renal Flashcards
causes of raised anion gap metabolic acidosis
lactate: shock, sepsis, hypoxia
ketones: DKA, alcohol
urate: renal failure
acid poisoning: salicylates, menthol
causes of normal anion gap metabolic acidosis
GI bicarb loss: diarrhoea, fistula
renal tubular acidosis
Addison’s disease
causes of metabolic alkalosis
vomiting diuretics hyperaldosteronism hypokalaemia Cushing's CAH
causes of respiratory alkalosis
hyperventilation due to:
- anxiety
- pain
- hypoxia
- acute lung insult, e.g. PE
causes of respiratory acidosis
hypoventilation due to:
- COPD, severe asthma
- sedative drugs
- CNS depression
drugs to stop in AKI
DAAAMN
Diuretics Aminoglycosides ACE inhibitors ARBs Metformin NSAIDs
IgA nephropathy vs post-streptococcus glomerulonephritis
IgA nephropathy occurs 2-3 days after URTI
post-strep occurs 2-3 weeks after URTI
extra-renal features of autosomal dominant polycystic kidney disease
liver cysts - most common extra-renal feature, cause hepatomegaly
berry aneurysms - rupture leads to SAH
mitral valve prolapse
most common causative organism of peritonitis in patients who receive peritoneal dialysis
Staphlycoccus epidermidis is most common
Staph aureus is another cause
how does lithium cause diabetes insipidus
lithium desensitises the kidney’s ability to respond to ADH in the collecting ducts
rate of potassium administration
peripheral line - should not exceed 10 mmol/hr
central line - should not exceed 20mmol/hr, need continuous cardiac monitoring
TCC of bladder vs RCC
TCC of bladder - painless visible haematuria
RCC - haematuria, loin pain, abdominal mass
cANCA is found in…
features of what it is found in…
Wegeners granulomatosis (granulomatosis with polyangitis) features: chronic sinusitis, epistaxis haemoptysis crescenteric glomerulonephritis
complication of nephrotic syndrome
hyper coagulable state due to loss of anti thrombin III
this can lead to VTE or renal vein thrombosis
what should be done before commencing EPO in anaemia in CKD
check iron studies first
metabolic adverse effects of thiazides diuretics
hyponatraemia
hypokalaemia
hypercalcaemia
features of Goodpasture’s syndrome
pulmonary haemorrhage -> haemoptysis
rapidly progressive glomerulonephritis -> proteinurea and haematuria
which type of glomerulonephritis can HIV cause
focal segmental glomerulosclerosis
acute tubular necrosis vs acute interstitial nephritis
ATN - BROWN, muddy urinary casts, unresolving renal dysfunction despite fluid therapy. Causes include shock and sepsis, and nephrotoxins. Urine osmolality >350
AIN - often drug-induced (NSAIDs), sterile pyuria with WHITE casts, does not occur until 4-7 days after commencing drugs
renal pathology associated with SLE
nephrotic syndrome - membranous glomerulonephritis
found by low T4
daily glucose requirement
50-100 g/day irrespective of the patient’s weight
eGFR variables - CAGE
Creatinine, Age, Gender, Ethnicity
which condition may be found by significant renal impairment after starting ACEi
bilateral renal artery stenosis
cause of AKI most likely in sepsis
renal hypoperfusion
rhabdomyolysis vs hypovolaemia causing AKI
rhabdomyolysis CK is >10000
urine osmolality and sodium in pre-renal AKI
osmolality >500
sodium low
because, body thinks it does not have enough fluid therefore increases aldosterone and ADH meaning little sodium is lost to urine
how to differentiate between primary vs secondary aldosteronism
look at renin - high renin means a secondary cause, e.g. renal artery stenosis
low renin means a primary cause, e.g. bilateral adrenal hyperplasia
indications for haemodialysis in AKI
pulmonary oedema
hyperkalaemia
uraemia
acidosis
ix for nephrotic syndrome
renal biopsy
causative organism in peritonitis secondary to peritoneal dialysis
Staph epidermidis
what to do if a person suffers gynaecomastia on spironolactone
switch to Eplerenone
