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OBS and gynae > renal > Flashcards

renal Flashcards

1
Q

what is stage 1 AKI

A

creatinine 1.5x of baseline and urine output is less than 0.5ml/kg in 6 hours

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2
Q

what is stage 2 AKI

A

creatinine 2x of baseline and urine output is less than 0.5ml/kg in 12 hours

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3
Q

what is stage 3 AKI

A

creatinine 3x of baseline and urine output is less than 0.5ml/kg in 24 hours

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4
Q

What are the pre-renal causes of AKI

A

shock: distributive, cardiogenic, hypovolaemic and renal artery stenosis

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5
Q

What are the renal causes of AKI

A

acute glomerulonephritis, interstitial nephritis

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6
Q

Post-renal causes of AKI

A

mural: tumours, luminal: stones and compression: BPH

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7
Q

Fractional excretion is normal

A

pre-renal cause of AKI

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8
Q

fractional excretion is elevated

A

renal cause of AKI

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9
Q

treatment for post renal AKI

A

catheterise

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10
Q

first line management for AKI

A

sit patient up and give furosemide and diamorphine

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11
Q

ECG findings for hypokalaemia

A

QT prolongation, PR prolongation, t wave inversion and st depression

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12
Q

ECG findings for hyperkalaemia

A

PR prolongation, small p waves and tall tented t waves, wide QRS complexes

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13
Q

which electrolyte abnormality can be caused by deep hypothermia

A

hypokalaemia

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14
Q

hypovolaemic, hyponatraemic and abnormal renal function tests

A

diarrhoea

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15
Q

pt in shock, hypernatraemic and needed ABCDE. resp compromise what is the maintenance

A

IV crystalloid bolus, if not enough give 2000ml of fluid resus

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16
Q

pt is shock, hypernatraemic but did not need ABCDE what is the maintenance

A

IV maintenance fluids

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17
Q

high potassium, with fist pumping, delayed analysis or excessive tourniquet use

A

pseudohyperkalaemia

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18
Q

treatment for hypokalaemia severe

A

IV potassium chloride and treat low magnesium and low glucose

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19
Q

treatment for hypokalaemia mild

A

oral release potassium

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20
Q

treatment for hyperkalaemia

A

10% calcium gluconate solution, 10ml over 10mins, insulin, salbutamol and glucose

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21
Q

Can you give potassium as a bolus dose

A

no it can cause arrythmias

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22
Q

patient presents with:
osteopenia, cardiovascular defects, oedema, electrolyte abnormalities, anaemia, leg restlessness and sensory neuropathy

A

chronic end stage kidney disease

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23
Q

patient with chronic kidney disease presents with egfr of 25

A

stage 4

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24
Q

patient with chronic kidney disease presents with egfr of 45

A

stage 3a

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25
Q

patient with chronic kidney disease presents with egfr of 69

A

stage 2

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26
Q

patient with chronic kidney disease presents with egfr of 78

A

stage 2

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27
Q

treatment for chronic kidney disease: oedema

A

fluid and salt restrict and furosemide

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28
Q

treatment for chronic kidney disease: hypocalcaemia

A

alphacalciferol

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29
Q

treatment for chronic kidney disease: hyperphosphatemia

A

selvemer

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30
Q

treatment for chronic kidney disease: anaemia

A

monthly subcutaneous erythropoetin injections

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31
Q

constant abdominal pain, early satiety and hepatomegaly

A

autosomal dominant polycystic kidney disease

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32
Q

abdominal mass, flank pain and painless haematuria in a 3 year old

A

wilm’s nephroblastoma

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33
Q

investigation if there is no obvious cause of AKI

A

renal ultrasound

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34
Q

first line treatment with CKD in a patient is polycystic kidney disease

A

tolvaptan: vasopressin receptor 2 antagonist

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35
Q

which is more abrupt: nephrotic or nephritic

A

nephritic

36
Q

which has HTN nephrotic or nephritic

A

nephritic

37
Q

which has proteinuria nephrotic or nephritic

A

nephrotic

38
Q

which has red cell casts in urine nephrotic or nephritic

A

nephritic

39
Q

which has oliguria nephrotic or nephritic

A

nephritic

40
Q

which has hypoalbuminaemia nephrotic or nephritic

A

nephrotic

41
Q

which has more oedema nephrotic or nephritic

A

nephrotic

42
Q

example of a nephritic

A

IgA nephropathy, goodpasstures syndrome

43
Q

example of a nephrotic

A

glomerulonephritis

44
Q

which glomerulonephritis is associated with SLE

A

membranous glomerulonephritis

45
Q

difference in renal ultrasound between; diabetic nephropathy and chronic kidney disease

A

former has bilaterally enlarged kidney while latter than shrunken

46
Q

when would you seem hyaline casts in the urine

A

loop diuretics like furosemide

47
Q

holliday seager formula

A

to calculate the maintainence dose for IV fluids in young adults

48
Q

frank haematuria after a respiratory tract infection

A

nephritic: IgA nephropathy

49
Q

most common viral infection in solid organ transplant recipients

A

CMV

50
Q

with severe vomiting, what is the chloride

A

hypercholraemic

51
Q

with severe vomiting, what is the potassium

A

hypokalaemic

52
Q

raised creatinine kinase, raised potassium and immobility and AKI

A

rhabdomyolysis

53
Q

which bipolar medication can cause polyuria

A

lithium

54
Q

potassium in AKI

A

hyperkalaemia

55
Q

if there is hypocalcaemia is it AKI or CKD

A

CKD

56
Q

when should metformin be stopped according to egfr rate

A

less than 30

57
Q

when should we be cautious with metformin associated with HbA1c levels

A

less than 45mmol/L

58
Q

target and treatment for blood pressure in pt with type 2 diabetes and chronic kidney disease

A

130/80 and ACEi like ramipril

59
Q

who would you see with minimal change disease

A

normotensive children, no renal histological cnahges and no blood in urine

60
Q

renal failure, ocular abnormalities and sensorineural hearing loss

A

alport syndrome?

61
Q

thrombocytopaenia and normoncytic anaemia following a diarrhoeal illness

A

haemolyic uraemic syndrome

62
Q

Urine investigation to confirm the diagnosis of CKD

A

urine albumin:creatinine ratio is more than 3

63
Q

fluid requirement for potassium mmol/kg/day

A

1mmol.kg/day

64
Q

abdo pain, arthritis, purpuric rash and preceding respiratory illness

A

Henoch-Schonlein purpura

65
Q

how can you tell if a condition is pre-renal based on osmolality

A

more than 500mOsm/kg

66
Q

which medication can cause hyperkalemia:

allopurinol
ramipril
amlodopine
propanol

A

ramipril

67
Q

which SSRI can cause hyponatraemia

A

sertraline

68
Q

Which conditions can cause a normal anion gap with metabolic acidosis

A

Addisons disease, Bicarb loss, Chloride, Drugs

69
Q

Which conditions can cause a metabolic acidosis with an raised anion gap

A

lactic acidosis and aspirin overdose

70
Q

how do we diagnose acute tubular necrosis

A

urinary sodium more than 40

71
Q

brown granular casts in urine

A

acute tubular necrosis

72
Q

sodium and urine:creatinine ratio in pre-renal AKI

A

low urinary sodium, and high urea:creatinine ratio

73
Q

biopsy finds podocyte effacement on biopsy

A

consistent with the diagnosis of minimal change disease

74
Q

mesangial expansion found on biopsy

A

diabetic nephropathy

75
Q

eosinophillic casts in urine

A

tubulointersitial nephritis. penicillin can cause this, fever, eosinophilia and rash

76
Q

side effect of amytriptylline

A

urinary retention

77
Q

side effect of verampril

A

headache, dizziness and peripheral oedema

78
Q

diagnosis of CKD using egfr

A

Repeat eGFR of <60 at three months

79
Q

which type of dialysis is needed everyday

A

peritoneal

80
Q

dialysis that needs good renal function

A

peritoneal

81
Q

dialysis that is more commonly used

A

haemolysis

82
Q

dialysis that is more commonly used

A

haemolysis

83
Q

side effect of amiodarone

A

thyrotoxicosis, increase in T4 not T3

84
Q

men type 1

A

pituitary tumours and pancreatic tumours

85
Q

men type 2

A

phaechromocytoma

86
Q

difference between conservative treatment for urge and stress incontinence

A

stress: pelvic floor training
urge: bladder retraining

OBS and gynae (17 decks)

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