Renal 7 - Renal Tubular Acidosis + HUS

Question 1

1 sentence summary:

renal tubular acidosis
acute interstitial nephritis
acute tubular necrosis
glomerulonephritis

Answer 1

RTA - metabolic acidosis due to tubular pathology

AIN - inflammatory hypersensitivity reaction

ATN - death of kidney tissue due to direct insult

GN - nephrotic or nephritic syndrome due to inflammation of glomerulus

Question 2

type 1 renal tubular acidosis

Answer 2

distal tubule pathology

can’t excrete protons

Question 3

causes of type 1 RTA

Answer 3

genetic, Marfan’s, sickle cell
SLE, Sjogren’s
PBC
hyperthyroid

Question 4

presentation and treatment of type 1 RTA

Answer 4

FTT if kid
hyperventilation
CKD
bone disease

hypokal
metabolic acidosis
high urine pH

give oral bicarb

Question 5

type 4 renal tubular acidosis

Answer 5

due to low aldosterone

hyperkalaemia
acidotic urine due to low ammonia excretion

most common one

Question 6

causes and inv results in renal tubular acidosis

Answer 6

adrenal insufficiency - affects distal tubule

ACE inhibitors
spironolactone
SLE, diabetes, HIV

high potassium
high chloride
metabolic acidosis
low urine pH

give fludrocortisone + deal with ions etc

Question 7

define haemolytic uraemic syndrome

Answer 7

thrombosis in small blood vessels due to Shiga toxin

haemolytic anaemia
AKI
low platelets

Question 8

presentation of HUS

Answer 8

5 days after gastroenteritis (E coli or Shigella)

present with:

low urine output
dark brown urine (blood)
abdo pain
confusion
HTN
bruising

Question 9

management of haemolytic uraemic syndrome

Answer 9

medical emergency

give supportive management

dialyse
anti HTN
transfuse