QUEEFMED Flashcards
87 year old woman
Nitrites +++
Leucocytes +++
Confused + fell over
Urinary tract infection
Nitrites + leucocytes = infection
Confusion + falls = indicator of infection in geriatric population
Renal transplantation contraindications
Active infections
Cancer
Severe co-morbidity
(poor prognosis so transplant organ could benefit someone else more)
Pathophysiology of nephrotic syndrome
Cytokines damage podocytes causing them to fuse together and destroy charge of the glomerular basement membrane.
This allows increased permeability to plasma proteins. This causes massive protein loss in the urine.
UTI + onset of the fever, shakes and cold sweats and back pain after a few days
Acute pyelonephritis
Which cardiac medication should be withheld with AKI?
ACE inhibitors !!
(can cause reduced renal perfusion)
Why does rhabdomyolysis cause AKI?
Muscle breakdown produces myoglobin which is extremely toxic to the glomerulus
Peripheral oedema in a young child
Probably nephrotic syndrome
Management of thyroid storm
- High dose carbimazole
- β-blockers (propranolol)
- Potassium iodide
- Hydrocortisone
- IV fluids +/- inotropes
- Treat precipitating cause e.g. MI, infection, PE
- Rapid deterioration of hyperthyroidism with hyperpyrexia, severe tachycardia, extreme restlessness, cardiac failure and liver dysfunction
- Typically seen in hyperthyroid patient with an acute infection/illness or recent thyroid surgery
Thyroid storm
Rhabdomyolysis + ventricular tachycardia
What is the cause?
Hyperkalaemia
Blood abnormalities caused by rhabdomyolysis
Myoglobin + potassium increase
Major waste product of protein metabolism in the liver ?
Urea
Bodybuilder, high urea
What is the cause?
Protein supplements
Alport’s syndrome gene defect
Both copies of COL4A3 and COL4A4
Type IV collagen, alpha 3 subunit
X-linked dominant
Polycystic kidney disease investigation
Abdominal ultrasound
