Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Heaven ૮ ˶ᵔ ᵕ ᵔ˶ ა > Renal > Flashcards

Renal Flashcards

1
Q

Old man with suprapubic tenderness, palpably full bladder. Decreased urine output.

What do we even do?
US bladder
Urinalysis + culture
PSA
Immediate prostatectomy

A

US bladder

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Someone taking lots of drugs like beta blocker, ACEi, Aspirin, spironolactone. Has eGFR of <35 ish. Regular blood tests would prevent which ADR?
a. Hyperkalaemia
b. Hyponatraemia
c. Acute renal failure

A

Hyperkalaemia - spirinolactone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Is this the one where the person had a kidney stone and fever/rigors and then kidneys went off. Table provided of biochemistry results. Increased creatinine, increased urea, 30mls urine output for 5 hours. K of 6.4 (honestly bugger em). No ECG changes. What is the best management?
a) IV bicarbonate
b) Risperdronate
c) IV furosemide
d) IV insulin and dextrose
e) Calcium gluconate

A

IV insulin and dextrose

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Guy with CKD, deranged electrolytes. Hella high K+ over 7 (was 7.2) also had hyponatremia, high urea, low bicarb, high other stuff. with bradycardia. How would you manage this?
a) Insulin and dextrose
b) IV Bicarbonate administration
c) IV calcium gluconate
d) Rectal resonium
e) IV fluids
f) Normal saline

A

Insulin + dextrose.

IV calcium gluconate if there is ECG changes - this stabilises membrane but doesnt help high potassium.

But for all hyperkalemia - salbutamol first while setting it up

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Māori kid with haematuria and lower limb oedema. BP 125/85. Electron microscopy showing subepithelial humps with fused podocyte foot processes. Low C3. Had no clear Hx of recent infections but gets ‘colds during winter’, admitted to hospital last year for clavicle fracture.
- Post-infectious glomerulonephritis
- Minimal change
- Membranous GN
- Focal glomerular sclerosis
- Goodpasture syndrome
- Membrane proliferative GN
- Alports
- Mesangial proliferative GN
- Idiopathic crescentic GN

A

Post-infectious glomerulonephritis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Girl with loin pain - urine showed signs of UTI. Treat with antibiotics. Later on still unwell, now has a palpable loin mass?? What investigation
· CT abdomen
· Renal USS
· DMSA scan

A

Renal USS

nb DMSA used for size, shape, scarring.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Guy who hasn’t peed for 18hours, large suprapubic mass, cannot catheterise, enlarged uniform prostate. What is next step
· Bladder ultrasound
· Suprapubic catheter
· Suprapubic needle aspiration
- Catheter
· Emergency prostatectomy

A

· Suprapubic catheter

Needle aspiration is for taking a tiny sample, would take forever and this is an emergency.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Man has urinary problems (think it just said leakage of urine when coming home, causing him to withdraw from social events) preventing from attending social events or something?? Nah think it was the when coming home question from past years. Also was on atenolol (or something) and something else

a. Stress incontinence
b. Detrusor instability
c. Idk what else
d. Medication side effects
e. BPH

A

Detrusor instability

This is urge incontinence

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Old man had urinary incontinence after long trips so had to cut his social events down. At other times struggled to achieve adequate flow/had to push out pee to achieve complete emptying? What’s your next step/management?
a. Urinalysis
b. Rectal exam
c. PSA

A

Rectal exam

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Person with mild hypertension and has family history of CKD. His eGFR was 80. What investigation
a. Urine microalbumin
b. Urine osmolality
c. Renal artery duplex
d. Uric acid

A

Urine microalbumin

protein:creatinine ratio would pop off

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

urine shows increased sodium. plasma shows decreased sodium. patient is fatigued.
which part of kidney is affected?-

A

Most sodium reabsorption occurs in…. Proximal convoluted tubule (PCT)

But the collecting duct is where water is reabsorbed via ADH.. this guy may have SIADH.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Death following renal transplant - most common cause?

A

Acute rejection immediately

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Investigation of renal stones first line

A

If patient is not pregnant, arrange CT‑KUB (kidneys, ureters, and bladder) (without contrast) as first imaging

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Test for kidney scarring in young boy

A

DSMA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Investigation of choice for quick surgical evaluation at bedside for pyelonephritis

A

renal USS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Most common organism causing pyelonephritis

A

E. coli, gram negative bacteria

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Best way to monitor fluid load in a patient on dialysis?-

A

Daily weight

18
Q

Child with UTI, treated with antibiotics which didn’t help. Now has pain in flank and
palpable mass. What investigation do you use?

A

USS to look for fluid collection - abscess

19
Q

Kidney question - proteinuria 3+, fusion of foot processes and sclerotic changes, low C3 complement

A

membranous GN

Common cause of nephrotic syndrome in adults

PLA2R receptor, Immune complexes deposition on subepithelial location —> thickening

20
Q

Location of action of thiazides

A

Distal tubule

21
Q

Male. Colicky left flank pain radiating to testicle

A

Ureteric calculi

22
Q

Patient with mahogany urine and suprapubic pressure

A

Acute cystitis

23
Q

Dude with ureteric calculus at Vesicoureteric junction, 4mm. Proximal ureteral
dilation. Treatment?

A

Probably just conservative - pain relief, fluids and

If a small stone is stuck and creates blockage at UVJ (the junction of the ureter and the bladder), and the patient has symptoms of severe pain, nausea and vomiting, or signs of infection (fever, chills, UTI), then surgical treatment needs to be instituted immediately.

If no infection can look at other options.

24
Q

Lady with CKD presenting with malaise. Low BP and bradycardia. Blood results: deranged electrolytes, hyperkalaemia (7.2), hyponatremia, high urea, low bicarb. How would you manage this?

A

IV 1g calcium gluconate

25
Q

Person had a kidney stone and fever/rigors and then kidneys went off. Increased creatinine, increased urea, 30mls urine output for 5 hours. K 6.4 (high). No ECG changes. What is the best management?
a) IV bicarbonate
b) Risperdronate
c) IV furosemide
d) IV insulin and dextrose
e) Calcium gluconate

A

Insulin + dextrose

Insulin stimulate Na/K ATPase 􏰀 drive K+ into cells Dextrose prevent hypoglycaemia
Calcium gluconate if ECG changes or K >6.5

26
Q

75 year old man with recent onset problems with urination. Incontinent when returning home after being out with friends (key in lock) and has had to stop social interactions due to this. Takes a beta blocker and losartan for HTN only. Rectal exam showed smooth prostate not enlarged. What is most likely causing this?
a) Stress incontinence
b) Detrusor instability
c) Effects of medication
d) Benign prostatic hypertrophy

A

URGE caused by Detrusor instability

27
Q

Guy who hasn’t peed for 18 hours, large suprapubic mass, cannot catheterise, enlarged uniform prostate. What is next step?
a) Bladder ultrasound
b) Suprapubic catheter
c) Suprapubic needle
d) Emergency prostatectomy

A

Suprapubic catheter

28
Q

80 year old man brought in with a Hx of dementia. Has been unwell for a couple of days, decreased urine output in the last 2 days. Now presents with suprapubic tenderness and distended bladder. What investigations would you do?
a) Bladder USS
b) PSA
c) Urinalysis and culture
d) CT abdo

A

USS confirms retention + can guide suprapubic catheter if needed

29
Q

Girl with loin pain. Urine showed signs of UTI. Treat with antibiotics. Later on still unwell, now has a palpable loin mass. What investigation?
a) CT abdomen
b) Renal USS
c) DMSA scan

A

USS abscess

30
Q

Man 8hr post anterior resection, difficult surgery requiring drain insertion, has a catheter in. Only had 100mL of urine output since. Has had 1.5L of saline since surgery. BP 110/70 HR 100. What is the best investigation to determine cause of his oliguria?
a) U/E’s and creatinine
b) Bladder ultrasound
c) Urine output after saline fluid bolus
d) Central Venous Pressure
e) Serum and urine osmolality

A

Post-surgery oliguria
- Cause: structural damage, AKI - Ix
-Serum creatinine, urea, serum electrolytes
-Urine analysis
-Renal tract/abdominal ultrasound.

31
Q

Old man had urinary incontinence after long trips so had to cut his social events down. At other times struggled to achieve adequate flow/had to push out pee to achieve complete emptying? What’s your next step/management?
a) Urinalysis
b) Rectal exam
c) PSA

A

DRE

32
Q

Male with colicky left flank pain radiating to testicle. Diagnosis?
a) Renal calculi
b) Testicular torsion
c) Appendicitis

A

Renal calculi

TESTICULAR IS CONSTANT AND SEVERE

33
Q

Location of majority of sodium reabsorption in the kidney?
a) Proximal collecting tubule
b) Collecting duct
c) Distal tubule
d) Loop of Henle

A

PCT

34
Q
A

Calcium oxalate

35
Q

Woman with dysuria, urinary frequency and urgency develops flank pain, fever and vomiting after 3 days. Bedside investigation?
a) Renal USS
b) Abdo xray

A

USS

(bloods + MSU not bedside)

36
Q

Heavy exercise without rest. Presents with weak sore muscles and renal failure. Dx? a) Rhabdomyolysis
b) Weekly NSAID use

A

Rhabdomyolysis

37
Q

First line investigation of renal stones?
a) Dipstick
b) KUB CT
c) KUB X-ray
d) Renal USS

A

FIRSTLINE = dipstick for blood.

38
Q

You are the HO. Registrar asks you to insert catheter into patient, but he refuses. What to do next?
a) Ask him to sign consent form to not have catheter
b) Insist he has a catheter

A

Lol

39
Q

Diabetic patient concerned about eye sight. Best management to avoid retinopathy?
a) Good glycaemic control
b) Regular retina screening
c) Weight loss
d) ACEi

A

Good glycaemic control

40
Q
A

Heaven ૮ ˶ᵔ ᵕ ᵔ˶ ა (27 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions