Renal

Question 1

what are the abnormalities?

Answer 1

HAGMA
intrinsic renal failure
hyperkalamia

Question 2

What are the causes of AKI?

Answer 2

Pre-Renal
* hypovolaemia eg poor intake, high output stoma, third space losses, GI loss
* Sepsis

Renal
* nephrotoxic drugs
* glomerulonephritifis eg post strep, GBM

Post-Renal
* BPH, blocked cathter
* renal stones

Question 3

5 investigations and why

Answer 3

bladder scan - ?retention
Urine dip -?infection, casts
Septic screen
VBG - any hypoperfusion
CXR - fluid overload
ECG - ?hyperkalaemia
CT - ?stone

Question 4

with renal failure what are the indications for urgent dialysis?

Answer 4

• refractory hyperkalaemia
• uremic encephalopathy
• refractory acidosis
• volume overload
• uraemic pericarditis

Question 5

in a child what can cause dark red urine for upper urinary tract?

How may you narrow down the cause in history and exam?

Answer 5

Causes
* post strep glomerulonephritis
* Iga nephritis
* membranoproliferative glomerulonephritis
* interstitial nephritis eg drugs
* alport syndrome

History and exam
* FH eg alport
* fever and if so when
* ?sore throat eg post strep
* rashes eg HSP
* any new drugs
* diarrhoea or abdo pain
* ?repeat episodes

Question 6

post strep V Iga

Answer 6

Question 7

what futher tests may you do and why?

Answer 7

• urine microscopy - for infective cause
• renal biopsy - look for glomerulonephritidis
• throat swab - ?strep
• FBC - platelt count low in HUS, TTP
• complement - low in post strep