Presentation of renal disease.

Question 1

Asymptomatic presentation of renal disease? (4)

Answer 1

Microscopic heamaturia
Asymptomatic proteinuria
abnormal eGFR
High BP

Question 2

Define and list causes (2) of asymptomatic proteinuria:

Answer 2

Normal - 150mg /24hrs
Abnormal - A:Cr >3.
Cause - glomerular disease or tubular disease

Question 3

List urinary symptoms (4)

Answer 3

Dysuria - associated with urgency, frequency, nocturia. cause = UTI, prostate disease.
Macroscopic heamaturia = Malignancy, glomerular disease, anti-GBM disease, PKD.
Loin pain = pyelonephritis, renal infarct, renal stone
Nephrotic syndrome = proteinuria, hypoalbuminaemia, peripheral oedema

Question 4

List 6 symptoms of CKD?

Answer 4

Weight loss
Bone pain
Pruritis
Cognitive decline 
Sex dysfunction
SOB

Question 5

Metabolic conditions with kidney involvement (3)

Answer 5

sickle cell disease
tuberous sclerosis
fabry disease

Question 6

Infections with kidney involvement (5)

Answer 6

sepsis 
malaria
TB 
chronic hepatitis
HIV

Question 7

Autoimmune conditions with kidney involvement (5)

Answer 7

vasculitis (ANCA associated)
SLE
Henoch-schonlein purpura
systemic sclerosis
sarcoidosis

Question 8

Drugs with kidney involvement (4)

Answer 8

NSAID
ACEi
Aminoglycosides
chemotherapy

Question 9

Pregnancy conditions with kidney involvement (2)

Answer 9

Pre-eclampsia

obstruction.

Question 10

Findings on urine dipstick and causes (6)

Answer 10

Proteinuria = glomerulonephritis, DM, amyloidosis, myeloma, high BP. 
Heamaturia = Malignancy, IgA nephropathy, PKD
Glucose = DM, pregnancy, sepsis
Ketones = Starvation, DKA. 
Leucocytes = UTI, vaginal discharge. 
Nitrites = UTI.

Question 11

Microalbuminaemia causes (3)

Answer 11

Early glomerular disease
DM
High BP.

Question 12

False positives of proteinuria

Answer 12

Heart failure
Fever
post-exercise.

Question 13

Heamaturia Ix

Answer 13

Malignancy = cystoscopy + CT abdomen and pelvis
BP
eGFR

Question 14

Urine microscopy

Answer 14

RBCs - bleeding from GU or glomerulus.
WBCs - UTI, glomerulonephritis, malignancy
Casts: Red cells - glomerular inflammation, White cells - pyelonephritis/ glomerulonephritis, Granular - CKD.
Crystals: uric acid or calcium oxalate.