Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Finals Revision > Renal > Flashcards

Renal Flashcards

1
Q

What is the classic triad of symptoms for renal cell carcinoma?

A

Haematuria
Flank pain
Palpable mass

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are risk factors for renal cell carcinoma?

A

Smoking, obesity, age
End-stage renal disease
Tuberous sclerosis, von Hippel Lindau syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is the most common histology of renal cell carcinoma?

A

Clear cell carcinoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are paraneoplastic syndromes associated with renal cell carcinoma?

A

Hypercalcaemia
Polycythaemia
Hypertension
Varicocele in men

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is the classic radiological feature of renal cell carcinoma metastasis?

A

Cannonball mets in the lungs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is the gold standard test for renal cell carcinoma?

A

Contrast-enhanced CT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are the complications of renal transplant?

A 
Rejection
Failure of transplant
Electrolyte imbalance
Recurrence of disease
Ureter blockage/leakage of anastomosis
Infection + effect of immunosuppressant medication
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are the complications of immunosuppressant therapy post-transplant?

A 
Infection
IHD
T2DM
Non-Hodgkin Lymphoma
Skin cancer
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are pre-renal causes of AKI?

A

Hypovolemia - blood loss / dehydration
Hypotension - heart failure, shock
Sepsis
Renal artery obstruction / stenosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are renal causes of AKI?

A

Nephrotoxic medication
Glomerulonephritis
Interstitial nephritis
Acute tubular necrosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are post-renal causes of AKI?

A 
Renal/ ureteric calculi
Ureteric stricture / blockage
Tumour compression / internal tumours
Enlarged prostate
VUJ dysfunction
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

How would you approach a patient with suspected AKI?

A

A-E assessment
Full set of obs
Prescription review
Bloods: FBC, U&E, CRP, LFT, Cultures if septic
Urinalysis: dip for blood, protein, infection
MSU -> MC+S to look for casts, cells and organisms
USS urinary tract -> CTKUB

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are the complications of AKI?

A 
Hyperkalaemia
Hyper-uraemia -> encephalopathy, pericarditis
Fluid overload -> pulmonary oedema
Metabolic acidosis
Interstitial damage
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are the causes of CKD?

A 
Diabetes
Hypertension
Long term use of nephrotoxic medication
PKD, Glomerulonephritis
Childhood renal disease

Medication: NSAIDs and lithium most commonly

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are the symptoms of CKD?

A 
Often asymptomatic
Fluid overload + oedema
Nausea, Pruritus, loss of appetite
Pallor
Hypertension
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What investigations can be done for CKD?

A
  1. A-E + full set of obs
  2. Bloods: FBC, U&E, CRP, bone profile, LFT, HbA1c
  3. Urine: albumin: creatinine ratio, blood (A:Cr >3 = significant)
  4. Renal USS

For diagnosis, need eGFR <60 or proteinuria

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

How is CKD managed?

A
  1. Fluid restriction
  2. Sodium restriction
  3. Glycaemic control
    SGLT2 inhibitor eg. dapagliflozin should be given
  4. BP control: ACE-I -> diltiazem
  5. Atorvastatin
  6. RRT
  7. Dialysis

Treat complications

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What are the complications of CKD?

A
  1. Renal anaemia
  2. Secondary hyperparathyroidism
  3. Metabolic acidosis
  4. Hyperkalaemia
  5. CVD
  6. Pulmonary Oedema
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is the treatment for renal anaemia?

A
  1. Treat any iron deficiency
  2. If Hb very low, transfuse (but avoid regular transfusion due to risk of sensitisation)
  3. Erythropoietin
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What are the features of renal bone disease?

A

Osteomalacia, osteoporosis, osteosclerosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is the pathophysiology of secondary hyperparathyroidism?

A

Reduced phosphate excretion, increased serum levels
Reduced activation of vitamin D by the kidneys -> reduced calcium absorption from gut
In response to low calcium and high phosphate, increased PTH release
PTH stimulates osteoclast activity to resorb bone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What is the management for secondary hyperparathyroidism?

A 
Low phosphate diet
Activated vitamin D supplementation: alfacalcidol, calcitriol
Bisphosphonates for bone protection
Calcium carbonate
Phosphate binder e.g. calcium acetate
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What are the indications for dialysis?

A

AEIOU

A: Acidosis- severe, refractory metabolic acidosis
E: Electrolyte abnormality: Severe, refractory hyprekalaemia
I: Intoxication- ingestion of certain toxins
O: Oedema - severe, treatment resistant pulmonary oedema
U: Uraemia- High urea causing encephalopathy or pericarditis

End stage renal failure with anuria

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What are the two most common types of AV fistula?

A

Radiocephalic

Brachiocephalic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

How long before an AV fistula is mature and ready to use?

A

4w-4m

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What are the complications of AV fistulae?

A 
Infection
Aneurysm formation
Thrombosis
Stenosis
STEAL syndrome: ischaemia to distal limb
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What is nephrotic syndrome?

A

Group of symptoms characterised by:
significant proteinuria, oedema and low serum albumin

You also get high cholesterol production to compensate for the loss in albumin

28
Q

What are important complications of nephrotic syndrome?

A

High cholesterol
Loss of antithrombin III - increased risk of clotting
Loss of immunoglobulins- increased risk of infection
Hypertension
Fluid overload -> heart strain

29
Q

What is nephritic syndrome?

A

Characterised by group of symptoms:
haematuria, low grade proteinuria, oliguria

Hypertension and oedema also occur as a result of fluid retention

30
Q

What are common causes of nephrotic syndrome?

A 
Minimal change disease
FSGS
Membranous nephropathy
Diabetic nephropathy
Severe membranoproliferazive GN
31
Q

What are common causes of nephritic syndrome?

A 
IgA nephropathy
Post-streptococcal GN
Membranoproliferative GN
Goodpasture syndrome
Alport syndrome
Small vessel vasculitis: GPA, EGPA, MPA, HSP
RPGN
32
Q

What is the most common cause of nephrotic syndrome in children?

A

Minimal change disease

33
Q

What is the diagnostic test for minimal change disease?

A

Renal biopsy and electron microscopy - loss of podocyte foot processes

34
Q

How is minimal change disease managed?

A

Tapering course of prednisolone over 4-16w

35
Q

What is the most common cause of nephrotic syndrome in adults?

A

Focal segmental glomerulosclerosis

36
Q

What is seen on biopsy in FSGS?

A

Focal areas of glomerular scarring

37
Q

How is FSGS managed?

A

ACE-I / ARB + other BP control
Steroids
Plasma exchange in recurrent disease

38
Q

What is seen on biopsy in membranous nephropathy?

A

IgG and complement deposits in the glomerular basement membrane

39
Q

How is membranous nephropathy managed?

A

ACE-I / ARB and BP control

Immunosuppressants in severe disease

40
Q

What are the general symptoms of nephrotic syndrome?

A

Oedema, breathlessness, frothy urine, increased clotting, fatigue

41
Q

What investigations should be done in suspected nephrotic syndrome?

A

Bloods: FBC, U+E, LFT (low albumin), clotting, lipids
Urine dip: proteinuria
MSU: A:Cr ratio
Renal USS and biopsy -> microscopy

42
Q

What is the general management in nephrotic syndrome?

A

Fluid and salt restriction, daily weights
Loop diuretics + thiazide if insufficient response
ACE-I/ARB and BP control
Glycaemic control
Statin
VTE prophylaxis
Steroids/immunosuppressants in more severe disease

43
Q

What are the classic symptoms of IgA nephropathy?

A

Microscopic haematuria with episode of macroscopic following: respiratory/GI infection, strenuous exercise

Discernable from post-strep as occurs DURING/days after infection rather than weeks

44
Q

How is IgA nephropathy diagnosed?

A

Elevated serum IgA
Low serum C3
Mesangial proliferation
IgA deposits in the mesangium

45
Q

Which vasculitis has identical findings on renal biopsy to IgA nephropathy?

A

HSP

- discernible by systemic symptoms in HSP

46
Q

How is IgA nephropathy treated?

A

ACE-I / ARB

Steroids if persisting >6m

47
Q

What is the characteristic presentation of post-strep GN?

A

Macroscopic haematuria presenting weeks post strep infection - most commonly throat or skin infection
-> 1-2 w post pharyngitis/tonsilitis
-> 3-4w post skin infection
Caused by group A B-haemolytic strep

Also present with oedema, HTN

48
Q

What is the hypersensitivity type of post-strep GN?

A

Type 3

49
Q

What is found on investigation in post-strep GN?

A
  1. Low serum C3
  2. Anti-strep antibodies
  3. Complement and IgG deposits in GBM and mesangium
50
Q

How is post-strep GN managed?

A

Supportive treatment- fluid restrict, diuretics, ACE-I

Antibiotics if any remaining infection

51
Q

What is goodpasture’s syndrome?

A

Anti-GBM syndrome- antibodies against type 4 collagen

Causes haemoptysis and nephritic syndrome

52
Q

How is goodpasture’s syndrome diagnosed?

A

Symptoms of haemoptysis + haematuria
Presence of anti-GBM/type 4 collagen antibodies in circulation and in the mesangium on renal biopsy
Pulmonary infiltrates on CXR
Iron deficiency anaemia

Usually presents with RPGN

53
Q

How is goodpasture’s syndrome managed?

A
  1. Plasma exchange
  2. Steroids + cyclophosphamide

+ other nephritic syndrome managements

54
Q

What is Alport’s syndrome?

A

X-linked condition: most commonly dominant but can be recessive
Mutation in gene encoding type 4 collagen

Leads to sensorineural hearing loss, loss of vision, haematuria and oedema
Often leads to end-stage renal disease

No specific treatment

55
Q

Which small vessel vasculitis most commonly cause nephritic syndrome?

A

GPA and EGPA

GPA: nasal crusting/nasopharyngeal involvement + haemoptysis + haematuria + Purpura
C-ANCA

EGPA: brittle asthma/eosinophilia + haematuria + purpura
P-ANCA

56
Q

What is rapidly progressing GN?

A

Rapid decline in renal function due to any form of nephritic syndrome
Can case ESRD within a matter of weeks-months
Characterised by cresents on renal biopsy
Usually requires plasma exchange and immunosuppression

57
Q

How does nephritic syndrome most commonly present?

A

Haematuria, proteinuria, hypertension, oedema and oliguria

Proteinuria is far less prominent than in nephrotic syndrome

58
Q

How would you investigate somebody presenting with nephritic syndrome?

A 
Bloods: FBC, U&E, LFT, CRP
              Immunoglobulins, complement, ANCA + antibody screen
Urine dip: haematuria, protein
MSU: A:CR ratio, granular casts in some
Renal USS + biopsy
59
Q

What is the generic management of nephritic syndrome?

A

ACE-I and BP control
Low sodium diet and fluid restriction
Diuretics if severe oedema
Sometimes immunosuppression/plasma exchange

60
Q

In what condition would you expect waxy urinary casts?

A

Advanced CKD

61
Q

In what condition would you expect RBC casts in the urine?

A

Nephritic syndrome / glomerulonephritis

62
Q

In which conditions would you expect epithelial cell casts in the urine?

A

Glomerulonephritis

Nephrotic syndrome

63
Q

In which condition would you expect WBC casts in the urine?

A

Pyelonephritis

64
Q

In which condition would you expect granular/muddy brown casts in the urine?

A

Acute tubular necrosis

65
Q

In which condition would you expect fatty casts in the urine?

A

Nephrotic syndrome

Finals Revision (23 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions