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Medicine (Y4) > Renal > Flashcards

Renal Flashcards

1
Q

raised anion gap metabolic acidosis suggests…

A

Salicyclate poisoning

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2
Q

Patients receiving large volumes of NaCl solution are at increased risk of which metabolic derangement?

A

Hyperchloraemic metabolic acidosis

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3
Q

What is the recommended maintenance fluid requirement per day?

A

25-30 ml/kg/day

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4
Q

What is the normal expected urine output?

A

0.5ml/kg/hr

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5
Q

Give common symptoms of CKD.

A

Fatigue, itch, N&V, oedema

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6
Q

What is the main cause of death in CKD?

A

Cardiovascular disease

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7
Q

How can you predict the risk of a patient developing ESRD?

A

Kidney Failure Risk Equation

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8
Q

What are the top 3 causes of CKD?

A

Diabetes, Hypertension, PKD

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9
Q

What are the mainstays of CKD treatment?

A

BP management, reducing CV risk, managing complications

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10
Q

What are the BP targets in CKD?

A

< 140/90 in CKD ACR < 70

< 130/80 in CKD + Diabetes or ACR > 70

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11
Q

How should CV risk be managed in CKD?

A

Atorvastatin 20mg

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12
Q

What is the Hb target in CKD?

A

100 - 120

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13
Q

How should renal anaemia be managed in CKD?

A

Replace Iron/B12/Folate then give EPO if still anaemic

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14
Q

What dietary advice should be given in CKD?

A

K+ restriction → vegetables, potatoes, chocolate, crisps

Diary restriction → milk, cheese, eggs are high in phosphate

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15
Q

What are the options in ESRD?

A

Supportive
Haemodialysis/ Peritoneal dialysis
Kidney transplantation

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16
Q

What are the options in ESRD?

A

Supportive
Haemodialysis/ Peritoneal dialysis
Kidney transplantation

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17
Q

Which medications are usually given after kidney transplantation?

A

tri-therapy of steroid, calcineurin inhibitor (eg. tacrolimus), anti-proliferative (eg. mycophenolate)

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18
Q

How can you differentiate between AKI and CKD?

A

CKD - readings should be taken at least 90 days apart

On USS, kidneys will likely be normal in AKI but small & scarred in CKD

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19
Q

What is meant by a stage 1 AKI?

A

Cr 1.5-1.9 times baseline or < 0.5mls/kg/hr for 6-12 hours

20
Q

What is meant by a stage 2 AKI?

A

Cr 2-2.9 times baseline or < 0.5mls/kg/hr for > 12 hours

21
Q

What is meant by a stage 3 AKI?

A

Cr > 3 times baseline or < 0.3mls/kg/hr > 24 hours or anuric > 12 hours

22
Q

What are the 3 main groups of causes of AKI?

A

Pre-renal, renal, post-renal

23
Q

Give pre-renal causes of AKI.

A

Usually due to hypotension - volume loss or redistribution eg. haemorrhage, vomiting, sepsis or decreased cardiac output

24
Q

Give renal causes of AKI.

A

Acute tubular necrosis, Acute interstitial nephritis, vasculitis, GN, myeloma, coagulopathy

25
Q

How can you test for renal AKI?

A

Urinalysis

26
Q

Give post-renal causes of AKI.

A

Obstruction of the urinary tract or a major vessel

27
Q

What investigation should be used if considering post-renal causes of AKI?

A

USS

28
Q

What is the management of AKI?

A

Mainly supportive (fluids, K monitoring, stop nephrotoxics) and identify cause

29
Q

Give indications for urgent dialysis.

A

Resistant hyperkalaemia
Pulmonary oedema
Uraemic pericarditis
Severe acidosis

30
Q

White cell casts in urine suggest…

A

Acute interstitial nephritis

31
Q

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

A

Focal segmental glomerulosclerosis (FSGS) or membranous glomerulopathy

32
Q

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

A

Minimal change disease

33
Q

‘Muddy brown casts’ in urine suggests…

A

Acute tubular necrosis

34
Q

What is Alport Syndrome?

A

X-linked dominant disease - progressive renal failure, SNHL and retinitis pigmentosa

35
Q

What is the most common viral infection in solid organ transplant recipients?

A

CMV

36
Q

Nephritic syndrome days after UTRI suggests…

A

IgA nephropathy

37
Q

Which type of GN does not respond to steroids?

A

FSGS

38
Q

Nephritic syndrome weeks after URTI suggests…

A

Post-streptococcal GN

39
Q

Give differentials of crescenteric GN.

A

GPA, EGPA, Goodpasture’s syndrome

40
Q

Which metabolic derangement may result from excess of NaCl fluid?

A

Hyperchloraemic acidosis

41
Q

Which ECG finding is suggestive of hypocalcaemia?

A

Prolonged QT interval

42
Q

Which ECG finding is suggestive of hypercalcaemia?

A

Short QT interval

43
Q

Vasculitis + collapse of nasal bridge suggests…

A

GPA

44
Q

Nephrotic syndrome + malignancy suggests…

A

Membranous nephropathy

45
Q

CKD with large kidneys suggests…

A

HIV nephropathy

46
Q

What is the prognosis for HSP with renal involvement?

A

2/3 make full recovery

47
Q

What is the treatment for HUS?

A

Supportive

Medicine (Y4) (13 decks)

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