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Final Year - Passmed > Renal 2 > Flashcards

Renal 2 Flashcards

1
Q

Patients with active Henoch-Schonlein purpura

monitor what?

A

blood pressure and urinanlysis
> progressive renal involvement

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2
Q

how to calculate anion gap?

A

sum of positive cations

negative anions

[Na+ K] - [Cl+HCO3]

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3
Q

what is a normal anion gap?

A

10-18 mmol/L

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4
Q

What changes in patients with nephrotic syndrome predispose to the development of venous thromboembolism

A

loss of antithrombin III

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5
Q

muddy brown casts

A

acute tubular necrosis
> epithelial cell damage

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6
Q

‘bag of worms’ texture
right-sided testicular swelling

A

varicocele

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7
Q

negative fluid balance

A

tachycardia

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8
Q

Chronic diabetic nephropathy

imaging results?

A

bilateral enlarged kidneys

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9
Q

Ix for diabetes insipidus?

A

water deprivation test

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10
Q

acute interstitial nephritis
drug causes?

A

abx
NSAIDS
salicylates
acei
diuretics

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11
Q

polyuria

random capillary glucose is normal

A

lithium use
diabetes insipidus - nephrogenci

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12
Q

HUS management

when is plasma exchange indicated?

A

no diarrhoea present

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13
Q

MAHA is coombs?

A

coombs negative haemolysis

> formation of schistocytes

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14
Q

shiga toxins are seen by?

A

PCR

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15
Q

Investigating frank haematuria?
Gold standard?

A

urgent referral on cancer pathway

cystoscopy

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16
Q

urgent referral for haematuria?

A

> 45
- visible haematuria wo UTI
- visible persistent

> 60
- dysuria
- raised WCC
non visibile hameutria

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17
Q

why would you USS KUB when suspecting AKI?

A

post renal causes
catheter blockage
stones
malignancy
prostatic hypertrophy

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18
Q

hypoxaemia is defined as?

A

<8.0

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19
Q

type 2 respiratory failure is?

A

hypercapnia and hypoxia

CO2
>6

O2
<8

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20
Q

noradrenaline infusion can cause what kind of acid base?

A

tissue Hypoperfusion + increased lactate

metabolic acidosis

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21
Q

Bowel ischaemia acid base?

A

metabolic acidosis
due to raised lactate

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22
Q

hyperchloraemic metabolic acidosis

A

when you aggressivle fluid resus

++ Na but also ++ CL-

23
Q

Types of renal replacement therapy

A

haemodialysis
peritoneal dialysis
renal transplant

24
Q

Haemodialysis?

A

dialysis 3x a week
lasts 3-5 hours

arteriovenous fistula

25
Q

Peritoneal dialysis

A

Continuous ambulatory peritoneal dialysis
30-40 mins lasts 3/4 hours

Automated peritoneal dialysis
sleeping
3-5 exchanges over 8-10 hours

26
Q

usual first line for renal replacement therapy?

when would haemodialysis be good instead?

A

peritoneal dialysis

crohns patients

27
Q

prolonged diarrhoea results in what type of acid - base?

A

metabolic acidosis w hypokalaemia

28
Q

Triad of renal cell carcinoma?

presents with?

A

haematuria, loin pain, abdominal mass

pyrexia
left varicocele due to occlusion of left testicular vein

29
Q

all patients with CKD should be on?

A

statin

30
Q

prolonged diarrhoea is associated with?

A

metabolic acidosis with hypokalaemia

31
Q

____ disease has a good response to fluid challenge

A

pre renal

32
Q

if there is an increase risk fo VTE in a patient with nephrotic syndrome

what prophylaxis?

A

LMWH

nephrotic syndrome leads to = loss of antithrombin 3

to prevent a thrombus give LMWH

33
Q

pathophysiology of nephrotic syndrome

A

glomerular basement membrane is damaged

= increased permeability to proteins

= hypoalbumin
= oedema

lose antithrombin 33

34
Q

differentiating primary and secondary aldosteronism

look at?

A

renin

if renin is high than secondary cause as not suppressed by action of increased aldosterone (expected in bilateral hyperplasia and Conns)

35
Q

renal artery stenosis

due to?

A

atherosclerosis
fibromusuclar dysplasia

36
Q

hereditary haemochromatosis is a cause of

A

cranial diabetes insipidus

37
Q

nephrogenic DI causes

A

adrenalcortical insuffiency
sjogrens syndrome

38
Q

urine osmolality of >______ excludes?

A

700mOsm/kg excludes DI

39
Q

investigating diabetes insipidus?

A

water deprivation test

40
Q

what is useful in differentiating between AKI and CKD?

A

uss of urinary tract as small kidneys bilateral is sign of CKD

calcium also

41
Q

raised anion gap metabolic acidosis

A

septic shock due to lactate
> inadequate tissue perfusion

42
Q

addisons disease
acid base

A

hyponatraemia with hyperkalaemia

acidosis is caused by a loss of bicarb due to cortisol deficiency

43
Q

raised anion gap metabolic acidosis

A

lactate: shock
ketones: DKA /alcohol

urate : renal failure

acid poisoning

5-oxoproline - chronic paracetamol usage

44
Q

daily amount of glucose?

A

50-100g/day regardless of weight

45
Q

what is the principle behind glucose requirements?

A

2g/kg of ideal or 100g

46
Q

initial management of CKD related bone disease?

A

correct hyperphosphataemia first

with dietary changes
> phosphate binders

47
Q

managing hypercalcaemia?

A

IV fluids first due to cardiac stability

48
Q

what is an expected rise of creatinine ?

A

> 30% from baseline

49
Q

calcium acetate is?

A

calcium based binder used to treat the hyperphosphataemia

50
Q

sevelamer

A

non calcium based phosphate binder - would not cause hypercalcaemia

51
Q

what is stage 3 AKI based on urine output

A

<0.3mL /kg/hr for 24 hours

52
Q

CKD on haemodialysis most likely cause of death?

A

IHD

53
Q

does HSP present with thrombocytopenia?

A

no

54
Q

acute urinary retention

mx

PMHx of bladder cancer and BPH

bladder scan confirms residual volume of >1000ml

A

bladder irrigation via 3 way urethral catheter

Final Year - Passmed (22 decks)

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