renal

Question 1

what is nephrogenic diabetes insipidus

Answer 1

insensitvity to ADH

Question 2

treatment of diabetes insipidus

Answer 2

desmopressin can be used to treat central diabetes insipidus
correct hypernatraemia

Question 3

stage 2 CKD

Answer 3

kidney damage with mild drop in GFR (60-89)

Question 4

stage 3 CKD

Answer 4

moderate drop in GFR (30-59)

Question 5

stage 4 CKD

Answer 5

severe drop (15-59)
needs kidney transplant

Question 6

stage 5 CKD

Answer 6

<15 GFR

Question 7

complications of CKD

Answer 7

anaemia 
metabolic acidosis 
CVD 
hypertension 
gout 
renal bone disease 
hyperkalaemia

Question 8

renal bone disease pathogenesis

Answer 8

high serum phosphate 
low plasma calcium 
secondary hyperparaathyroidism 
acidosis 
management is to reduce phosphate

Question 9

management of CKD

Answer 9

treat reversible causes
decrease CV risk- antiplatelets and statins
diet- high calorie and normal protein
slow progression- ACEi/ARB

Question 10

diet when on haemodialysis

Answer 10

fluid restriction and low salt/phosphate/potassium

Question 11

graft rejection presentation

Answer 11

within 6 months
fever
flank pain
rigor

Question 12

drugs to avoid in renal failure

Answer 12

tetracycline, nitrofurantoin
NSAIDs
lithium
metformin

Question 13

investigations for renal artery stenosis

Answer 13

renal US
duplex US
CT angiography

Question 14

prostatitis management

Answer 14

Ofloxacin 200mg bd or Ciprofloxacin 500mg bd. If high risk CDI: Trimethoprim 200mg bd (all 28 days)

Question 15

Abdominal distension and suprapubic tenderness on a background of prostatic hyperplasia

Answer 15

acute urinary retention

Question 16

most common cause of acute urinary retention in men

Answer 16

BPH

Question 17

presentation of acute urinary retention

Answer 17

Inability to pass urine
Lower abdominal discomfort
Considerable pain or distress
an acute confusional state may also be present in elderly patients
Palpable distended urinary bladder either on an abdominal or rectal exam
Lower abdominal tenderness

Question 18

investigation for acute urinary retention

Answer 18

bladder US to diagnose

urinalysis, bloods etc

Question 19

management of acute urinary retention

Answer 19

decompression of bladder by urinary catheterisation

Question 20

what indicated a bladder washouts

Answer 20

moderate or severe haematuria

Question 21

nephrotic picture with history of IVDU

Answer 21

focal segmental glomerulosclerosis

Question 22

first line investigation in suspected prostate cancer

Answer 22

multiparametric MRI

Question 23

Urinary incontinence in a man with a history of gonorrhoea

Answer 23

urinary stricture

Question 24

investigation for kidney stones

Answer 24

non-contrast KUB

Question 25

type of drug is tamsulosin

Answer 25

alpha-1 antagonist | - promote relaxation of bladder and prostate

Question 26

catheter used in long term urinary retention

Answer 26

intermittent self-catherterisation

Question 27

low urea:creatinine ration

Answer 27

SIADH, rhabdomylosis, renal damage

Question 28

high urea:creatinine ratio

Answer 28

dehydration, steroids, high protein diet or pre-renal failure

Question 29

linear immunofluorescence

Answer 29

goodpastures

Question 30

splitting of basement membrane

Answer 30

alports- hereditary

Question 31

management of dry ARMD

Answer 31

Avoid smoking Control blood pressure Vitamin supplementation has some evidence in slowing progression- zinc with anti-oxidant vitamins A,C and E

Question 32

management of wet ARMD

Answer 32

Anti-VEGF medications | ranibizumab, bevacizumab and pegaptanib

Question 33

important thing to measure in HHS

Answer 33

serum osmolality

Question 34

most common type of prostate cancer

Answer 34

adenocarcinoma

Question 35

most common cause of erectile dysfunction

Answer 35

vascular cause | hypertension, hyperlipidaemia, diabetes mellitus, smoking, and major pelvic surgery

Question 36

Homonymous hemianopia with macula sparing

Answer 36

lesion of occipital cortex

Question 37

Hypercalcaemia, renal failure, high total protein

Answer 37

multiple myeloma

Question 38

CKD with extremely high PTH and raised calcium

Answer 38

tertiary hyperparathyroid

Question 39

type 1 renal tubular acidosis

Answer 39

pathology in distal tubule- unable to excrete hydrogens

Question 40

causes of renal tubular acidosis type 1

Answer 40

``` genetic SLE sjogren's PBC hyperthyroidism sickle cell anaemia marfans ```

Question 41

presentation of renal tubular acidosis type 1

Answer 41

failure to thrive hyperventilation CKD bone disase

Question 42

treatment of renal tubular acidosis type 1

Answer 42

bicarbonate

Question 43

most common type of renal tubular acidosis

Answer 43

type 4

Question 44

cause of renal tubular acidosis type 4

Answer 44

adrenal insufficiency ACEi and spironolactone SLE, HIV, diabetes

Question 45

management of renal tubular acidosis type 4

Answer 45

fludrocortisone | sodium bicarbonate and treat hyperkalaemia

Question 46

AKI rash fever eosinophilia

Answer 46

acute interstitial nephritis

Question 47

management of acute interstitial nephritis

Answer 47

steroids | treat underlying