Renal

Question 1

rise in creatinine AKI definition

Answer 1

25 mml/L in 48 hrs
over 50% in 7 days

Question 2

rise in creatinine in past 48 hrs for diagnosis of AKI

Answer 2

25 microcol/L

Question 3

rise in creatinine over past 7 days for diagnosis of AKI

Answer 3

over 50%

Question 4

urine output for diagnosis of AKI

Answer 4

less than 0.5ml/kg/hr over minimum 6 hrs

Question 5

renal causes of AKI

Answer 5

acute tubular necrosis
glomerulonpehritis
acute interstitial nephritis
haemolytic uraemic syndrome
rhabdomyolysis

Question 6

pre renal causes of AKI

Answer 6

dehydration
shock eg sepsis, acute blood loss
heart failure

Question 7

most common renal intrinsic cause of AKI

Answer 7

acute tubular necrosis

Question 8

what cells are damaged in acute tubular necrosis

Answer 8

epithelial cells of renal tubules

Question 9

medications that cause AKI

Answer 9

NSAIDs
gentamicin
diuretics
ACEi

Question 10

how do ACEi affect the kidneys

Answer 10

they are reno protective

they are stopped in AKI as they reduce the filtration pressure, but are given to protect the kidneys in htn, diabetes, CKD

Question 11

complications of AKI

Answer 11

fluid overload- pulmonary oedema
hyperkalemia
metabolic acidosis
uraemia

Question 12

how is proteinuria quantified

Answer 12

urine albumin:creatinine

Question 13

eGFR for diagosis of CKD

Answer 13

<60 ml/min for 3 months

Question 14

urine albumin:creatinine for diagnosis of CKD

Answer 14

> 30 mg/mmol for 3 months

Question 15

what medications help slow the progression of CKD

Answer 15

ACEi
SGLT-2 inhibitors

Question 16

what medication are all patients with CKD put on

Answer 16

atorvastatin 20 mg

Question 17

what happens to phosphate in CKD

what advice is given

Answer 17

rises

low phosphate diet and phosphate binders

Question 18

what should be corrected before giving erythropoietin in CKD

Answer 18

iron deficiency

Question 19

describe what happens in renal bone disease

Answer 19

calcium is low as the kidneys cant metabolise vitamin D into calcitriol

this causes a rise in PTH and activates osteoclasts, so calcium can be released from bones

when this is done with inadequate calcium supply, osteomalacia occurs

osteosclerosis also occur as osteoblasts match osteoclast activity, but without sufficient calcium this leads to unmineralised bone

Question 20

pneumonic for indications for dialysis

Answer 20

AEIOU

acidosis
electrolyte imbalance
intoxication
oedema
uraemia

Question 21

how might long term haemodialysis be carried out

Answer 21

tunnelled cuffed catheter
ateriovenous fistula

Question 22

where is a tunnelled cuff catheter inserted

Answer 22

subclavian or jugular vein

Question 23

how might you identify a ateriovenous fistula

Answer 23

aneurysm
palpable thrill
machinery murmur

Question 24

what is steal syndrome

Answer 24

when the portion of the lim distal to an AV fistula doesnt receive enough blood leading to ischaemia

Question 25

what does peritoneal dialysis occur through

Answer 25

a tenckhoff catheter

Question 26

2 types of dialysis

Answer 26

haemo peritoneal

Question 27

most common AV fistula

Answer 27

radiocephalic

Question 28

where is a donor kidney implanted

Answer 28

in the iliac fossa

Question 29

what scar is seen in kidney transplant

Answer 29

hockey stick

Question 30

tacrolimus side effect

Answer 30

tremor

Question 31

cyclosporine side effect

Answer 31

gum hypertrophy

Question 32

what is given after kidney transplant to prevent acute rejection

Answer 32

basiliximab

Question 33

complications of immunosupression in kidney transplant

Answer 33

due to steroids: cushings diabetes NHL skin cancer tremor (tacrolimus) gum hypertrophy (cyclosporine)

Question 34

nephritic syndrome features

Answer 34

heamaturia oliguria fluid retention

Question 35

nephrotic syndrome triad

Answer 35

proteinuria hypoalbuminaemia oedema

Question 36

what happens to cholesterol in nephrotic syndrome

Answer 36

rises

Question 37

most common cause of nephrotic syndrome in children

Answer 37

minimal change disease

Question 38

how is minimal change disease mx

Answer 38

steroids

Question 39

causes of nephrotic syndrome

Answer 39

minimal change disease membranous glomerulonephropathy FSGS membranoprolifertive glomerulonephritis HSP

Question 40

nephrotic syndrome inflammation occurs where

Answer 40

basement membrane

Question 41

histology of IgA deposits and mesangial proliferation suggests

Answer 41

Bergers disease

Question 42

other name for bergers disease

Answer 42

IgA nephropathy

Question 43

histology of IgG and complement deposits on the basement membrane suggests

Answer 43

membranous nephropathy

Question 44

histology of immune complex deposits and mesangial proliferation suggests

Answer 44

membranoproliferative glomerulonephritis

Question 45

how long after infection does post strep glomerulonephritis occur

Answer 45

1-3 weeks

Question 46

what is goodpastures syndrome

Answer 46

where there are anti glomerular basement membrane antibodies

Question 47

goodpasture syndrome sx

Answer 47

acute kidney failure and haemoptysis

Question 48

patient presents with AKI and haemoptysis how do you reach a diagnosis

Answer 48

test for autoantibodies anti GBM= goodpastures syndrome p-ANCA= microscopic polyangiitis c-ANCA= granulomatosis with polyangiitis

Question 49

what are MPO antibodies

Answer 49

p ANCA

Question 50

what are PR3 antibodies

Answer 50

c ANCA

Question 51

p ANCA, AKI and haemoptysis diagnosis

Answer 51

microscopic polyangitis

Question 52

c ANCA, AKI and haemoptysis diagnosis

Answer 52

granulomatosis with polyangiitis

Question 54

what are microscopic polyangiitis and granulomatosis with polyangiitis

Answer 54

vasculitis they can present with AKI and haemoptysis the first is assoc w p ANCA the second is assoc w c ANCA

Question 55

how are nephrotic/nephritic syndromes definetively diagnosed

Answer 55

kidney biopsy