Renal

Question 1

Minimal change disease

Answer 1

NORMAL light microscopy but LOSS OF PODOCYTES on electron microscopy

Children, facial oedema

Causes = NSAIDs, gold, Hodgkin’s lymphoma

Question 2

Membranous glomerulonepthritis

Answer 2

Anti-GBM antibodies
Goodpasture’s syndrome

Haematuria, systemic Sx, pulmonary involvement

Question 3

IgA Nephropathy

Answer 3

Frank haematuria 48hr post pharyngitis

Young men 20-30yo

MCC GN, associated with coeliac, dermatitis herpetiformis

Question 4

Wegener’s granulomatosis

Answer 4

Granulomatosis with polyangitis

Triad = URTI, LRTI, renal involvement

c-ANCA

Question 5

Henoch-Schoenlein purpura

Answer 5

Purpura of the extensor surfaces of the limbs and buttocks (sparing of face and trunk)

Associated MEMBRANOUS NEPHROPATHY

Question 6

Sickle-cell disease

renal manifestations

Answer 6

Frank haematuria
Nocturnal enuresis
Acute membranoproliferative GN –> nephrotic syndrome

Question 7

Sarcoidosis

renal manifestations

Answer 7

Direct granulomatous infiltration –> CKD
Nephrocalcinosis, renal stones
Interstitial nephritis
Amyloidosis

Question 8

SLE

renal manifestations - “lupus nephritis

Answer 8

Women, 15-25
Defined by histology
Malar rash, arthritis, HTN, proteinuria, oedema

Question 9

Crohn’s disease

renal manifestations

Answer 9

Oxalate renal stones (esp. after small-bowel resection) –> pyelonephritis

Question 10

Hepatitis B & C

renal manifestations

Answer 10

HBV = DNA virus

HCV = RNA virus

Question 11

Haemolytic Uraemic Syndrome

Answer 11

Clasically post gastroenteritis with E. Coli O157

haemolytic anaemia + thrombocyopenia

Haematuria, proteinuria, purpuric rash, CNS complications

Question 12

Acute tubular necrosis

Answer 12

MC due to renal ischaemia

Also due to drugs, haemorrhage, contrast, heart failure

Question 13

Bilateral hydronephrosis

Answer 13

Due to acute urinary obstruction (MCC bladder malignancy)

Urine accumulates in bladder –> backflow to kidneys

Bimanually ballotable masses on examination

INVESTIGATION = USS abdo

Question 14

Pregnany lady presents with symptoms of a UTI - urine dip supports the diagnosis - what antibiotic would you prescribe?

Answer 14

Cephalexin (cephalosporin) is best

Penicillins can be used (NOT ampicillin)

Question 15

Investigations

AKI

Answer 15

****U+Es / Cr

***Urine dip / urinalysis

Question 16

Investigations

CKD

Answer 16

****Creatinine and GFR

**Albumin / urinalysis

**USS KUB

Question 17

Investigations

Cystitis

Answer 17

****FIRST = urine dipstick

***BEST = MSU for MC+S

Question 18

Investigations

Renal colic

Answer 18

****BEST = x-ray KUB

Question 19

Investigations

Recurrent UTI / atypical presentation

Answer 19

****Renal tract USS

***DMSA scan

**Micturating cystourethrogram (to establish reflux)

Question 20

Investigations

Haematuria (trauma)

Answer 20

****BEST = CT scan

Question 21

Investigations

Acute urinary retention

Answer 21

***Bladder scan + urethral catheterisation

Question 22

Investigations

Nephrotic syndrome

Answer 22

****MOST DIAGNOSTIC = renal biopsy

Question 23

Investigations

Renal stones

Answer 23

****FIRST = renal USS (dilation)

**NEXT = xray KUB

**BEST = intravenous urography

Question 24

Investigations

Renal artery stenosis

Answer 24

Renal arteriography

Question 25

Investigations

Prostatic hypertrophy

Answer 25

****FIRST = PSA

***BEST = USS prostate

Question 26

Investigations

Bladder UMN lesion

Answer 26

USS bladder

Question 27

Investigations

Weakness of pelvic floor muscles

Answer 27

Urodynamic studies

Question 28

Investigations

Renal tumour

Answer 28

USS scan abdo/KUB

**CT scan abdo/KUB

IVU –> renal mass

Question 29

Investigations

Bladder tumour

Answer 29

+ve urine cytology

**CYTOSCOPY

Question 30

Investigations

Nephrotic syndrome

Answer 30

Albumin

24 hour urinary protein