Renal

Question 0

Name two causes of acute tubular necrosis

Answer 0

Ischaemia (shock), drugs/toxins

Question 1

What are three causes of painless haematuria?

Answer 1

UT neoplasm, glomerulonephritides, vasculitides

Question 2

What are 3 symptoms of pyelonephritis?

Answer 2

Fever, loin pain, increased urinary frequency

Question 3

What is the definition of renal failure?

Answer 3

A decrease in GFR resulting in an increase in plasma conc of creatinine and urea.

Question 4

At what percentage of normal GFR do symptoms of CKD manifest themselves?

Answer 4

Below ~20% of normal (very low)

Question 5

What are the 5 main characteristics of CKD?

Answer 5

Nephron loss
Glomerular hyperfiltration
Mesangial cell proliferation
Increased mesangial matrix deposition
Glomerulosclerosis

Question 6

What are the textbook values of GFR, creatinine clearance and urea clearance?

Answer 6

GFR -125ml/min
Creatinine - 140ml/min
Urea - 80ml/min

Question 7

Which two formula can be used to estimate clearance taking into account age etc.

Answer 7

Cockcroft and Gault

Modification of Diet in Renal Disease (MDRD)

Question 8

Explain the basis of proteinuria

Answer 8

Upset balance between intraglomerular pressure and integrity of BM (eg deposition of immune complexes, loss of negative charge, inflammation)

Question 9

Which molecule forms the slit-diaphragm that separates the podocytes of the glomerular basement membrane?

Answer 9

ZO-1 molecule

Question 10

What is the name of the specific condition caused when there is damage to glomerular podocytes?

Answer 10

Focal Segmental Glomerulosclerosis (FSGS)

Question 11

What are 2 trivial causes of a positive dipstick proteinuria?

Answer 11

Orthostatic (standing)

UTI

Question 12

What are the 4 symptoms that make up the Nephrotic Syndrome?

Answer 12

Oedema (caused by low serum albumin -> hypo-oncotic)
Heavy proteinuria
Hypoalbuminaemia
Hyperlipidaemia

Question 13

Name 3 major causes of nephrotic syndrome

Answer 13

Glomerulonephritis
Diabetic nephropathy
Hypertensive Ischaemic Nephropathy

Question 14

Name 4 drugs given in kidney transplant

Answer 14

Tacrolimus (calcineurin inhibitor)
Mycophenylate
Basiliximab
Prednisolone (steroid)

Question 15

What percentage of erythropoietin is produced in which places?

Answer 15

Tubular epithelial cells (85%)

Liver (15%)

Question 16

What is the normal range of extracellular [Ca2+]?

Answer 16

2.2-2.6 mM

Question 17

What are the two names for the active form of Vit D?

Answer 17

1,25-dihydroxycholecalciferol

Calcitriol

Question 18

What is the name for the adult form of Rickets?

Answer 18

Osteomalacia

Question 19

What are the main 4 presentations of kidney stones?

Answer 19

Pain (excruciating and intermittent)
UTI
Fever
Haematuria

Question 20

Name 5 characteristics of all tumours

Answer 20

Uncontrolled cell proliferation
Angiogenesis
Evasion of apoptosis
Can acquire ability to metastasise
Have non-lethal defects in DNA

Question 21

What is the most common type of renal cell carcinoma?

Answer 21

Clear cell carcinoma

Question 22

What are the two types of dialysis?

Answer 22

Haemodialysis and peritoneal dialysis

Question 27

What are the main 3 causes of haematuria?

Answer 27

Glomerular disease eg IgA nephropathy
Malignancy eg renal cell carcinoma
Polycystic disease

Question 28

Which protein is lost that leads to the development of clear cell carcinoma? What does it do?

Answer 28

Von Hippel-Lindau protein normally marks proteins for breakdown by ubiquitin pathway, including hypoxia induce le factor 1a (HIF1a) which promotes transcription of proteins that stimulate angiogenesis.

Question 29

What are the 4 endocrine secretions of the kidney?

Answer 29

Calcitriol
Erythropoietin
Renin
Prostaglandins