Renal Flashcards
Where is PTH most likely to act
PCT as this is where the most renal phosphate reabsorption takes place
What are the 5Ps of tubulonephritis
Pain: Nsaids
Penicillin: antibiotics and associated rash
CycloPhoshamide
Pee: thiazide diuretics
PPI: omeprazole
RifamPicin
Definition of dialysis
Diffusion of particles across a semi-permeable membrane
What does dialyse provide
serum bicarbonate
What is peritoneal dialysis
Catheter sits in abdominal cavity and dialycate pumped into abdomen and solutes diffuse into peritoneal cavity and fluid emptied and new fluid inserted
What is hemodilaysis
Blood pumped into tube with smaller tubes bathed in dialycate which gets rid of the substances and puts it back into body
What pressure is used in hemodialysis
hydrostatic
What pressure is used in peritoneal dialysis
osmotic to pull fluid across peritoneal membrane
What toxins are removed through dialysis
Urea and creatinine
Potassium
Sodium
Where is the bladders lymphatic drainage to
External and internal illiac nodes
When does post-streptococcal glomerularnephritis present
7-14 days afrer infection typically URTI
Which nerves for the bladder receive parasymp innervation from
Pelvic Splanchnic nerves
Which nerves do the bladder receive symp innervation from
hypogastric plexus
What are the superior and inferior vesical arteries a branch of
Internal illiac
Treatment for hypercalcemia
Rehydration, bisphosphonates
Why does alcohol cause polyuria
Alcohol leads to ADH suppression in posterior pituitary so polyuria
What are the key features of nephrotic syndrome
Oedema, proteinuria, hypercholestermia, hypoalbuminia
What does nephrotic syndrome lead to
Hypervolaemic hyponatraemia
Kidney transplantation rejection is what type of hypersensitivity?
Type 2
What does tall tented t waves suggest
Hyperkalemia
What is the histopathological sign of goodpastures
cresent formation
What is the definitive management of minimal change glorerulonephritis: nephrotic syndrome in kids
12 weeks course of pred
What would GPA show on histology
Investigation with renal biopsy will show epithelial crescents in Bowman’s capsule
What are red cell cast seen in
Nephritic syndrome
What are brown cell casts seen in
Acute tubular necrosis
What is minimal change disease
Most common cause of nephrotic syndrome in children. Shortening of podocyte processes cannot be seen on light microscopy
What drugs classically cause acute interstitial nephritis
PPIs eg omeprazole
What chromosome abnormality is autosomal dominant polycystic kidney disease found on
Chromosome 16
What is the trigone of the bladder formed of
two ureteric orifices and the internal urethral orifice
Spiralactone is a ___ anatogonist
Aldosterone
Which diuretic can be used for renal stones
Bendroflumethiazide as it causes calcium excretion
What drugs should be stopped in AKI
NSAIDS, aminoglycaside antibiotics (gent), ACEi, ARBs, diuretics
What do horseshoe kidneys become trapped under in their ascent
Inferior mesenteric artery so remain low in abdomen
What can myeloma lead to
AKI
What is myeloma
Cancer of plasma cells (B lymphocytes) so excessive clonal production of immunoglobulins these can accumulate in bone marrow or soft tissue. impairment of production of normal blood cells leads to anaemia.
In relation to what rib do the kidneys lie
11th rib -> beware of pneumothorax during nephrectomy
What structures does the right kidney make direct contact with
Right suprarenal gland
Duodenum
Colon
What does the left kidney make direct contact with
Left suprarenal gland
Pancreas
Colon
What is posterior to the right kidney
Quadratus lumborum, diaphragm, psoas major, transversus abdominis
What is Anterior to the right kidney
Hepatic flexure of colon
What is superior to the right kidney
Liver, adrenal gland
What is posterior to the left kidney
Quadratus lumborum, diaphragm, psoas major, transversus abdominis
What is anterior to the left kidney
Stomach, pancreatic tail
What is superior to the left kidney
Spleen, adrenal gland
goodpastures is what sensitivity
Type 2
At what level does the renal artery branch of the abdominal aorta
L2
Congo red stain showing apple green birefringence under polarised light is
Amyloidosis
What is amyloidosis
Disorder of extracellular deposits of misfolded protein.
What lobe is usually enlarged in BPH
Median lobe sometimes lateral
what is the mode of inheritance of alports
Xlinked dominant
What is eGPA associated with
P-ANCA
What is the classic presentation of acute interstitial nephritis
non-oliguric acute renal failure associated with the hypersensitivity triad (rash, raised eoisinophillia, fever) and nephrotic syndrome induced by drug therapy eg NSAIDs
What medication can cause an isolated rise in creatinine
Trimepothrin
What are the risk factors for renal cell carcinoma
Smoking, obesity, hypertension
What secretes AFP
Non-seminomatous germ cell tumours: embryonal carcinomas, yolk sac tumour or teratoma
What do seminomas secrete
Lactate dehyrogenase
First line pharmocotherapy for urge incontinence
Anti-muscarinics eg oxybutynin
What is the diagnostic test for a STI
Nucleic acid amplification test
What organism causes peritoneal dialysis peritonitis
Staph epi
First line treatment for priapism
Aspiration and irrigation with saline,
Link between nephrotic syndrome and DVT
Nephrotic syndrome leads to loss of proteins in the urine and anticoagulants such as prothrombin 3 leading to hypercoagulability
What renal stones are often genetic
Cystine- autosomal recessive pattern
Treatment for minimal change disease
12 weeks of prednisolone
What is the most common cause of focal segmental glomerulosclerosis
HIV
Glomerulosclerosis leads to mesangial collapse and sclerosis of the basement membrane
What is a common electrolyte abnormality in CKD
Hyperklaemia- Acidosis increases the plasma potassium concentration by inducing a net shift of potassium from the intracellular to the extracellular compartment in exchange for hydrogen.
Where is the lymphatic drainage from the scrotum and distal anus
Superficial inguinal
What structures drain into the internal illiac lymph nodes
Prostate, corpus cavernosum, bladder and rectum (above dentate line)
What drains into the external illiac
Superior bladder
What drains into the inguinal lymph nodes
Glans penis and anterior urethra
What type of testicular cancer is common in those with undescended testes
Seminoma
What do seminomas secrete
LDH
What should you think in a left sided varicocele
Renal cancer- due to venous congestion of the left testicle.
First line treatment in testicular cancer
Radial Orchidectomy
What is treatment for suspected epidymorchitis
intramuscular ceftriaxone (single dose)
Doxycycline
Ofloxacin
Criteria for CKD
<60ml/min GFR +-symptoms for three months or more
Side effect of thiazide diuretic
Hypokalemia
What can be used in recurrent renal calculi
Thiazide diuretics as increases calcium reabsorption