop AKI after the initiation of an ACE inhibitor?

Seen on imaging?

A

fibromuscular dysplasia

string of beads’ appearance.

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10
Q

Most common virus in organ transplant

A

cytomegalovirus

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11
Q

3 comps post renal transplant

A

Ca - due to immune supression Esp Basal / squamous skin Ca

Renal failure - ciclosporin/graft rejection/recurrenc

Cardiovascular disease - due to meds

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12
Q

Name 2 differences between IgA nephropathy and post strep glomerulonephritis

A

IgA - 1-2days after URTI
Can get frank haematuria

Pos t stret - 1-2 weeks
proteinuria

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13
Q

Usual screening for PKD

A

USS

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14
Q

name 2 parts of Mx hyper k

A

Stabilisation of the cardiac membrane
intravenous calcium gluconate

Short-term shift in potassium from extracellular to intracellular fluid compartment
combined insulin/dextrose infusion
nebulised salbutamol

Removal of potassium from the body
calcium resonium (orally or enema)
loop diuretics
dialysis

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15
Q

Basics of cranial vs nephrogenic DI

A

Cranial - dont produce enough vasopressin

neph - kidneys dont respond to vassopressin

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16
Q

Mx nephrogenic DI

A

thiazide like diuretic

17
Q

Mx HUS

A

Supportive - e.g. Fluids, blood transfusion and dialysis if required

18
Q

DI plasma vs urine osmolality

A

high plasma osmolality

and a low urine osmolality

19
Q

Dx of DI

A

water deprivation test

20
Q

Ix for diabetic nephropathy

A

albumin:creatinine ratio (ACR) in early morning

21
Q

55-year-old man presenting with progressive weakness and dyspnoea, hepatomegaly, proteinuria and worsening renal function.

A

amyloidosis

22
Q

Stain for amyloid?

A

congo red staining - apple -green birefringence

23
Q

urea / creatinine in dehydration

A

urea that is proportionally higher than the rise in creatinine

24
Q

Persistent pyuria and negative urine culture

A

Renal TB

25
Q

Mx of hyperK

A

IV calcium gluconate

26
Q

Indication that renal disease is chronic and not acute?

A

hypocalcaemia

[Due to reduced synthesis of vit D -> less Ca reabsorption]

Bilat small kidneys on USS

27
Q

Signs of drug induced nephritis

A

Raised urinary WCC/IgE/Eosiniphils

Fever
Rash
Arthralgia

28
Q

Seen on biopsy of wegners / good pastures / SLE …[Rapid progressive glomerulonephritis]

A

Crescentic glomerulonephritis

29
Q

Pre/intra/post renal if dip has protein

A

only Intra

30
Q

Acute interstitial nephritis vs Acute tubular necrosis on dip

A

nephritis is inflammatory process -> higher white cell content in the urine

31
Q

A 55-year-old man presents with a one month history of fever, arthralgia and lethargy. He also recently developed haemoptysis and dyspnoea. Investigations show that he has an acute kidney injury. ANCA (anti-neutrophil cytoplasmic antibody) is negative.
Que es?

A

anti gbm

32
Q

tachycardia, fatigue, pallor and an aortic flow murmur in CKD

A

anaemia

33
Q

Why does nephrotic syndrome predispose to thrombus

A

Loss of antithrombin-III, proteins C and S and an associated rise in fibrinogen levels

34
Q

How to differentiate kidneys not getting enough blood (pre-renal) and Acute tubular necrosis?

A

The job of the kidneys is to take blood, remove all the shite from it and make concentrated urine.

So if the urine osmolality = plasma osmolality then you know that the kidneys are knackered.

But if the urine osmolality > plasma, then you know the kidneys themselves are fine but they’re just not getting enough blood.

35
Q

A 4-year-old boy with recurrent urinary tract infections is referred to the paediatric team due to worries over reflux nephropathy.

Key Ix?

A

micturating cystography

36
Q

drug causing rhabdomyolysis?

A

statin

37
Q

Urinary sodium in pre-renal vs intra renal

A

pre renal is low Urinary as kidneys try and hold onto sodium to increase blood volume

Sheff 3b (33 decks)

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