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Renal Flashcards

1
Q

most common nephrotic syndrome in children

A

minimal change disease

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2
Q

Mx of minimal change

A

steroids

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3
Q

IgA nephropathy

A

Bergers sydnrome
Nephritic syndrome 1-2 days after a URTI

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4
Q

Post strep glomerulonephritis

A

Nephritic syndrome 1-2 weeks after URTI

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5
Q

goodpastures

A

Anti GBM antibodies against type 4 collagen
Px: heaemoptysis (lung haemorrhage) + nephritic syndrome

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6
Q

Alports

A

defect in gene for type 4 collagen
Px: renal failure, hearing loss, retinitis pigmentosa

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7
Q

renal biopsy in alports

A

splitting of the lamina dense shows a basket weave appearance

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8
Q

haemolytic uremic syndrome

A

caused by shiga toxin ( e coli 0157 / shigella)
AKI + thrombocytopenia + haemolytic anaemia)

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9
Q

henoch schlonhein purpura

A

abdominal pain
arthalgia
non-blanching rash

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10
Q

Granulomatosis with polyangiitis / wegener’s

A

URT = saddle shaped nose deformity, epistaxis

LRT = haemoptysis

Renal failure

cANCA!!!!!!

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11
Q

Churg strauss (eosinophilic granulomatosis and polyangitis)

A

Asthma

Rash

Renal failure

pANCA!!!!!!!

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12
Q

pain radiating from loin to groin

A

renal stones

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13
Q

what drugs cause AKI

A

diuretics, aminoglycosides, metformin, NSAIDs, lithium, ACEis, ARBS, digoxin

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14
Q

fever, uncontrollable shaking, flank/abdominal tenderness
gas in the renal parenchyma

A

pyelonephritis

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15
Q

antibiotics of choice for UTI in pregnancy

A

nitrofurantoin

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16
Q

acute tubular necrosis is caused by:

A

drugs (aminoglycosides, NSAIDs), radiocontrast

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17
Q

acute interstitial nephritis is caused by:

A

hypersensitivity, rheumatological conditions

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18
Q

Mx of pyelonephritis

A

IV gentamicin / ciprofloxacin

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19
Q

muddy brown casts

A

acute tubular necrosis

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20
Q

indications of acute dialysis

A

AEIOU
acidosis (<7.2)
electrolyte abnormalities (refractory hyperkalaemia)
intoxication e.g. alcohol, lithium
overload (fluid)
uremia (encephalopathy)

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21
Q

chronic reflux nephropathy

A

kidney scarring resulting from vesico-ureteric reflux

chronic UTIs in childhood
scarring and reduced size in one kidney
raised creatinine and hypertension

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22
Q

gold standard Dx for kidney stones

A

CT KUB

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23
Q

pathophis of type 1,2,4 renal tubular acidosis

A

(Distal) Type 1 = cannot excrete H+

hypokalemia, severe acidosis

(Proximal) Type 2 = cannot absorb HCO3-

hypokalemia, less acidosis

Type 4 = reduced aldosterone function

hyperkalemia, no significant acidosis

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24
Q

fanconi syndrome

A

Fanconi Sydnrome = proximal tubule dysfunction leading to poor electrolyte absorption

hypokalemia, acidosis

proteinuria, glycosuria

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25
persisten hypertension not responding to ACEi
renal artery stenosis more common in older people
26
testicular cancer markers (3)
AFP + pALP non-seminoma bHCG raised in non-seminona
27
diagnosis of acute tubular necrosis (x2)
muddy brown casts in urinalysis fraction of excreted sodium >3%
28
two types of ATN and causes
toxic: drugs e.g. aminoglycosides, bisphosphonates, myoglobin ischaemic: renal artery stenosis, hypoperfusion
29
more common form of PKD
autosomal dominant
30
assoc with ADPKD
berry aneurysms in the circle of willis hypertension urinary sx liver cysts abdominal mass
31
combo of immunosuppression after kidney transplant
tacrolimus mycophenalate mofetil prednisolone
32
side effects of MMF
gastro, bone marrow suppression
33
when is radiofrequency ablation done in renal cancer
non surgical stage 1/2
34
when is partial nephrectomy done
stage 1
35
when is radical nephrectomy done
stage 2/3
36
when are immunomodulatory drugs given in renal cancer
stage 4 (metastasis)
37
ideal dialysate (urea, cret, bicarb, K)
0 urea 0 creat high bicarb low K
38
struvite stones
chronic UTIS
39
calcium oxalate stones
fat malabsorption (crohns, pancreatic insufficiency)
40
calcium phosphate stones
hypercalcemia, hyperparathyroidism
41
cystine
cystinuria autosomal recessive
41
uric acid stones
hyperuricemia (gout)
42
symptoms of acute tubulointerstitial nephritis
fever eosinophilia rash
43
causes of renal papillary necrosis
sickle cell anaemia diabetes mellitus acute pyelonephritis chronic paracetamol use
44
indications of calcium gluconate vs insulin&dextrose
calcium gluconate is used for cardioprotection in hyperkalemia insulin and dextrose used to lower potassium need both!!!!!!
45
pain relief for kidney stones 1st line
IM diclofenac
46
Potter syndrome
Oligohydramnios and resultant pulmonary hypoplasia with in utero renal failure
47
inheritance of Alports
X linked recessive (most)
48
inheritance of Von Hippel Lindau
autosomal dominant
49
medullary sponge kidney cause, Px, Dx
congenital cystic dilatation of the collecting tubules in the kidney increased risk of UTIs and kidney stones grape-like appearance on ultrasound
50
irregular testicular mass lesion bHCG and AFP are not elevated what could it. be?
testicular seminoma
51
what does albumin:creatinine test for? who to test
protein in the urine test all people with diabetes + everyone without diabetes but have GFR<60
52
best initial screening investigation for renal hypertension
abdo duplex ultrasound
53
management of kidney stones >2cm
percutaneous ureterolithotomy
54
management of kidney stones <0.5cm
paracetamol drink water stone passes spontaneously within 1-3 weeks
55
management of stones <2cm
extracorporeal shock wave lithotripsy
56
management of cryptorchid testis
orchidectomy (remove it)
57
square envelope shaped crystals are caused by... + what vitamin increases the risk of this
calcium oxalate vitamin c
58
how to calculate osmolality
Serum osmolality is 2 x(Na) + Urea + glucose
59
acute vs chronic rejection of kidney transplant
acute <6 months. fever, graft pain, sudden rise in creatinine chronic >6months. gradual creatinine rise, fibrosis and tubular atrophy
60
most common cause of peritonitis from peritoneal dialysis
staph epidermidis
61
what should be prescribed to reduce progression of CKD caused by ADPKD how does it work
tolvaptan reduces cyst formation and renal insufficiency
62
Urinalysis in interstitial nephritis x2
Eosinophilia White cell casts
63
Recommended potassium intake for normokalemic pt
1 mmol/ kg
64
What level of K+ should treatment be started immediately? What to do if not reached this threshold?
>6.5 start treatment Less than : do ECG
66
First line test for HUS
Blood film
67
What cancer is increased risk after a renal transplant
Squamous cell carcinoma of the skin
68
Normal anion gap
8-14
69
Managing renal stones in three ways
Less than 5mm conservative Less than 2cm shock wave lithotripsy 2cm more nephrolithotomy
70
What medication can help to reduce kidney stones caused by hypercalciuria
Indapamide (thiazide like diuretic ) Increases calcium reabsorption so less excreted in urinary tract
71
Most common viral infection in solid organ transplants and mx
Cytomegalovirus Ganciclovir
72
criteria to be on renal transplant waiting list
expected to be alive in 5 years needing dialysis in 6 months
73
3 drugs to treat proteinuria
1. ACEIs 2. SGLT2 inhibitors 3. finerenone (mineralocorticoid receptor antagonist)
74
most common site for developing prostate cancer
peripheral zone of the prostate
75
Loop diuretic moa
Blocks Na K 2Cl co transporter in thick ascending loop of henle
76
2 examples of loop diuretics
Furosemide Bumetanide
77
4 side effects of loop diuretics
Hypokalemia Hypocalcemia Kidney stones Gout
78
1 example of thiazide diuretic
Bendroflumethiazide
79
2 examples of thiazide like diuretics
Indapamide Chlorthalidone
80
Moa of thiazide and thiazide like diuretics
Blocks Na Cl cotransporter in DCT
81
4 side effects of thiazide like diuretics
Hypokalemia Hypercalcemia High glucose Gout
82
2 MOAS of potassium sparing diuretics
Inhibits aldosterone (spironolactone, eplenerone) Inhibits ENAC (amiloride) so increased excretion of Na
83
2 side effects of potassium sparing diuretics
Hyperkalemia Gynacomastia
84
Where do potassium sparing diuretics work
DCT and collecting duct
85
Membranous nephropathy aetiology
IgG complex deposition in the sub epithelial space
86
Membranous nephropathy investigations
Light : ball and spike pattern with silver stain Electron : sub epithelial deposits Immuno: diffuse IgG uptake
87
focal segmental glomerulosclerosis cause
dead podocytes fall off causing the basement membrane and GBM to stick to each other = SCARRING
88
FSGS investigations
light: scarring of glomeruli electron: effacement of podocytes IF: nothing
89
IGA nephropathy investigations
IgA deposits, mesangial proliferation
90
POst strep GN investigation
light: electron: electron dense "humps" (immune complexes) IF: IgG and C3 deposits
91
renal transplant. oliguria, swelling at the transplant site within hours. what has happened and what is the mx?
hyperacute graft rejection remove the transplanted kidney

AMK (30 decks)

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