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RENAL FINALS > Passmedicine Knowledge > Flashcards

Passmedicine Knowledge Flashcards

1
Q

Definition and Management of Severe Hyperkalaemia

A 
>6.5 or <6.5 with ECG changes
IV calcium gluconates
Insulin/Dextrose Infusion
Stop Exacerbating drugs
Treat underlying cause
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2
Q

Blood Gas Pattern of Salicylate Poisoning

A

Raised Anion Gap Metabolic Acidosis4

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3
Q

Mx of cranial and nephrogenic DI

A

Cranial: Desmopressin

Nephrogenic: Diuretics/Low salt + protein diet

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4
Q

How is anaemia treated in CKD

A

Oral Iron

Then Erythropoetin

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5
Q

Side effects of erythropoetin

A

Hypertension
Flu like symptoms
Encephalopathy
Pure red cell aplasia

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6
Q

Stages of AKI

A

Stage 1:

1.5-1.9x baseline creatinine
Creatinine rise of 26.5 in 48 hours or >50% in 7 days
<0.5ml/kg/hr urine for 6 hours

Stage 2:

2-2.9x baseline creatinine
<0.5mls/kg/hr for 12 hrs

Stage 3
>3x baseline
Creatinine at 353.6
<0.3mls/kg/hr for >24 hrs

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7
Q

Most common viral pathogen in solid organ transplants and its management

A

Cytomegalovirus

Ganicociclovir

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8
Q

CKD staging

A

1: >90 with signs of kidney damage on other tests
2: 60-90 with signs of kidney damage on other tests
3a: 45-59
3b: 30-44
4: 15-29
5: <15

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9
Q

Maintenance fluids requirements

A

25-30mls/kg/day water
1mmol/kg/day potassium
50-100g/day of glucose

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10
Q

Maintenance Fluids in a child

A

100mls/kg first 10kg
50mls/kg second 10 kg
20mls/kg after that

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11
Q

What is renal cell TCC associated with

A

Exposure to dyes etc
Smoking
Rubber manufacturing
Cyclophosphamide

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12
Q

Which renal stones are opaque

A

Calcium phosphate
Calcium oxalate
Triple Phosphate
Mixed calcium oxalate/phosphate

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13
Q

Which renal stones are radio lucent

A

Xanthine

Urate

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14
Q

Which renal stones are semi opaque “ground glass” appearance

A

Cystine

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15
Q

Where do the majority of varicoceles occurs

A

left side

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16
Q

mx of renal stones

A

<5mm: Expectant
<2cm or not passed within 48 hours: Lithotripsy
<2cm pregnant: Ureteroscopy
Complex or staghorn: Percutaneous nephrolithotomy

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17
Q

Symptoms of TURP syndrome

A

Hypoatraemia and agitation after resection of the prostate

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18
Q

Ix and Mx of testicular cancer

A

US first line

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19
Q

Adult with hydrocele management

A

Referral as this is a RF for cancer

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20
Q

When should PSA testing not be done

A

6 weeks afer biopsy
4 weeks after proven UTI
1 week after rectal exam
48 hrs after exercise or ejaculation

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21
Q

Epididymo orchitis causes

A

<35 or v sexually active: Chlamydia

>35 or low sexual risk: E.Coli

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22
Q

Bladder Cancer Mx

A

Superficial lesions: TURBT
High recurrence risk: Intravesical Chemo
T2 or more: Radical cystectomy

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23
Q

How long does an AV fistula take to become ready for use

A

6-8 weeks

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24
Q

Features of acute interstitial nephritis

A

Sterile pyuria

White cell casts

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25
Q

Peristent pyuria?

A

Renal TB

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26
Q

1st line ix for prostate cancer

A

MRI

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27
Q

Nephritic Syndrome Definition

A

Haematuria
Oliguria
Proteinuria <3g/24hrs
Fluid Retention

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28
Q

Nephrotic Syndrome Definition

A

peripheral oedema
Proteinuria >3g/24 hours
Serum Albumin <25g/L
Hypercholesterolaemia

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29
Q

Most common cause of peritonitis secondary to peritoneal dialysis

A

Staph Epidermidis

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30
Q

Salicyate poisoning blood gas pattern

A

Raised anion gap metabolic acidosis

31
Q

Triad in HUS

A

AKI
Microangiopathic Haemolytic Anaemia
Thrombocytopenia

32
Q

What is a normal anion gap

A

6-16

33
Q

Nephrotic Syndrome in HIV and IVDU

A

Focal Segmental Glomerulosclerosis

34
Q

Definition of high pressure and low pressure chronic urinary retention

A

High Pressure: W/ assoc hydronephrosis or renal impairment

Low Pressure: W/ no renal impairment or hydronephrosis

35
Q

Most common cause of death on haemodialysis

A

Ischaemic heart disease.

36
Q

Risk factors for testicular cancer

A

Cryptorchitis
Infertility
Mumps orchitis
Klinefelters.

37
Q

Follow up for Vasectomy

A

sperm count at 16 and 20 weeks. Use barrier methods until azoospermia is confirmed.

38
Q

What are staghorn calculi made of and what is the most common organism

A

Struvite, proteus mirabalis

39
Q

Normal fluid challenge and fluid challenge in heart failure

A

500 mls Normal saline STAT

HF: 250 mls normal saline STAT

40
Q

Risk of radiotherapy for prostate cancer

A

Bladder colon and rectal cancer.

41
Q

Side effects of erythropoetin

A

Flu like symptoms
Rash
Bone aches

42
Q

Aetiology and Management of hyperacute graft rejection

A

Preexisting HLA or AB antigens, in minutes/hours

Removal of graft

43
Q

Aetiology and Management of Acute graft rejection

A

Mismatched HLA, <6 months

Steroids and Immunosuppressants

44
Q

mx of renal cell carcinomoa

A

<7cm partial nephrectomy
>7cm total nephrectomy
Interferon A and IL2 used to shrink lesions and for mets.

45
Q

Renal cell carcinoma does not become symptomatic until what stage

A

Stage 4

46
Q

Most common type of renal stone

A

Calcium oxalate

47
Q

When should ACEI’s be started in diabetic nephropathy and what is the target BP

A

Urinary ACR >3

<130/80

48
Q

What kind of cancer is varicoceles associated with

A

RCC

49
Q

What is important when prescribing a goserelin analogue for prostate cancer

A

Anti androgen treatment (Cyproterone) to prevent tumour flare.

50
Q

What type of testicular cancer has raised AFP and HCG

A

Teratomas.

51
Q

Indication for haemodialysis in AKI

A

Hyperkalaemia
Pulmonary Oedema
Acidosis
Uraemia

with no response to medical treatment.

52
Q

Best Ix for hydronephrosis

A

US

53
Q

Normal Post Void Volumes in <65 and >65

A 
<65 = 50mls
>65 = 100mls
54
Q

Management of hydroceles

A

Infants: Surgical removal if nor resolution within 1 yr
Adults: Conservative but investigate for testicular cancer.

55
Q

How does lithium cause nephrogenic DI

How do genetics cause nephrogenic DI

A

Desensitisation of Kindey response to ADH.

Common: Defect in Desmopresin receptors,
Less common: Defect in aquaporin 2 receptors.

56
Q

Suspected bladder cancer but cystoscopy was normal?

A

Renal tract US

57
Q

RF for SCC of the bladder

A

Schistosomiasis

Smoking

58
Q

AKI after starting an ACE?

Common finding?

A

Fibromuscular dysplasia

String of beads appearance

59
Q

Pelvic fracture and displaced prostate?

A

Membranous urethral rupture

60
Q

Pelvic fracture, no passing urine and lower abdo peritonism

A

Bladder rupture

61
Q

What is the most common US finding on CKD patients and what are the exceptions?

A

Bilaterally shrunk kidneys

Exceptions (Enlarged kidneys):

  • ADPKD
  • Diabetic Nephropathy
  • Amyloidosis
  • HIV associated nephropathy.
62
Q

When should CKD patients be referred from primary care

A

EGFR <30 or drop by 15 in one year.

63
Q

Prostatitis Mx

A

Quinolone (ciprofloxacin) for 14 days.

64
Q

Most common form of prostate cancer

A

Adenocarcinoma

65
Q

Normal urinary findings in acute graft failure

A

Rise in creatinine
Pyuria
Proteinuria

66
Q

Mx of prostate cancer

What does hormonal therapy involve

A

T1/2: Radical prostatectomy or Radiotherapy. Conservative if patient is palliative

T3/4: Hormonal therapy or radical prostatectomy or radiotherapy

Hormonal Therapy:

GNRH analogues
Non Steroidal Anti Androgens (Bicalutamide)
Cyproterone acetate (Androgen receptor blocker)

67
Q

Side effect of radical prostatectomy

A

ED

68
Q

What kind of testicular cancer has a better prognosis

A

Seminomas

69
Q

Acute prostatitis in a young man requires what additional Ix

A

STI screening

70
Q

Haematuria post Catheterisation

A

Normal

71
Q

Hyaline Casts?

A

Furosemide

72
Q

Extrarenal Manifestations in ADPKD

A

Hepatomegaly/Cysts (most common)

Berry aneurysms leading to SAH

73
Q

Findings on Renal Biopsy in minimal change disease

A

Podocyte fusion and effacement of foot processes on electron microscopy

RENAL FINALS (3 decks)

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