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Finals Flash Cards 🩺 > Renal > Flashcards

Renal Flashcards

1
Q

What is the management of Nephrotic syndrome?

A

Oedema - Low salt diet/Diuretics
Hypoalbuminaemia - Albumin infusions may be required
High dose steroids
Antibiotic prophylaxis may be given in severe cases

In steroid resistant children, ACEi and Immunosuppressants such as cyclosporine, tacrolimus and rituximab may be used

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2
Q

What are the causes of Nephrotic Syndrome?

A
  • Diabetic Nephropathy
  • Minimal change disease (more common in childhood)
  • Membranous nephropathy
  • Focal Segmental glomerulosclerosis
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3
Q

What are the features of Nephrotic syndrome?

A

Classic triad of
- Low serum albumin
- High urine protein content (>3+ protein on urine dipstick)
- Oedema

With three other features
- High blood pressure
- Deranged lipid profile
- Hyper-coagulability

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4
Q

What anticoagulant is licensed for use in Nephrotic Syndrome?

A

Warfarin

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5
Q

What is Nephritis?

A

Refers to inflammation within the nephrons in the Kidneys

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6
Q

What are the indications for renal replacement therapy

A

A cidosis - usually pH <7.20
E lectrolyte abnormalities (hyperkalaemia, hyponatreamia hypercalcaemia)
I ntoxication (salicyclates, lithium)
O verload (severe pulmonary oedema, or overload on BG: AKI/CKD)
U raemia -soft threshold of 50mmol or symptomatic

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7
Q

What is the most common gene mutation implicated in ADPKD?

A

About 85% of ADPKD cases arise from mutations in the PKD-1 gene (polycystin-1) located on chromosome 16

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8
Q

What are the renal symptoms of ADPKD?

A
  • Flank pain and hematuria, characteristic of cyst rupture
  • Flank pain, fever, and urinary symptoms, associated with cyst infection
  • Hypertension (HTN)
  • Slowly progressive chronic kidney disease (CKD)
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9
Q

What are the extrarenal manifestations for ADPKD?

A
  • Cysts in other organs, such as the liver, pancreas and spleen
  • Intracranial berry aneurysms, commonly at the junction of the anterior communicating artery and anterior cerebral artery
  • Mitral valve prolapse and aortic regurgitation
  • Diverticular disease
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10
Q

What are some pre-renal causes of AKI?

A

Hypoperfusion
Hypovolaemia
Shock
Diuretics

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11
Q

What are the intra-renal causes of AKI?

A
  • Acute tubular necrosis
  • Acute interstitial nephritis
  • Rhabdomyolysis
  • Hypertension
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12
Q

What are some post-renal causes of AKI?

A
  • Renal Mass
  • Uretetric stones
  • Bladder cancer
  • Prostate cancer/hypetertrophy
  • Abdominal masses
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13
Q

What is the imaging method of choice in ADPKD

A

USS

Ages 15-39 years: More than three renal cysts.
Ages 40-59 years: More than two renal cysts bilaterally.
Ages >60 years: More than four renal cysts bilaterally.

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14
Q

What are the features of Nephritic syndrome?

A

AKI
Haematuria
Oliguria

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15
Q

What are the causes of nephritis syndrome?

A
  • Immune complex mediated (most common e.g., IgA nephropathy)
  • Anti-GBM disease
  • ANCA- associated vasculitis
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16
Q

What is Acute Tubular Necrosis?

A
  • It is a renal condition describing injury to the tubular epithelial cells of the kidneys due to ischaemic events or direct toxicity.
  • Most common cause of Intrinsic AKI
17
Q

What is the aetiology of Acute Tubular Necrosis?

A

Split into Ischaemic or Nephrotoxic causes

Ischaemia
- Hypotension
- Shock (Haemorrhagic, Cardiogenic, Septic)
-Direct vascular injury as seen in trauma and surgery

Nephrotoxic causes
- Drugs such as (Gentamicin, amphotericin, cisplatin, tenofovir, NSAIDs)
- Contrast agents
- Myoglobin (as seen in Rhabdomyolysis)
- Haemoglobin (as seen in Haemolysis)
- Uric acid (as seen in Tumour lysis syndrome)

18
Q

What is the clinical presentation of Acute Tubular Necrosis?

A
  • Acute Kidney Injury
  • Oliguria
  • Uraemia
  • Electrolyte imbalance
19
Q

What is the management for Acute Tubular Necrosis?

A
  • Correct the underlying cause, such as fluid resuscitation
  • Remove any nephrotoxins
  • Provide supportive care, which may require haemofiltration or haemodialysis until kidney function recovers
20
Q

What are the components of a renal screen?

A

Protein electrophoresis
C3
C4
ANA
dsDNA
ANCA
Anti-GBM
Immunoglobulins

21
Q

What is the most common cause of Chronic kidney disease in the UK?

A

T2DM

22
Q

Why does Nephrotic syndrome occur?

A

Occurs when the basement membrane in the glomerulus becomes highly permeable resulting in significant proteinuria.

23
Q

What is the investigation of choice for reflux nephropathy?

A

Micturating cystography

24
Q

What does a DMSA scan look for?

A

Renal scarring

Finals Flash Cards 🩺 (32 decks)

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