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Medicine and Surgery Mushkies > Passmed Renal Mushkies > Flashcards

Passmed Renal Mushkies Flashcards

1
Q

What predisposes to increased thrombosis in nephrotic syndrome?

A
  1. Loss of antithrombin III, Protein C & S

2. Rise in fibrinogen levels

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2
Q

What Abxs require therapeutic monitoring in pts with renal failure?

A

Vancomycin and gentamicin

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3
Q

What are 4 drugs to avoid in renal failure?

A
  1. Abx e.g. tetracyclines, nitrofurantoin
  2. NSAIDs
  3. Lithium
  4. Metformin
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4
Q

What are some drugs that are likely to accumulate in CKD and thus need dose adjustment?

A

A MAD FOS

  1. Most Abx
  2. Methotrexate
  3. Atenolol
  4. Digoxin
  5. Furosemide
  6. Opioids
  7. Sulphonylureas
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5
Q

What is the management for acute clot retention?

A

Bladder irrigation via a 3-way urethral catheter

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6
Q

How can you classify haematuria?

A

Visible vs. non-visible haematuria

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7
Q

How can you classify causes of non-visible haematuria?

A
  1. Transient

2. Persistent

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8
Q

What are the transient causes of non-visible haematuria?

A
  1. UTI
  2. Menstruation
  3. Vigorous exercise
  4. Sexual intercourse
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9
Q

What are the permanent causes of non-visible haematuria?

A
  1. Infection = prostatitis, urethritis
  2. Inflammation = IgA nephropathy, thin basement membrane disease
  3. Malignancy = bladder, renal, prostate
  4. BPH
  5. Stones
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10
Q

What are some spurious causes of haematuria?

A
  1. Foods = beetroot, rhubarb

2. Drugs = rifampicin, doxorubicin

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11
Q

What is the definition for persistent non-visible haematuria?

A

Blood being present in 2 out of 3 samples tested 2-3 weeks apart

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12
Q

What are 4 features of HSP?

A
  1. Rash over buttocks and extensor surfaces
  2. Abdo pain
  3. Polyarthritis
  4. Features of IgA nephropathy e.g. haematuria, renal failure
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13
Q

What are stag-horn calculi typically composed of?

A

Struvite = Ammonium Magnesium Phosphate

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14
Q

What typically causes staghorn calculi?

A

Alkaline urine due to e.g. Proteus Mirabilis and Ureaplasma urealyticum

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15
Q

When is a triple phosphate stone defined as a staghorn calculus?

A

Whe nit involves the renal pelvis and extends into at least 2 calyces

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16
Q

How can one manage lupus nephritis?

A
  1. Treat HTN
  2. Corticosteroids if clinical evidence of disease
  3. Immunosuppressants e.g. azathioprine/cyclophosphamide
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17
Q

How can you differentiate between ATN or prerenal uraemia?

A

In prerenal uraemia the kidneys hold onto sodium to preserve volume

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18
Q

What is dialysis disequilibrium syndrome?

A

A rare complication usually affecting those who have recently started renal replacement therapy, causes cerebral oedema, but the exact mechanism is unclear. Therefore, this is a diagnosis of exclusion

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19
Q

What are the 3 different types of renal replacement therapy?

A
  1. Haemodialysis
  2. Peritoneal dialysis
  3. Renal transplant
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20
Q

What kind of things are taken into account by pt and the healthcare team when deciding which RRT to have?

A
  1. Predicted QoL
  2. Predicted life expectancy
  3. Pt preference
  4. Co-existing medical conditions
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21
Q

What are the 2 types of peritoneal dialysis?

A
  1. Continuous ambulatory peritoneal dialysis (CAPD)

2. Automated peritoneal dialysis (APD)

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22
Q

What is the average lifespan of a donated kidney?

A

10-12 yrs from deceased donors, 12-15 yrs from living donors

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23
Q

What is the average life expectancy of a pt with renal failure that does not receive renal replacement therapy?

A

6 months

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24
Q

How can you classify causes of metabolic acidosis?

A

Normal or raised anion gap

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25
Q

What are the causes of a normal anion gap metabolic acidosis?

A
  1. GI loss e.g. diarrhoea
  2. Renal tubular acidosis
  3. Drugs e.g. acetazolamide
  4. Ammonium chloride injection
  5. Addison’s disease
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26
Q

What are the causes of a raised anion gap metabolic acidosis?

A
  1. Lactate = shock, hypoxia
  2. Ketones = DKA, alcohol
  3. Urate = renal failure
  4. Acid poisoning = salicylates, methanols
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27
Q

What are some causes of metabolic alkalosis?

A
  1. Vomiting
  2. Diuretics
  3. Hypokalaemia
  4. Cushings
  5. CAH
  6. Primary hyperaldosteronism
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28
Q

What are some causes of a respiratory acidosis?

A
  1. COPD
  2. Resp condition e.g. asthma decompensation
  3. Drugs e.g. benzodiazepines, opiate overdose
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29
Q

What are some causes of a respiratory alkalosis?

A
  1. Anxiety
  2. PE
  3. CNS e.g. stroke
  4. Altitude
  5. Pregnancy
  6. Salicylate poisoning
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30
Q

What is a common for a rise in urea that is proportionally higher than the rise in creatinine?

A

Dehydration

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31
Q

What are 5 intrinsic causes of renal failure?

A
  1. Glomerulonephritis
  2. ATN
  3. AIN
  4. Rhabdyomyolysis
  5. Tumour lysis syndrome
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32
Q

How does one diagnose AKI?

A
  1. a rise in serum creatinine of 26 micromol/litre or greater within 48 hours
  2. a 50% or greater rise in serum creatinine known or presumed to have occurred within the past 7 days
  3. a fall in urine output to less than 0.5 ml/kg/hour for more than 6 hours in adults and more than
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33
Q

What 5 drugs should be stopped in AKI as it may worsen renal function?

A
  1. NSAIDs
  2. Aminoglycosides
  3. ACE inhibitors
  4. Ang II receptor antagonists
  5. Diuretics
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34
Q

What are 3 drugs that may have to be stoppefd in AKI as increased risk of toxicity but doesnt usually worsen the AKI itself?

A
  1. Metformin
  2. Lithium
  3. Digoxin
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35
Q

What is the potassium requirement per day?

A

1 mmol/kg/day

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36
Q

What is the sodium requirement per day?

A

1 mmol/kg/day

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37
Q

What is the chloride requirement per day?

A

1 mmol/kg/day

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38
Q

How much Na and Cl is in normal saline?

A

154mmol

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39
Q

How much Na and Cl is in Hartmann’s? How much K and HCO3 is in Hartmann’s?

A 
Na = 131
Cl = 111
K = 5
HCO3 = 29
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40
Q

Why shouldnt you use Hartmanns in pts with hyperkalaemia?

A

It contains potassium

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41
Q

What are some complications of giving erythropoietin?

A
  1. Accelerated HTN –> encephalopathy and seizures
  2. Bone ache
  3. Flu-like symptoms
  4. Skin rashes, urticaria
  5. Pure red cell aplasia (due to Abs against EPO)
  6. Thrombosis
  7. Iron deficiency 2nd to increased erythropoiesis
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42
Q

What is the most common viral infection in solid organ transplant recipients?

A

CMV

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43
Q

How can you classify graft failure in renal transplant?

A
  1. Hyperacute rejection (mins to hrs)
  2. Acute graft failure (<6m)
  3. Chronic graft failure (>6m)
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44
Q

What causes hyperacute rejection of renal transplants?

A

Due to pre-existent Abs against donor HLA antigens (Type II Hypersensitivity reaction), and is rarely seen due to HLA matching

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45
Q

What causes acute graft failure?

A

Usually due to mismatched HLA, and is cell-mediated (cytotoxic T cells). Can also be caused by CMV infection. may be reversible with steroids and immunosuppressants

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46
Q

What causes chronic graft failure?

A
  1. Both antibody and cell mediated mechanisms causes fibrosis to the transplanted kidney
  2. Recurrence of original renal disease (MCGN > IgA > FSGS)
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47
Q

What are the causes of minimal change disease?

A
  1. Idiopathic (majority)
  2. Drugs = NSAIDs, rifampicin
  3. Hodgkins lymphoma, thymoma
  4. Infectious mononucleosis
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48
Q

What is the prognosis for minimal change disease?

A

1/3rd one episode
1/3rd infrequent relapses
1/3rd frequent relapses

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49
Q

What are 2 risk factors for urate stones?

A
  1. Gout

2. Ileostomy (loss of bicarb and fluid results in acidic urine, causing precipitation of uric acid)

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50
Q

What are 2 drugs that promote calcium stones?

A

Loop diuretics and steroids

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51
Q

What are 2 pertinent manifestations of uraemia?

A

Encephalopathy and pericarditis

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52
Q

What is the management of renal stones?

A
  1. Conservatively = pass spontaneously

2. Surgical = ESWL, percutaneous nephrolithotomy, ureteroscopy, open surgery

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53
Q

How do you manage calculi <5mm?

A

Expectant

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54
Q

How do you manage calculi <2cm?

A

ESWL

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55
Q

How do you manage calculi <2cm in pregnant women?

A

Ureteroscopy

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56
Q

How do you manage complex renal calculi and staghorn calculi?

A

Percutaneous nephrolithotomy

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57
Q

How can you prevent calcium stones?

A
  1. High fluid intake
  2. Low animal protein, low salt diet
  3. Thiazide diuretics
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58
Q

How can you prevent oxalate stones?

A

Cholestyramine and pyridoxine both reduce urinary oxalate excretion

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59
Q

How can you prevent uric acid stones?

A
  1. Allopurinol

2. Urinary alkalinisation e.g. oral bicarbonate

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60
Q

What is the mainstay of treatment for rhabdomyolysis?

A

Rapid IV fluid rehydration

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61
Q

What electrolyte changes do you see in rhabdomyolysis?

A
  1. Hypocalcaemia (myoglobin binds to calcium)
  2. High phosphate (released from myocytes)
  3. Hyperkalaemia
  4. Metabolic acidosis
  5. AKI with disproportionately raised creatinine
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62
Q

What is the triad for renal cancer?

A

Flank pain, mass and haematuria

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63
Q

What is the most common type of renal cancer?

A

Clear cell

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64
Q

What are some associations of renal cell carcinoma?

A
  1. Middle aged men
  2. Smokers
  3. vHL syndrome
  4. Tuberous sclerosis
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65
Q

What cancer can cause a left varicocoele?

A

Renal cell carcinoma due to occlusion of left testicular vein

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66
Q

What are 4 hormones that a RCC may secrete?

A
  1. EPO
  2. PTH
  3. Renin
  4. ACTH
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67
Q

What diagnosis should you consider in young female pts who develop AKI after the initiation of an ACE inhibitor?

A

Fibromuscular dysplasia

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68
Q

What is the most common cause of renal artery stenosis?

A

Atherosclerosis

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69
Q

What is fibromuscular dysplasia?

A

Proliferation of cells in the walls of the arteries causing vessels to bulge or narrow. ‘String of beads’ appearance.

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70
Q

Haematuria 1-2 days after an URTI?

A

IgA Nephropathy

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71
Q

Haematuria 1-2 wks after an URTI?

A

Post-streptococcal glomerulonephritis

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72
Q

What is the commonest cause of glomerulonephritis worldwide?

A

IgA nephropathy

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73
Q

What percentage of pts with IgA nephropathy develop ESRF?

A

25%

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74
Q

What are 4 extra-renal features of ADPKD?

A
  1. Hepatomegaly due to hepatic cysts
  2. Diverticulosis
  3. Ovarian cysts
  4. Berry aneurysms
  5. Mitral valve prolapse/aortic dissection
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75
Q

How might ADPKD present?

A
  1. HTN
  2. Recurrent UTIs
  3. Abdo pain
  4. Renal stones
  5. Haematuria
  6. CKD
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76
Q

What kind of blocker can be given to pts to aid passage of a stone?

A

Alpha blocker

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77
Q

What pain relief should be given in the acute management of renal colic?

A

IM diclofenac 75mg

78
Q

What might you see on US in pts with chronic HIV-associated nephropathy?

A

Large/normal sized kidneys, as opposed to pts with CKD who will have bilateral small kidneys

79
Q

What is the management of salicylate poisoning?

A

IV sodium bicarbonate

80
Q

What is the ABG reading with salicylate poisoning?

A

Raised anion gap metabolic acidosis

81
Q

What else can you give to an aspirin overdose if it was very recent?

A

Activated charcoal

82
Q

What is the treatment for benzodiazepine overdose?

A

Flumazenil

83
Q

How do you calculate anion gap?

A

(Na + K) - (HCO3 + Cl)

84
Q

What is the normal range for anion gap?

A

10-18mmol/L

85
Q

How can you classify metabolic acidosis secondary to high lactate levels?

A
  1. Type A = sepsis, shock, hypoxia, burns

2. Type B = metformin

86
Q

What is the management for renal bone disease?

A
  1. Conservative = reduced dietary intake of phosphate
  2. Medical = phosphate binders, Vit D (alfacalcidol)
  3. Surgical = parathyroidectomy
87
Q

What are 3 classes of phosphate binders?

A
  1. Aluminium-based (less common)
  2. Calcium-based binders
  3. Sevelamer
88
Q

What is Sevelamer?

A

A non-calcium based binder that binds to dietary phosphate and prevents its absorption

89
Q

What investigation can you do to differentiate between ATN and AIN?

A

Urine dip

90
Q

What is the management for nephrogenic DI?

A
  1. Thiazide diuretic

2. Low salt/protein diet

91
Q

What would cause a young male to have recurrent episodes of macroscopic haematuria?

A

IgA Nephropathy

92
Q

What are the causes of nephrogenic DI?

A
  1. Genetic = ADH receptor mutation, AQP2 mutation
  2. Electrolytes = hypercalcaemia, hypokalaemia
  3. Drugs = lithium, demeclocycline
  4. Tubulo-interstitial disease = obstruction, sickle cell, pyelonephritis
93
Q

What is the management for minimal change disease?

A

Steroids, and cyclophosphamide if steroid-resistant

94
Q

What is the most common site of thrombosis in nephrotic syndrome?

A

Renal vein

95
Q

What is the most likely cause of death in pts with CKD on haemodialysis?

A

IHD

96
Q

What are the most common causes of CKD?

A
  1. DN
  2. Chronic glomerulonephritis
  3. Chronic pyelonephritis
  4. HTN
  5. ADPKD
97
Q

What do you see on urine dip with acute interstitial nephritis?

A

An ‘allergic’ type picture consisting usually of raised urinary WCC, IgE and eosinophils

98
Q

What are the causes of acute interstitial nephritis?

A
  1. Idiopathic
  2. Drugs = penicillin, rifampicin, NSAIDs, allopurinol, furosemide
  3. Infection = staphylococcus, hanta virus
99
Q

What is TINU?

A

Tubulointerstitial nephritis with uveitis, usually occurs in young females

100
Q

When do you start treating a hyperkalaemia?

A

If K+ > 6.5 mmol/l or if there are ECG changes

101
Q

What is the treatment for hyperkalaemia?

A
  1. Calcium gluconate 10% 10-20ml by slow IV injection titrated to ECG response
  2. Give 10 U Actrapid in 50 ml of 50% glucose over 10-15 minutes
  3. Consider use of nebulised salbutamol
  4. Consider correcting acidosis with sodium bicarbonate infusion
102
Q

What are 4 causes of rapidly progressive glomerulonephritis?

A
  1. Goodpasture’s
  2. GPA
  3. SLE
  4. MPA
103
Q

What electrolyte abnormality is likely to happen if 0.9% saline is used for fluid therapy in pts requiring large volumes?

A

Hyperchloraemic metabolic acidosis

104
Q

What are the NICE requirements for maintenance fluids?

A
  1. 25-30ml/kg/day water
  2. 1mmol/kg/day of K + Na + Cl
  3. 50-100g/day glucose to limit starvation ketosis
105
Q

What are 4 common post-op problems with kidney transplants?

A
  1. ATN of graft
  2. Vascular thrombosis
  3. Urine leakage
  4. UTI
106
Q

What may peri-ureteric fat on CT KUB indicate?

A

May indicate recent stone passage if a ureteric calculus is not present

107
Q

What opioid is safer to use in pts with moderate to end stage renal failure?

A

Oxycodone

108
Q

What test is done for all diabetic patients requiring screening for diabetic nephropathy?

A

Early morning albumin:creatinine ratio (ACR)

109
Q

What ACR is indicative of microalbuminuria?

A

ACR > 2.5

110
Q

What is the management of diabetic nephropathy?

A
  1. Conservative = dietary protein restriction, tight glycaemic control, BP < 130/80 mmHg
  2. Medical = ACEi, statin
  3. Surgical = transplant
111
Q

What is the gold standard investigation for bladder cancer?

A

Cystoscopy

112
Q

What is the most common cause of AIN?

A

Drugs account for 75% cases

113
Q

What is the most common cause of nephrotic syndrome in children?

A

Minimal change disease

114
Q

How can you reduce the risk of having contrast-induced nephropathy?

A

Volume expansion with IV 0.9% NaCl pre and post procedure

115
Q

How can you define contrast media nephrotoxicity?

A

25% increase in creatinine occurring within 3 days of IV administration of contrast media

116
Q

What is an example of an immunosuppression regime following a renal transplant?

A
  1. Initial = ciclosporin/tacrolimus with a monoclonal Ab
  2. Maintenance = ciclosporine/tacrolimus with MMF/sirolimus
  3. Add steroids if more than one steroid responsive acute rejection episode
117
Q

What is the MOA of ciclosporin?

A

Calcineurin inhibitor

118
Q

What is a s/e of tacrolimus?

A
  1. Impaired glucose tolerance and diabetes

2. Hyperlipidaemia

119
Q

What are 2 mABs that can be given after renal transplant?

A

Daclizumab and Basiliximab

120
Q

What is a cancer that renal pts are at increased risk of?

A

Squamous cell carcinomas

121
Q

How can you classify glomerulonephritis?

A

Proliferative vs. Non-proliferative

122
Q

What is a renal mechanism by which cirrhotic pts develop ascites?

A

They can develop a secondary hyperaldosteronism

123
Q

What GN is associated with SLE?

A

Membranous

124
Q

What are the thyroxine levels like in nephrotic syndrome and why?

A

Low thyroxine levels, due to loss of urinary loss of TBG leading to a low total T4 level, but normal free thyroxine levels

125
Q

What is the definition for severe hypokalaemia?

A

<2.5mmol/L

126
Q

How can you classify the causes of hypokalaemia?

A
  1. Increased potassium loss
  2. Trans-cellular shift
  3. Decreased potassium intake
  4. Magnesim depletion
127
Q

What are the causes of increased potassium loss?

A
  1. Drugs = diuretics, laxatives, glucocorticoids, Abx
  2. GI loss = diarrhoea, vomiting, ileostomy
  3. Renal loss = dialysis
  4. Endo = hyperaldosteronism, Cushing’s syndrome
128
Q

What are the trans-cellular shift causes of hypokalaemia?

A
  1. Insulin/glucose
  2. Salbutamol
  3. Theophylline
  4. Metabolic alkalosis
129
Q

What ECG changes are seen in Hypokalaemia?

A
  1. U waves
  2. T wave flattening
  3. ST segment changes
130
Q

How can you treat mild to moderate hypokalaemia?

A

Oral potassium provided the pt is not symptomatic and there are no ECG changes

131
Q

How do you manage severe hypokalaemia?

A

IV replacement

132
Q

What drug toxicity does hypokalaemia predispose pts to?

A

Digoxin toxicity

133
Q

What will kidneys look like on US with chronic diabetic nephropathy?

A

Bilateral large/normal sized kidneys, whilst pts with CKD usually have bilateral small kidneys

134
Q

What are 4 conditions in which you may see enlarged kidneys despite having CKD?

A
  1. APCKD
  2. DN
  3. Amyloidosis
  4. HIV-associated nephropathy
135
Q

What is the best way to differentiate between AKI and CKD?

A

Renal US

136
Q

What is Type I respiratory failure?

A

Hypoxia without hypercapnia

137
Q

What is Type II respiratory failure?

A

Hypoxia with hypercapnia

138
Q

What can be given to pts with troublesome gynaecomastia on spironolactone?

A

Eplerenone

139
Q

What are 5 indications for spironolactone?

A
  1. Ascites
  2. HTN
  3. HF
  4. Nephrotic syndrome
  5. Conn’s syndrome
140
Q

What is the most common cause of peritonitis secondary to peritoneal dialysis?

A

CoNS e.g. Staphylococcus epidermidis

141
Q

What are 2 complications of peritoneal dialysis?

A
  1. Peritonitis (S. epidermidis/aureus)

2. Sclerosing peritonitis

142
Q

What is the time taken for an AV fistula to develop?

A

6-8 weeks

143
Q

What are 4 complications of an AV fistula?

A
  1. Infection
  2. Thrombosis
  3. Stenosis
  4. Steal syndrome
144
Q

How might an AV fistula thrombosis present?

A

Absence of a bruit

145
Q

How might an AV fistula stenosis present?

A

Acute limb pain

146
Q

What syndrome presents with haemoptysis and haematuria?

A

Goodpasture’s syndrome

147
Q

What is the management of Goodpasture’s syndrome?

A
  1. Plasma exchange
  2. Steroids
  3. Cyclophosphamide
148
Q

What would cause a persistent pyuria with negative urine culture?

A

Renal TB

149
Q

What are the causes of sterile pyuria?

A 
AAABRUPT
APCKD
1. Appendicitis
2. Analgesic nephropathy
3. Bladder/renal cell carcinoma
4. Renal Stones
5. Urethritis e.g. chlamydia
6. Partially treated UTI
TB (renal TB)
150
Q

What do you see on EM of post-streptococcal GN?

A

Subepithelial ‘humps’

151
Q

What is a cause of an inappropriately low eGFR?

A

Large muscle mass secondary to body building

152
Q

What is the most commonly used equation for eGFR?

A

Modification of Diet in Renal Disease (MDRD) equation

153
Q

What variables does the MDRD take into account?

A 
CAGE
Serum creatinine
Age
Gender
Ethnicity
154
Q

What are factors which may affect eGFR?

A
  1. Pregnancy
  2. Muscle mass (amputees, body builders)
  3. Eating red meat 12 hours prior to the sample being taken
155
Q

What are the stages of CKD>

A
  1. > 90 ml/min
  2. 60-89 ml/min
    3a. 45-59 ml/min
    3b. 30-44 ml/min
  3. 30-45 ml/min
  4. <15 ml/min
156
Q

What is a blood marker that suggests that kidney disease is chronic rather than acute?

A

Hypocalcaemia

157
Q

What is the triad of Alport’s syndrome?

A

1, Renal failure

  1. Sensorineural hearing loss
  2. Ocular abnormalities
158
Q

What are the causes of HUS?

A
  1. E. coli 0157:H7
  2. Pneumococcal infection
  3. HIV
  4. Rare = SLE, cancer, drugs
159
Q

What is the management of HUS?

A
  1. Supportive = fluids
  2. Blood transfusion PRN
  3. Dialysis PRN
  4. Plasma exchange (if severe and there is no diarrhoea)
160
Q

What is a common complication of nephrotic syndrome?

A

High risk of VTE

161
Q

What is a complication of cyclophosphamide?

A

Haemorrhagic cystitis

162
Q

What GI symptom can occur as a part of HUS?

A

Diarrhoea which becomes bloody 1-3 days after its onset

163
Q

What is the main benefit of EPO injections for pts with CKD?

A

Improved exercise tolerance

164
Q

At what age is amyloidosis typically diagnosed?

A

50-65 y/o

165
Q

What are the most common presenting features of amyloidosis?

A

Breathlessness and weakness

166
Q

What are the causes of anaemia in renal failure?

A
  1. Reduced EPO
  2. Reduced iron absorption
  3. Anorexia/nausea due to uraemia
  4. Reduced RBC survival
  5. Stress ulceration leading to chronic blood loss
167
Q

How can you classify the causes of polyuria?

A

1 .Common >1/10

  1. Infrequent 1/100
  2. Rare 1/1000
  3. Very rare 1/10,000
168
Q

What are 4 common causes of polyuria?

A
  1. Diuretics, caffeine and alcohol
  2. DM
  3. Lithium
  4. HF
169
Q

What are 2 infrequent causes of polyuria?

A
  1. Hypercalcaemia

2. Hyperthyroidism

170
Q

What are 3 rare causes of polyuria?

A
  1. CKD
  2. Primary polydipsia
  3. Hypokalaemia
171
Q

What is a very rare cause of polyuria?

A

Diabetes Insipidus

172
Q

What are haptoglobin levels like in HUS?

A

Low as they bind haemoglobins

173
Q

What is the normal range for anion gap?

A

10-18

174
Q

What are the causes of high anion gap metabolic acidosis?

A

CAT MUDPILES

  1. Carbon monoxide, Cyanide, Congenital HF
  2. Aminoglycosides
  3. Theophylline, Toluene (glue sniffing)
  4. Methanol
  5. Uraemia
  6. DKA, Alcoholic KA, Starvation KA
  7. Paracetamol, Paraldeyhyde
  8. Iron, Isoniazid, IEM
  9. Lactic Acidosis
  10. Ethylene glycol
  11. Salicylates
175
Q

How can cranial DI be treated?

A

Desmopressin

176
Q

What else is required in addition to eGFR levels to diagnose CKD Stage 1 or 2?

A

Supporting evidence from urinalysis or renal US

177
Q

Which NSAID doesnt need to stop in AKI?

A

Aspirin as long as it is at a cardio-protective dose

178
Q

What are the causes of FSGS?

A
  1. Idiopathic
  2. HIV
  3. Heroin
  4. Alport’s syndrome
  5. Sickle Cell
  6. Secondary to other renal pathology e.g. IgA nephropathy, reflux nephropathy
179
Q

What are the numerical values for the classification of hyperkalaemia?

A
  1. Mild = 5.5-5.9 mmol/l
  2. Moderate = 6.0-6.4 mmol/l
  3. Severe = 6.5mmol/l
180
Q

What is the US diagnostic criteria for PCKD in pts with a positive FH?

A
  1. 2 cysts, uni/bilateral, <30 y/o
  2. 2 cysts, bilateral, 30-59 y/o
  3. 4 cysts, bilateral, >60 y/o
181
Q

What drug can be given to some pts with ADPKD to slow the progression of cyst development/

A

Tolvaptan

182
Q

What are two eyes signs that are associated with Alport’s syndrome?

A
  1. Lenticonus = protrusion of lens surface into the anterior chamber
  2. Retinitis pigmentosa
183
Q

What is the investigation of choice for reflux nephropathy?

A

Micturating cystography

184
Q

How many AKI stages are there?

A

3

185
Q

What are the 3 AKI stages?

A

1.

186
Q

What are the 2 drugs for treatment of HTN in CKD?

A

ACE inhibitors and add Furosemide when GFR <45ml/min

187
Q

What are the thresholds of acceptance for change in GFR and creatinine in pts with CKD who are started on an ACE inhibitor?

A
  1. Decrease in eGFR of up to 25%

2. Rise in creatinine of up to 30%

188
Q

What investigation is required in all pts presenting with an AKI of unknown origin?

A

Renal US

189
Q

What percentage of minimal change disease is steroid-responsive?

A

80%

190
Q

What is given to pts with minimal change disease the is steroid-resistant?

A

Cyclophosphamide

Medicine and Surgery Mushkies (52 decks)

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