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MRCP > Renal > Flashcards

Renal Flashcards

1
Q

62M BG of HTN
Cr 280
Urine Blood ++ Protein 1.8g
US kidneys L 8.5cm R 8.9cm (b/l small)

Ix?

A

renal biopsy

for ? glomerulonephritis

NB if no blood or urine then angiogram for ?renovascular disease

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2
Q

Aspirin OD
Salicylate 1100

Rx?

A

Haemodialysis (FASTER than haemofiltration)

do dialysis when salicylate >700 or severe metabolic acidosis

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3
Q

Thiazide diuretics act on?

A

proximal convoluted tubule

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4
Q

Loop diuretics acts on

A

ascending Loop of Henle

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5
Q

Spironolactone acts on

A

DCT

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6
Q

14M
dark urine 2 weeks after sore throat

what do you see on renal biopsy?

A

Humps in the subepitheilal space on electron microscopy

post-streptococcal glomerulonephritis (GN)

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7
Q

Cystinuria, cystinosis, urate uropathy and hyperoxaluria

inheritance

A

AR

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8
Q

Idiopathic hypercalciuria (causes stones) inheritance

A

AD

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9
Q

Headaches
Hypertensive retinopathy associated with visual disturbances
Seizures
Heart failure and pulmonary oedema.

A

malignant HTN

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10
Q

Scleroderma renal crisis Rx

A

ACEi

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11
Q

16F ankle swelling 4 days post sore throat

Cr 90
Albumin 25
24hr urine protein 9

Dx?

Rx?

A

IgA nephropathy

Give Prenisolone (as nephrotic range proteinura >3g/day)

if <3g/day = ACEi
if just haematuria = conservative Mx

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12
Q

IgA nephropathy

nephrotic or nephritic?

A

BOTH

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13
Q

% IgA nephropathy with ESRF in 10 years

A

25%

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14
Q

Ig resposible for acute kidney rejection associated with anti-HLA Abs

A

IgG

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15
Q

16F
Father had ADPCKD

What Ix for her?
Why?

A

geneticist

US better at picking up in >20s

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16
Q

Cirrhosis +SBP

What will prevent hepatorenal syndrome?

A

IV Albumin

+ABx

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17
Q

Commonest type renal calculi

A

calcium oxalate

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18
Q

Stones that are radiolucent on XR

A

uric acid

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19
Q

HIV med causing acute renal impairment

A

Tenofovir

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20
Q

untreated granulomatosis with polyangiitis

Ab?

A

cANCA = antiproteinase 3

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21
Q

ANCA associated with which gastro condition

A

UC

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22
Q

sinusitis/epistaxis
glomerulonephritis
small vessel vasculitis

Dx?
Ab?

A

Granulomatosis with polyangiitis

cANCA/ antiproteinase 3

23
Q

Rx for SIADH

A

Demeclocycline

ADH blocker

24
Q

On LT doxycycline for acne
polydipsia, polyuria and nocturia

Dx?

A

nephrogenic diabetes insipidus

from doxycyline

25
Q

cinacalcet moa

A

calcimimetic

used in 2 hyperparathyroidism in CKD
low Ca, high PTH
stops more PTH release

26
Q

Imaging to identify renal scarring after childhood UTIs

A

Renal DMSA scan

27
Q

Kimmelstiel-Wilson stain for

A

Diabetic nephropathy

shows nodular glomerulosclerosis

28
Q

patient on dialysis for 5 years

carpal tunnel
bilateral shoulder pain

Cause?

A

B2 microglobulin amyloidosis

29
Q

worsening renal function haemoptysis
purpuric rash on lower limbs
MPO ANCA positive

A

Microscopic polyangiitis

30
Q

most common and severe form of lupus nephritis

A

Diffuse proliferative glomerulonephritis

31
Q

Started on amoxicillin

rapid AKI

rash

eosinophilia

Cause?

A

interstitial nephritis

32
Q

Drugs causing interstitial nephritis

A

amoxicillin

NSAIDs

33
Q

antiproteinase 3/cANCA

AKI

pulmonary haemorrhage

epistaxis/sinusitis

A

Granulomatosis with polyangiitis

34
Q

how to distinguish prerenal cause and ATN

A

Urine sodium concentration is typically above 30 mmol/L

fractional excretion of sodium distinguishes ATN from pre-renal diseases as a cause of AKI

35
Q

pANCA present in

A

UC and CD

36
Q

Start diuretic

develop hearing loss, tinnitus and vertigo

which diuretic?

A

furosemide

thiazide diuretics can -> OTOTOXICITY

37
Q

Focal segmental glomerulosclerosis Rx

A

Steroids

if dont respond then steroids

38
Q

IgA nephropathy Rx if:

haematuria only

> 3g/day proteinuria

<3g/day proteinuria

to control BP

A

haematuria - conservative Rx

> 3g/day proteinuria - steorids

<3g/day proteinuria - ACEi

to control BP- ACEi

39
Q

Nephrotic syndrome

membranous nephropathy (adult)

Rx?

A

Methylpred + cyclophosphamide

40
Q

64M

12h pleuritic CP

no murmurs, JVP normal
bibasal creps

ECG ST elevation all leads

Urea 44 Cr 746 K 5.2

Rx?

A

Haemodialysis

ECG - pericarditis ?2 to uraemia

41
Q

new HTN

after 20 wks gestation

no proteinuria

A

gestational HTN

42
Q

new HTN

sig proteinuria

AFTER 20 wk gestation

A

Pre-eclampsia

43
Q

HTN present before 20 wks gestation or pt on anti HTN

no proteinuria

A

chronic HTN

44
Q

chronic HTN

significant proteinuria

16 wks gestation (BEFORE 20 wks gestation)

A

secondary HTN

?2 to renal disease

NB if occurs at >20 wks then = preeclampsia

45
Q

Erythropoeitin SE

A

HTN

can lead to seizures

46
Q

First line Rx systemic sclerosis hypertensive crisis

A

ACEi

47
Q

Sx malignant HTN

A

Headaches
Hypertensive retinopathy associated with visual disturbances
Seizures
Heart failure and pulmonary oedema.

48
Q

electrolyte abnormality in rhabdomyolysis

why?

A

low Ca

as Ca bound to damaged muscle (lost)

49
Q

nephrotic syndrome

ADULTS
membranous nephropathy

Rx

A

oedema - low salt + diuretic

HTN + stop proteinuria - ACEi

Sx of nephrotic syndrome (oedema) = PREDNISOLONE + CYCLOPHOSPHAMIDE

50
Q

PCKD assocaited with what heart abnormality

A

Mitral valve prolapse

51
Q

Cirrhosis

what can you give to prevent hepatorenal syndrome?

A

IV albumin

52
Q

gastroenteritis
then

acute renal failure

microangiopathic haemolytic anaemia

thrombocytopenia with normal clotting

Dx?
Ix?

A

HUS

BLOOD FILM (MAHA)

53
Q

HUS vs TTP

A

TTP get HUS triad + neuro problems + fever

54
Q

70F

painless haematuria

started on IM authoramine + ibuprofen

First line Ix?

A

cystoscopy (rule out bladder Ca first)

could then also stop NSAID (cause of interstitial nephritis -> haematuria)

MRCP (12 decks)

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