Renal Flashcards
1
Q
aki serum reatinien needs to increase by
A
25.4 or 50%
2
Q
common causes of acute tubular necrosis
A
sepsis and severe dehydration
3
Q
uo criteria for AKI
A
1 <0.5 for greater than 6 hours
2 <0.5 for greater than 12 hours
3 <0.3 for greater than 24 hours or anuria for 12 hours
4
Q
what makes you consider myeloma
A
elderly AKI +bone pain + hypokalaemia + anaemia
5
Q
investigations for myeloma
A
protein electrophoresis and BJB
6
Q
what not to give for pre- renal treatment
A
dextrose- give crystalloid or colloid
7
Q
all these drugs are what: aminoglycosides, acei, arbs, bisphosphonates, calcineurin inhibitors, diuretics, lithium, mesalazine, NSAIDs
A
nephrotoxic
8
Q
if has no makers of kidney transplant then to be CKD needs to have eGFR of less than
A
60
9
Q
what can be classes as accelerated CKD
A
persistent decrease in eGFR by 25% or more and change in CKD category in 12 months
or
persistent decrease in eGFR of 15 within 12 months
10
Q
hypertension aim for CKD
A
140/90
11
Q
hypertension aim for CKD with diabetes
A
130/80
12
Q
what can be used for prevention of CKD
A
atorvastatin
13
Q
ckd can cause
A
metabolic acidosis
14
Q
what is main mineral that should be restricted in renal mineral and bone disorder
A
phosphate
15
Q
what drugs can cause hyperkalaemia
A
aldosterone antagonists
ace I
arbs
nsaids
potassium supplements
16
Q
treatment of hyperkalaemia
A
insulin and dextrose infusion and IV calcium gluconate
17
Q
what is the most dangerous breakdown product in rhabdomyolysis
A
k
18
Q
management for rhabdomylosis
A
Iv fluids
19
Q
does amyloidosis and diabetic nephropahty can have nephritic or nephrotic
A
nephrotic
20
Q
does SLE/HSP have nephrotic or nephritic
A
mixed
21
Q
which syndrome causes acute renal failure
A
nephritic
22
Q
cancer that often cause glomerulonephritis
A
lymphomas
23
Q
damage to what cells results in vascultiits
A
endothelial
24
Q
proliferative vs non proliferative referes to presence or absence of
A
mesangial cells
25
what syndrome is non proliferative
nephrotic
26
linear igG
goodpastures
27
minimal change has what syndrome
nephrotic
28
second line in minimal change
29
second line in minimal change
cyclophosphamide
30
focal segmental is what syndrome
nephrotic
31
2nd most common nephrotic syndrome in adults
membranous
32
anti PLA2r antibody
membranous
33
thickened basement membrane and spike on silver stain
membranous
34
rituximab is the treatment for
membranous nephropathy
35
what has mixed nephrotic and nephritic
membranoproliferative
36
hyeprcellular glomeruli with thick membranes - tram tracks
mebranoproliferativce
37
what is nephritic
IgA nephropathy
38
related to mesangial cells and mesangium
IgA
39
tretamtne for IgA
acei, arb
40
what is a treatable cause of acute renal failure
rapidly progressive glomerulonephritis
41
urine of rapidly progressive glomerulonephritis shows
active urinary sediment
42
what has a deficiency fo alpha galactosidase A
Anderson fabrys disease
43
fabryzme enzyme is the treatment for
Anderson fabrys disease
44
cutaneous manifestation of Anderson fabrys
angiokeratomas
45
what is a X linked mutation in COL4A5
alports syndrome
46
alports presents with what and hearing gloss
microscopic haematuria
47
ocular defect in alports
anterior lenticonus
48
what is the characteristic feature of aports on biopsy
variable thickness of the glomeuralr basement membrane
49
what is inflammatory but haas all radiological features of malignancy
xanthogranulomatous pyelonephritis
50
RCC is adenocarcinoma of the
renal cortex
51
what accounts for most sporadic renal cancers
VHL
52
what score is used to predict cancer vs cystic kidney disease
bosniak
53
most common RCC
clear cell
- cytoplasm rich in lipids
54
foamy cells
papilla RCC
55
what are large cell with defined borders. atypical nuclear resembling raisins
historically similar to oncoytomas
chromophone
56
what RCC is associated with young sickle cell patients
medullary cell
57
what RCC is the most aggressive
collecting duct
58
extra things that can be asscoited with RCC
polycythaemia (excess erythropoietin)
hypertension (excess renin)
hypercalcaemia
59
what is an onococyte
epithelial cell with an excess amount of mitochondria
60
what has a spoke wheel pattern
oncocytoma
61
what is mahogany brown with a central stellate scar
oncocytoma
62
20% of angiomyolipoma are associates with
tuberose sclerosis
63
us and ct of angiomylipoma
us - bright echo pattern
ct - fatty tumour of low density
64
what is a painless palpable abdominal mass in children
nephroblastoma
65
most common cause ph pyelonephritis
e.coli
66
there can be pain on bimanual palpation of the kidneys in
pyelonephritis
67
what should be given in pyelonephritis until cultures are available
amoxicillin and gentamicin
68
what can help confirm diagnosis of pyelonephritis
CT
69
how does drug induced interstitial nephritis present
usually about 15 days after starting the drug and usually has a fever and occasional a rash
70
bloods show what in drug induced interstitial nephritis
eosinophilia
71
common drugs to cause drug induced interstitial nephritis
ampicillin
rifampicin
thiazides
nsaids
allopurinol
72
analgesic nephropahty presentation
usually develop anaemia and many develop UTI
73
what is associated with hypercalcaemia and amyloid deposition
myeloma
74
hyperuricaemia can occur in leukaemia patients on
agressive chemo
75
most add mutations are on chromosome
16
76
common presentation of ADKD
reduced urine concentration ability
chronic pain
hypertension
haematuria
77
what extra renal manifestation in ADPKD can result in SOB,ankle swelling
hepatic cyst
78
intra cranial aneurysm can be seen in
ADPKD
79
if can't distinguish between ADPKD and recessive in children what should you do
US - congenital hepatic fibrosis suggest recessive
80
what is a new treatment to slow loss of kidney function in ADPKD
tolvpaton
81
most common mutation is on what chromosome for autosomal recessive kidney disease
6
82
abnormal gene in autosomal recessive kidney disease codes for what
fibrocystin
83
in arkd what are the kidneys like
usually of normal size and still have smooth outside
84
histologically in rececessice where are cysts seen as appearing from
collecting duct
85
what are always palpable in recessive disease
kidneys- despite being of normal size
86
renal tubules leading to fibrosis
medullary cystic kidney disease
87
cystic dilation of the collecting tubules
medially sponge kidney
88
investigation for medullary sponge kidney
exertion urography
89
what cysts have attenuated lining
simple
90
excessive production of immunoglobulins
myeloma
91
serum light chains
myeloma
92
management for myeloma
stop nephrotic and manage hypercalcarmai
93
hepatomegaly/ splenomegaly may be seen in
amyloidosis
94
renal wise amyloid presents as
nephrotic range proteinuria
95
good pastures is what type of hypersensotovty reaction
2
96
renal biopsy in good pastures shows
glomeurlonephitis
97
management fo good pastures
plasmapheresis
98
what small vessel vasculitis generally has no kidney innvolvemetn
eosinophilic gpa
99
what is NOT a good marker for disease severity in small vessel vasculitis
antibody titre
100
urinalysis shows active eerie (lots of blood and protein)
small vessel vasculitis
101
what is most frequently observed abnormality in SLE
proteinuria
102
what is defined as malignant hypertension
systolic> 180
diastolic >120
102
what is defined as malignant hypertension
systolic> 180
diastolic >120
103
how does malignant hypertension present
crushing chest pain
sign of raised ICP
104
management of malignant hypertension
medical emergency - urgent hospital admission
105
management for acute urinary retention
catheter
106
bell clapper deformity is a rf for
torsion of tests
107
what is a bellclapper deformity
insertion of tunica vaginalis is high
108
most common cause for epidiymoorchitis if under 25 vs over 35
under - n. gonorrhoea
over- e.coli
109
elevation of testes alleviates pain
epididymoorhcitis
110
management for epididymoorchitis
analgesia and antibiotics
111
2 types of priapism
ischaemic and non ischaemic
112
ischaemic o2 and co2 in
low 02 and high co2
whereas non ischaemic has normal arterial blood flow
113
manage ischaemic priapism
aspirate
if fails - alpha agonist
114
gas in tissues
fourneieres gangrene
114
gas in tissues
fourneieres gangrene
115
infection caused by gas forming pathogens usually e.coliu
emphysematous pyelonephritis
116
emphysematous pyelonephritis usually occurs in diabetics and presents as
fever, vomiting and flank pain
117
pyuria (pus in pee) may be
perinephric abscess
118
frank haemturia investigation
ct with contrast
119
how are most renal blunt injuries managed
angiography/embolization
120
what is commonly associate with pelvic fracture
bladder injury
121
investigation if got bladder injury
catheter, ct Cystography
122
fracture of pubic rami asscoaited with
urethral injury
123
high riding prostate suggest
urethral injury
124
investigations for urethral injury
retrograde urethrogram
125
inflammation of the bladder
cystitis
126
infolding of bladder mucosa into cyst
cystitis cystica
127
staghorn calculusu
proteus
128
uti associated with catheters
pseudomonas
129
staphylococcus saphrophticus usually affects
women of child bearing age
130
urine is the kidneys, ureters and bladder is normally
sterile
131
there is a risk of what in complicated UTI
gram negative septicaemia
132
when is dipstick not suitable for uTI
urine of elderly or urine from a catheter specimen
133
complicated UTi or pyelonephritis in rpiamry care
co amoxiclav or co- trimoxazole
134
complicated UTI or pyelonephritis in hospital
amoxicillin and gentamicin
135
when is asymptotic bacteria required
pregnancy
136
when do you only give antibiotics in catheterised patients for UTI
if there is fever/ symptoms as unnecessary antibiotics can result in the catheter becoming colonised with increasingly resistant organisms
137
symptoms fo UTI and Lowe abdo pain and tender prostate on examination
prostatitis
138
management for prostates
ciprofloaxicin
139
what composition of stone form stag horn calculi
magnesium ammonium phosphate
140
urinalysis of renal calculi shoes
non visible haematuria
141
what stones are not visible on X-ray
uric acid and cystine
142
initial investigation for diagnosing kidney stones
CT KUB
143
initial investigation for diagnosing kidney stones in children and pregnant. woman
US KUB
144
what is hydronephrosis
dilation of the renal pelvis and calyces
145
what incontinence may be due to bladder overactivity (prblem with detrusor)
urge
146
constant leakage of urine suggests
fistulous communication
147
medications for urge incontinence
anticholinergic and b agonists
148
what are associated with bladder cancer
schistosomiasis and aromatic amines (beta- napythyline)
149
most common type of bladder cancer
transitional cell
150
transitional cell cancer is often
papillary
151
forms dome of bladder
urachal adenocarcinoma
152
investigation for bladder cancer
CT -urogram or flexible cystoscopy
153
Benign prostate hyperplasia affects what cells of the prostate
stromal and epithelial
154
the prostate grows in response to what ( a breakdown products of testosterone)
dihydrotestosterone
155
does BPH make prostate cancer more likely
no
156
what is the most common early symptoms of BPH
frequency of urinating particularly at night
157
IF suspect bah do what
dipstick to exclude infection
158
management for bph
alpha blocker - tamsulosin
5 alpha reductase inhibitor - finasteride
159
rf for prostate cancer
cadmium batteries
160
rf for prostate cancer
cadmium batteries
161
transitional zone is where BPH occurs and surrounds what
prostatic urethra
162
central zone of prostate surrounds what
ejaculatory ducts
163
most common site of metastasis of prostate cancer
boen
164
PSA does what
liquifies semen and allows sperm to swim
165
high grader prostate cancers won't produce what
PSA
166
prostate cancer typically arises from what lobe
posterior
167
what determines prognosis of prostate cancer
Gleason score
168
what is unusually about the bony metastasis of prostate cancer
will show osterosclerosis - most malignancies cause osteolysis
169
what drugs inhibit testosterone slowing the progression of prostate cancer
LHRH agonists and anti androgens
170
non seminatous (teratoma) testiicualr cancer occurs in what age
under 35
171
seminamotous testicular cancer occur in what age
35-45
172
seminoma occurs from where
seminiferous tubules
173
what testicualr cancers are more aggressive and can metastasise
teratoma
174
what cancer is usually associated with other cell types
teratoma
175
yolk sac tumour produce what
alpha feto protein
176
what carcinoma is positive for beta HCG and shows positive pregnancy test
choriocarcinoma
177
what imaging to stage testiualr cancer
CT chest abdomen
178
alpha fetoprotein is not raised in
seminomas
179
beta hcg can be raised in seminomas and teratomas but more often in
teratomas
180
in what do you offer sperm preservation
radical inguinal orchidectomy
181
HPV 16 and 18 are associate with
penile cancer
182
most penile cancer are
squamous
183
investigation for penile cancers
biopsy
184
fluid filled cyst that develops at the head of the epididymis
spermatocele
185
varicocele is an enlargement fo the pampinifrom venous plexus in the
scrotum
186
varicoceles most commonly affects what side
left
187
left sided varicocele can also be a presenting feature of what
RCC
188
treatment for varicocele
generally need no treatment
