Renal

Question 1

what do loop diuretics inhibit?

Answer 1

Na/K/2Cl in ascending limb

Question 2

what do thiazide diuretics inhibit?

Answer 2

NaCl co-transporter in DCT

Question 3

renal causes of haematuria

Answer 3

congenital (PCK)
trauma
infection (pyelo)
neoplasm
immune (GN)

Question 4

extra-renal causes of haematuria

Answer 4

trauma (stones, catheter)
infection (cystitis, prostatitis)
neoplasm (bladder, prostate)
drugs (NSAIDs)

Question 5

commonest causes of proteinuria

Answer 5

DM
minimal change
amyloidosis
SLE

Question 6

other causes of proteinuria

Answer 6

HTN
ATN
UTI

Question 7

WBC casts

Answer 7

glomerular haematuria

Question 8

WBC casts

Answer 8

interstitial nephrotos

Question 9

tubular casts

Answer 9

ATN

Question 10

causes of isolated increase in urea

Answer 10

decrease flow
e.g. hypoperfusion, dehydration

Question 11

causes of rise in urea and creatinine

Answer 11

decrease filtration e.g. renal failure

Question 12

glomerulonephritis causes

Answer 12

idiopathic
immune (SLE, Goodpasture’s, vasculitis)
infection (HBV, HCV, Strep, HIV)
Drugs (gold, penicillamine)
Amyloid

Question 13

causes of nephritic syndrome

Answer 13

post-strep
RPGN (anti-GBM, immune complex, pauci immune)

Question 14

causes of nephrotic syndrome

Answer 14

minimal change
membranous
FSGS
Membranoproliferative

Question 15

RIFLE classification of AKI
Stage 1

Answer 15

creatinine increase x1.5
dec GFR >25%
UO < 0.5ml/kg/h x6h

Question 16

RIFLE classification of AKI
Stage 2

Answer 16

creatinine increase x2
dec GFR >50%
UO < 0.5ml/kg/h x12h

Question 17

RIFLE classification of AKI
Stage 3

Answer 17

creatinine increase x3
dec GFR >75%
UO < 0.3ml/kg/h x24h or anuria x 12hr

Question 18

what is acute interstitial nephritis? causes?

Answer 18

immune-mediated hypersensitivity
causes:
- drug hypersensitivty (NSAIDs, ABx)
- infection
- immune disorder

Question 19

by what stage is chronic renal failure symptomatic?

Answer 19

4

Question 20

stage 1 CRF GFR

Answer 20

> 90

Question 21

Stage 2 CRF GFR

Answer 21

60-89

Question 22

Stage 3a CRF GFR

Answer 22

45-59

Question 23

Stage 3b CRF GFR

Answer 23

30-44

Question 24

Stage 4 CRF GFR

Answer 24

16-29

Question 25

Stage 5 CRF GFR

Answer 25

<15

Question 26

bone changes in renal disease

Answer 26

renal osteodystrophy
osteoporosis
osteomalacia
secondary/tertiary hyperPTH = osteitis fibrosa cystica

Question 27

normal target BP and target BP in DM

Answer 27

<140/90
<130/80 ifDM

Question 28

differentials for rising Cr in transplant

Answer 28

rejection
obstruction
ATN
drug toxicity

Question 29

genes mutated in AD PCKD

Answer 29

PKD1 or PKD2

Question 30

presentation of PCKD

Answer 30

abdo/flank mass
stones
haematuria
berry aneurysms
polyuria/nocturia
extra-renal cysts = liver
systolic murmur: mitral valve prolapse

Question 31

management of PCKD

Answer 31

general: inc water intake, monitor U&Es/BP, genetic counselling
MRA for berry aneurysms
Medical: HTN + infection
ESRF - need dialysis/transplant

Question 32

renal enlargement differentials

Answer 32

PCKD
Obstruction (hydro)
Occlusion (Renal vein thrombosis)
Neoplasia (RCC, myeloma, amyloid)
Systemic (early DM, amyloid)