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Barts Final Year > Renal > Flashcards

Renal Flashcards

1
Q

4 subtypes of Rapidly progressive glomerulonephritis

A
  • Diffuse proliferative
  • Goodpastures (anti-GBM)
  • Microscopic polyangitis
  • Granulomatosis with polyangitis
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2
Q

Nephrotic syndrome with hepatosplenomegaly most likely what?

A

Amyloidosis

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3
Q

Acanthocytes are found in nephritic or nephrotic syndrome?

A

Nephritic

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4
Q

Most common viral infection after organ transplant?

A

CMV

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5
Q

Tetrad of symptoms in IgA vasculitis (nephropathy) (HSP)? (1 sign on bloods as well)

A
  • Non-thrombocytopenic palpable purpura,
  • Arthritis or arthralgia
  • Abdominal pain
  • Renal disease
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6
Q

All patients with CKD should be started on this drug?

A

Atorvastatin

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7
Q

A GFR of between 60 - 90 with no clinical signs/symptoms is what?

A

Normal kidney function (NOT CKD 1 or 2)

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8
Q

Causes of transient or spurious non-visible haematuria (4)

A
  • UTI
  • Menstruation
  • Vigorous exercise (this normally settles after around 3 days)
  • Sex
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9
Q

AKI definition (creatinine, urine output) (3)

A
  • Rise in serum creatinine of 26 micromol/litre or greater within 48 hours
  • > = 50% rise in serum creatinine in past week
  • Fall in urine output to less than 0.5 ml/kg/hour for more than 6 hours in adults
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10
Q

Name the 1st and 2nd line drug for proteinuric CKD (> 30 mg/mmol)

A
  • ACEi or ARB
  • SGLT2i
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11
Q

Drugs which may cause AIN

A
  • Penicillin
  • Rifampicin
  • NSAIDs
  • Allopurinol
  • Furosemide
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12
Q

AIN histology findings

A

Marked interstitial oedema and interstitial infiltrate in the connective tissue between renal tubules

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13
Q

What disease will have sterile pyuria,
white cell casts an allergic feel (fever, rash, arthralgia, eosinophilia) and HTN?

A

AIN

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14
Q

Non-drug causes of AIN

A
  • Systemic disease: SLE, sarcoidosis, and Sjögren’s syndrome
  • Infection: Hanta virus , staphylococci
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15
Q

What drugs cause Hyaline casts in urine?

A

Loop diuretics (Furosemide) (can be normal)

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16
Q

Acute tubular necrosis, what is seen in urine?

A

Brown granular casts

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17
Q

What is seen in urine of Prerenal uraemia

A

‘bland’ urinary sediment

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18
Q

Red cell casts seen in what condition (or group of conditions)?

A

Nephritic

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19
Q

Management of high phosphate in CKD
- what is the 1st line MEDICAL management?

A
  • Reduced dietary intake of phosphate (1st line)
  • Phosphate binders: Sevelamer (non-calcium based phosphate binder)
  • Aluminium and calcium-based binders (less commonly used)
20
Q

How to prevent contrast-induced nephropathy

A

IV 0.9% NaCl at a rate of 1 mL/kg/hour for 12 hours pre- and post- procedure

21
Q

All mostly nephritic syndromes (4 or 7)

A
  • PSGS
  • IgA nephropathy (HSP)
  • Alport Syndrome (collagen IV)

Rapidly progressive GN
- Goodpastures
- Diffuse proliferative
- Granulomatosis w. polyangitis
- Microscopic polyangitis)

22
Q

All nephrotic syndromes (5)

A
  • FSGS
  • Minimal change
  • Membranous nephropathy
  • Diabetic glomerulonephropathy
  • Amyloidosis
23
Q

Nephritic syndrome with hearing loss

A

Alports

24
Q

Hemoptysis + Nephritic syndrome

A

Goodpastures (anti-GBM)
(type of rapidly progressive GN)

25
Q

Nephrotic syndrome associated with spike and dome and Malignancy

A

Membranous nephropathy

26
Q

Neprhritic syndrome + Crescent formation in Bowmans space and fibrin or macrophage based crescentric expansion

A

Rapidly progressive GN
(Goodpastures, Microscopic polyangitis, granulomatosis w. polyangitis, diffuse proliferative GN)

27
Q

ADH receptor antagonist used in ADPKD and ?SIADH?

A

Tolvaptan

28
Q

Bacteria associated with bloody diarrhoea and renal impairment

A

E. coli 157:H7 (HUS syndrome)

29
Q

SIADH causes Hyo or Hypernatremia?

A

Hyponatremia, high Na+ in urine

30
Q

Nephrogenic DI management

A
  • Thiazides
  • Low salt/protein diet
31
Q

How is nephrogenic DI inherited?

A

X linked recessive (usually)

32
Q

Clinically relevant level of ACR (albumin:creatinine) ratio

A

3 mg/mmol

33
Q

1st line testing of ADPKD

A

Abdo US

34
Q

Carbamezapine can cause what disease

A

SIADH

35
Q

How is Henoch-Schonlein purpura usually treated?
(Berger’s disease), (IgA mediated small vessel vasculitis)

A

Supportive

36
Q

Chromosome responsible of ADPKD (type 1 and 2)

A
  • Type 1: chr 16
  • Type 2: chr 4
37
Q

Anti-phospholipase A2 antibodies cause the idiopathic disease of what?

A

Membranous nephropathy

38
Q

CKD usually causes small kidneys (AKI, large) - what conditions are an exception to this rule?

A
  • ADPKD
  • Diabetic nephropathy (early stages)
  • amyloidosis
  • HIV-associated nephropathy
39
Q

What nephrotic syndrome is usually seen in kids but has an association with Hodgkins lymphoma/

A

Minimal change

40
Q

The rapidly progressive GN disease (4 of them) have different features on immunofluorescence, what are they?

A
  • Granulomatosis with polyangitis: Negative or pauci immune
  • Microscopic polyangitis: Negative or pauci immune
  • Goodpastures: Linear
  • Diffuse proliferative: Granular
41
Q

What nephritic syndrome has thickening of glomerular capillaries (e.g. wire loops) and an association with SLE?

A

Diffuse proliferative GN

42
Q

Management of SIADH (4)

A
  • Correction must be done slowly to avoid precipitating central pontine myelinolysis
  • Fluid restriction
  • Demeclocycline: reduces the responsiveness of the collecting tubule cells to ADH
  • ADH (vasopressin) receptor antagonists (Tolvaptan)
43
Q

Stage 1, 2 and 3 AKI according to creatinine levels

A
  • Stage 1: 1.5-1.9 times baseline (or increase in creatinine by ≥26.5 µmol/L)
  • Stage 2: 2.0 to 2.9 times baseline
  • Stage 3 ≥ 3.0 times baseline
44
Q

Stage 1, 2 and 3 AKI according to urine output

A

Reduction in urine output to <0.5 mL/kg/hour for ≥ 6 hours
Reduction in urine output to <0.5 mL/kg/hour for ≥12 hours
Reduction in urine output to <0.3 mL/kg/hour for ≥24 hours

45
Q

What is the other criteria beyond urine output and creatinine that can define stage 3 AKI? (2)

A
  • Initiation of kidney replacement therapy
  • In patients <18 years, decrease in eGFR to <35 mL/min/1.73 m2

Barts Final Year (13 decks)

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