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2 Renal > Presentation of Kidney Disease > Flashcards

Presentation of Kidney Disease Flashcards

1
Q

name the 2 types of haematuria found in renal patients

A

microscopic

macroscopic

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2
Q

where is pain in the kidney usually felt?

A

loin

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3
Q

what conditions can present with uraemia?

A

pericarditis
encephalopathy
neuropathy
gastritis

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4
Q

what is the main electrolyte imbalance found in renal disease?

A

hyperkalaemia

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5
Q

main complication of hyperkalaemia?

A

arrhythmia

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6
Q

what acid base imbalance is most commonly found in renal disease?

A

metabolic acidosis

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7
Q

what happens if erythropoeitin is not made?

A

patient will get anaemia (no rbc’s made)

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8
Q

give examples of drugs that can be toxic to the kidneys

A 
digoxin
gabapentin
gentamicin
ACEi
ARB
NSAIDs
diuretics
PPIs
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9
Q

what techniques will be used to accompany kidney examination?

A

BP

urinalysis

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10
Q

how is GFR estimated?

A

biochemical screening

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11
Q

what dermatological symptoms are important in nephrology?

A

recent skin rash

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12
Q

what MSK symptoms are important in nephrology?

A

joint pain
bone pain
arthralgia

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13
Q

what GI symptoms are relevant to nephrology?

A

dyspepsia
nausea/vomiting
anorexia

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14
Q

what effect can oedema have on the kidney?

A

decreased pressure within the glomerulus -> decreased renal function

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15
Q

what effect can trimethoprim have on patients with CKD’s creatinine levels?

A

will rise

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16
Q

what signs on examination would suggest loss of kidney function?

A 
pallor
arrhythmia
pericardial rub
lung creps
raised JVP
oedema
gout
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17
Q

pericardial rub is caused by what problem with the kidneys?

A

uraemia

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18
Q

renal disease is a risk factor for gout T or F?

A

T

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19
Q

hypertension is classed as a BP of…

A

> 140/90

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20
Q

accelerated hypertension is not an emergency T or F

A

F

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21
Q

what is the diastolic BP in accelerated hypertension?

A

> !20mmHg

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22
Q

what retinal symptoms will a patient with accelerated hypertension present with?

A

papilloedema

23
Q

why are splinter haemorrhages important in renal?

A

allude to bacterial endocarditis or vasculitis which can both cause renal disease (eso glomerulonephritis)

24
Q

symptoms of henoch schonlein purpura?

A

abdo pain
joint pains
acute kidney injury

25
Q

what colour is urine in rhabdomyolysis

A

due to acute muscle damage causing myoglobin release

26
Q

what findings on urinalysis would indicate a UTI?

A

leukocytes
blood
nitrites

27
Q

presence of nitrites indicates…

A

bacteria

28
Q

normal 24hr urine collection?

A

<150mg/24hr

29
Q

normal urine protein/creatinine ratio?

A

0.5g/24hr

30
Q

what weight of protein per day would be classed as heavy proteinuria?

A

1-3g/day

31
Q

what type of urinary cast is indicative of chronic disease?

A

granular

32
Q

what urinary cast is usually benign?

A

hyaline

33
Q

red cell urinary casts indicate what problem?

A

nephritic syndrome

34
Q

what urinary cast indicates inflammation?

A

leukocyte

35
Q

what does rhabdomyolysis do to the kidneys?

A

causes acute kidney injury

36
Q

hyperkalaemia presentation on ECG?

A

tall T waves
broadened QRS
flat p waves
bradycardia

37
Q

normal K+ level?

A

5

38
Q

Tx of hyperkalaemia

A
  1. IV calcium gluconate
  2. actrapid + glucose
  3. salbutamol
39
Q

what test is the best overall measure of kidney function?

A

GFR

40
Q

what levels indicate severe GFR in ml/min

A

15-29

41
Q

kidney failure has what GFR level?

A

<15ml/min

42
Q

the higher the GFR, the less likely there is kidney disease T or F

A

T

43
Q

define acute kidney injury

A

decline in GFR over hours/days/weeks +/- oliguria

44
Q

name the 3 main components of nephrotic syndrome?

A

proteinuria >3g/day
hypoalbuminaemia
oedema

45
Q

why dont you get periorbital oedema in heart failure?

A

patients cant lie flat

46
Q

what is renal function like in nephrotic syndrome?

A

normal

47
Q

you cant get periorbital oedema in nephrotic syndrome?

A

F, you can because you can lie flat

48
Q

symptoms of nephritic syndrome?

A 
acute kidney injury
oligura
oedema
hypertension
positive urinalysis (blood, protein)
49
Q

what tests need to be done before a renal biopsy is carried out and why?

A

FBC - any thrombocytopaenia?
coagulation screen- clotting problems?
renal USS- size/position of kidneys

50
Q

contraindications to renal biopsy? why?

A 
small kidneys (inc bleeding risk)
uncontrolled HT (bleeding risk)
untreated UTI (bleeding risk)
51
Q

what dose of prednisolone is given for minimal change nephropathy?

A

40-60mg

52
Q

in patients <45, isolated haematuria is most likely to be from…

A

the kidneys

53
Q

in patients >45, isolated haematuria is most likely to be from…

A

the bladder

2 Renal (34 decks)

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