Renal 4

Question 1

holliday-segar formula?
28kg

Answer 1

first 10kg : 100ml/kg

second 10kg: 50ml/kg

subsequent kg: 20ml/kg

1000+500+ (20x8)

1500+160= 1660 ml > 24 hours

Question 2

maximum recommended rate of potassium infusion via a peripheral line?

Answer 2

10mmol/hour

Question 3

hyaline casts are seen in?

Answer 3

loop diuretic use

tamm-horsfall protein - secreted by DCT

Question 4

Kimmelstiel-Wilson nodules pathognomonic for?

Answer 4

diabetic nephropathy

Question 5

‘Full-house’ immunoglobulin deposition

Answer 5

characteristic of lupus

Question 6

S/E of erythropoietin

Answer 6

HTN accelerated
bone aches
flu like symptoms
rashes

Question 7

maintenance fluid should be prescribed at a rate of?

Answer 7

30ml/kg/24 hours

Question 8

paediatric fluid requirements

Answer 8

100ml / 24 hours for first 10kg
next 10kg
50ml/24

Question 9

Evidence currently supports the use of IV 0.9% sodium chloride

before contrast but at what rate?

Answer 9

maintenance fluid
1mL/kg/hour for 12 hours

Question 10

most common extra renal manifestation of ADPKD?

Answer 10

liver cysts

mitral valve prolapse

berry aneurysm

Question 11

urinary leucocytes

how to differentiate between Acute tubular necrosis and Acute interstitial nephritis

Answer 11

AIN - inflammatory process so presents with high WCC and only a trace amount of blood

Question 12

most useful initial diagnostic test for HUS>

blood culture
coagulation profile
stool culture
urine culture

Answer 12

blood culture - schistocytes

Question 13

what does high urine osmolality mean?

Answer 13

urine is very concentrated
> high osmolality
> kidneys holding onto sodium + water

Question 14

Cell-mediated (cytotoxic T-cell) mediated rejection

transplant

Answer 14

within first 6 months

Question 15

solid organ transplant recipients

most common?

Answer 15

cytomegalovirus

Question 16

acute graft is picked up by?

Answer 16

proteinuria
pyuria - leucocytes
creatinine

Question 17

how long does an arteriovenous fistula take to form?

Answer 17

6-8 weeks

Question 18

erythropoiesis-stimulating agents

Answer 18

erythropoeitin and darbepoietin

Question 19

HLA

Answer 19

major histocompatibility complex
chromosome 6

Question 20

mainetenance fluid

roughly for an 80kg ?

Answer 20

2 L of fluid
80mmol of potassium

split in 12 hour bags
is 1L of fluid w 40 mmol of potassium

Question 21

50kg women maintenance fluid ?

Answer 21

30mlxkgxday

30ml x 50 x1 = 1500L

750ml / 12 hours

50mmol of potassium
25mmol /12 hours

Question 22

Flumazenil

Answer 22

benzodiazepine overdose

Question 23

salicylate overdose management?

Answer 23

supportive

if recent activated charcoal

IV fluids

alkalinisation with IV sodium bicarbonate in order to maintain blood pH at 7.5-8.0

Question 24

amyloidosis

Answer 24

extracellular deposition of amyloid
Congo red staining: apple-green birefringence

most commonly causes loss of renal function and proteinuria
hepatosplenomegaly

Question 25

Membranous glomerulonephritis is frequently associated with?

Answer 25

malignancy nephrotic syndrome - most common

Question 26

when can you urgent refer >45s? for haematuria?

Answer 26

unexplained visible haematuria without urinary tract infection

Question 27

Is ADPKD associated with liver failure?

Answer 27

no liver cysts are associated

Question 28

in AKI renal USS or CT KUB?

Answer 28

renal USS preferred investigating intra renal or post renal causes 24 hours of diagnosing AKI when the cause is unclear

Question 29

indication for dialysis in AKI mx?

Answer 29

refractory acidosis hyperkalaemia pulomanry oedema - CXR urea levels

Question 30

uraemia manifestations?

Answer 30

pericarditis encephalopathy

Question 31

acute interstitial nephritis drug causes?

Answer 31

nsaids rifampicin penicillins allopurinol furesomide