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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
Q

persisten hypertension not responding to ACEi

A

renal artery stenosis
more common in older people

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26
Q

testicular cancer markers (3)

A

AFP + pALP non-seminoma
bHCG raised in non-seminona

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27
Q

diagnosis of acute tubular necrosis (x2)

A

muddy brown casts in urinalysis
fraction of excreted sodium >3%

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28
Q

two types of ATN and causes

A

toxic: drugs e.g. aminoglycosides, bisphosphonates, myoglobin

ischaemic: renal artery stenosis, hypoperfusion

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29
Q

more common form of PKD

A

autosomal dominant

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30
Q

assoc with ADPKD

A

berry aneurysms in the circle of willis
hypertension
urinary sx
liver cysts
abdominal mass

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31
Q

combo of immunosuppression after kidney transplant

A

tacrolimus
mycophenalate mofetil
prednisolone

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32
Q

side effects of MMF

A

gastro, bone marrow suppression

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33
Q

when is radiofrequency ablation done in renal cancer

A

non surgical stage 1/2

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34
Q

when is partial nephrectomy done

A

stage 1

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35
Q

when is radical nephrectomy done

A

stage 2/3

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36
Q

when are immunomodulatory drugs given in renal cancer

A

stage 4 (metastasis)

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37
Q

ideal dialysate (urea, cret, bicarb, K)

A

0 urea
0 creat
high bicarb
low K

38
Q

struvite stones

A

chronic UTIS

39
Q

calcium oxalate stones

A

fat malabsorption (crohns, pancreatic insufficiency)

40
Q

calcium phosphate stones

A

hypercalcemia, hyperparathyroidism

41
Q

cystine

A

cystinuria
autosomal recessive

41
Q

uric acid stones

A

hyperuricemia (gout)

42
Q

symptoms of acute tubulointerstitial nephritis

A

fever
eosinophilia
rash

43
Q

causes of renal papillary necrosis

A

sickle cell anaemia
diabetes mellitus
acute pyelonephritis
chronic paracetamol use

44
Q

indications of calcium gluconate vs insulin&dextrose

A

calcium gluconate is used for cardioprotection in hyperkalemia

insulin and dextrose used to lower potassium

need both!!!!!!

45
Q

pain relief for kidney stones 1st line

A

IM diclofenac

46
Q

Potter syndrome

A

Oligohydramnios and resultant pulmonary hypoplasia with in utero renal failure

47
Q

inheritance of Alports

A

X linked recessive (most)

48
Q

inheritance of Von Hippel Lindau

A

autosomal dominant

49
Q

medullary sponge kidney
cause, Px, Dx

A

congenital
cystic dilatation of the collecting tubules in the kidney
increased risk of UTIs and kidney stones
grape-like appearance on ultrasound

50
Q

irregular testicular mass lesion
bHCG and AFP are not elevated
what could it. be?

A

testicular seminoma

51
Q

what does albumin:creatinine test for?
who to test

A

protein in the urine
test all people with diabetes + everyone without diabetes but have GFR<60

52
Q

best initial screening investigation for renal hypertension

A

abdo duplex ultrasound

53
Q

management of kidney stones >2cm

A

percutaneous ureterolithotomy

54
Q

management of kidney stones <0.5cm

A

paracetamol
drink water
stone passes spontaneously within 1-3 weeks

55
Q

management of stones <2cm

A

extracorporeal shock wave lithotripsy

56
Q

management of cryptorchid testis

A

orchidectomy (remove it)

57
Q

square envelope shaped crystals are caused by…
+ what vitamin increases the risk of this

A

calcium oxalate
vitamin c

58
Q

how to calculate osmolality

A

Serum osmolality is 2 x(Na) + Urea + glucose

59
Q

acute vs chronic rejection of kidney transplant

A

acute <6 months. fever, graft pain, sudden rise in creatinine

chronic >6months. gradual creatinine rise, fibrosis and tubular atrophy

60
Q

most common cause of peritonitis from peritoneal dialysis

A

staph epidermidis

61
Q

what should be prescribed to reduce progression of CKD caused by ADPKD

how does it work

A

tolvaptan
reduces cyst formation and renal insufficiency

62
Q

Urinalysis in interstitial nephritis x2

A

Eosinophilia
White cell casts

63
Q

Recommended potassium intake for normokalemic pt

A

1 mmol/ kg

64
Q

What level of K+ should treatment be started immediately? What to do if not reached this threshold?

A

> 6.5 start treatment

Less than : do ECG

66
Q

First line test for HUS

A

Blood film

67
Q

What cancer is increased risk after a renal transplant

A

Squamous cell carcinoma of the skin

68
Q

Normal anion gap

69
Q

Managing renal stones in three ways

A

Less than 5mm conservative
Less than 2cm shock wave lithotripsy
2cm more nephrolithotomy

70
Q

What medication can help to reduce kidney stones caused by hypercalciuria

A

Indapamide (thiazide like diuretic )
Increases calcium reabsorption so less excreted in urinary tract

71
Q

Most common viral infection in solid organ transplants and mx

A

Cytomegalovirus
Ganciclovir

72
Q

criteria to be on renal transplant waiting list

A

expected to be alive in 5 years
needing dialysis in 6 months

73
Q

3 drugs to treat proteinuria

A
  1. ACEIs
  2. SGLT2 inhibitors
  3. finerenone (mineralocorticoid receptor antagonist)
74
Q

most common site for developing prostate cancer

A

peripheral zone of the prostate

75
Q

Loop diuretic moa

A

Blocks Na K 2Cl co transporter in thick ascending loop of henle

76
Q

2 examples of loop diuretics

A

Furosemide
Bumetanide

77
Q

4 side effects of loop diuretics

A

Hypokalemia
Hypocalcemia
Kidney stones
Gout

78
Q

1 example of thiazide diuretic

A

Bendroflumethiazide

79
Q

2 examples of thiazide like diuretics

A

Indapamide
Chlorthalidone

80
Q

Moa of thiazide and thiazide like diuretics

A

Blocks Na Cl cotransporter in DCT

81
Q

4 side effects of thiazide like diuretics

A

Hypokalemia
Hypercalcemia
High glucose
Gout

82
Q

2 MOAS of potassium sparing diuretics

A

Inhibits aldosterone (spironolactone, eplenerone)
Inhibits ENAC (amiloride) so increased excretion of Na

83
Q

2 side effects of potassium sparing diuretics

A

Hyperkalemia
Gynacomastia

84
Q

Where do potassium sparing diuretics work

A

DCT and collecting duct

85
Q

Membranous nephropathy aetiology

A

IgG complex deposition in the sub epithelial space

86
Q

Membranous nephropathy investigations

A

Light : ball and spike pattern with silver stain
Electron : sub epithelial deposits
Immuno: diffuse IgG uptake

87
Q

focal segmental glomerulosclerosis cause

A

dead podocytes fall off causing the basement membrane and GBM to stick to each other = SCARRING

88
Q

FSGS investigations

A

light: scarring of glomeruli
electron: effacement of podocytes
IF: nothing

89
Q

IGA nephropathy investigations

A

IgA deposits, mesangial proliferation

90
Q

POst strep GN investigation

A

light:
electron: electron dense “humps” (immune complexes)
IF: IgG and C3 deposits

91
Q

renal transplant. oliguria, swelling at the transplant site within hours. what has happened and what is the mx?

A

hyperacute graft rejection

remove the transplanted kidney

AMK (30 decks)

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