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MRCP > Renal > Flashcards

Renal Flashcards

1
Q

Cranial causes of DI

A 
Idiopathic
Head injury
Pituitary surgery
Histiocytosis X
Craniopharyngiomas
DIDMOAD
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2
Q

Nephrogenic DI causes

A

Genetic - ADH receptor mutation (AQP mutation)
Electrolytes - hypercalcaemia, hypokalaemia
Drugs - demeclocycline, LITHIUM
Tubulointerstitial disease - obstruction, sickle cell, pyelonephritis

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3
Q

DI Ix

A

High plasma osmolality (concentrated)
Low urine osmolality (dilute)
Urine osmolality >700 excludes DI
Water deprivation test

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4
Q

ADPKD genes

A

PKD1>2 (ch16 vs 4)

One is more common and presents earlier with renal failure

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5
Q

ADPKD USS criteria in those with pos FHX

A

Two cysts ( uni or bilateral) if <30
Two cysts in both kidneys if 30-59
Four cysts in both kidneys if >60

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6
Q

ACR sample collection rules

A

First pass morning sample

If 3-70 repeat, if >70 no need to repeat

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7
Q

Referral to a nephrologist

A

ACR >70 (unless known diabetic and already appropriately treated)
ACR >30 + persistent haematuria after UTI excluded (2/3 show >1+)
Consider if ACR 3-29 plus persistent haematuria and other RFs - declining eGFR, cardiovascular disease

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8
Q

HTN in CKD
First line
GFR <45

A

ACEi - esp good in proteinuric renal disease diabetic

At this point furosemide is useful, added benefit of lowering serum K

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9
Q

ACEi acceptable Cr and GfR changes

A

GFR decrease 25%

Cr rise 30%

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10
Q

Bladder TCC RFs

A

Smoking
Aniline dyes
Rubber manufacture
Cyclophosphamide

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11
Q

Bladder SqCC RFs

A

Schistosomiasis
Calmette-Guerin (BCG Rx)
Smoking

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12
Q

Goodpastures/anti GBM biopsy

A

Linear IgG deposition
Against type IV collagen
HLA DR2 associated

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13
Q

Anti GBM Mx

A

Plasmapheresis
Steroids
Cyclo

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14
Q

Alports mutation
Inheritance
Demographics

A

Type IV collagen
X linked dominant
More severe in males

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15
Q

Alports features

A 
Microscopic haematuria 
Progressive renal failure 
Bilateral sensorineural deafness 
Lenticonus - protrusion of lens surface into anterior chamber 
Retinitis pigmentosa
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16
Q

Alports bx results

A

Renal Bx result- splitting of lamina densa on EM

17
Q

Features of Diabetic nephroptathy

A 
Thickened GBM
Mesangial expansion
Kimmelstein-Wilson nodules 
Disruption of podocytes 
(Glycation of basement membrane of efferent arteriole -> glomerular pressure -> dilation of afferent arteriole -> further inc in pressure -> hyperfiltrarion ( inc in GFR)
18
Q

Diabetic nephropathy stage 1

A

Hyperfiltration (inc GFR)

May be reversible

19
Q

Diabetic nephropathy stage 2

Silent /latent

A

GFR remains elevated , not yet developed microalbiminuria

20
Q

Stage 3 diabetic nephropathy

Incipient

A

Microalbuminuria 30-300 mg/day, dipstick neg

21
Q

Diabetic nephropathy stage 4
Overt nephropathy
Histology

A

Persistent proteinuria - albumin excretion >300mg/day, dipstick pos
HTN
Likely present
Histology - diffuse glomerulisclerosis and focal (Kimmelstein Wilson)

22
Q

Stage 5 diabetic nephropathy

A

ESRF - GFR < 10

Needs RRT

23
Q

Renal stones - calcium oxalate
Freq
Radiolucency

A

40%

Opaque

24
Q

Renal stones - mixed calcium oxalate, phos
Freq
Radiolucency

A

25%

Opaque

25
Q

Renal stones - triple phosphate
Freq
Radiolucency

A

10%

Opaque

26
Q

Renal stones - calcium phosphate
10%
Radiolucency

A

10%

Opaque

27
Q

Renal stones- urate stones
Freq
Radiolucency

A

5-10%

Radiolucent

28
Q

Renal stones - cystine
Freq
Radiolucency

A

1%

Semi opaque, ground glass

29
Q

Renal stones - xanthine
Freq
Radiolucency

A

<1%

Radiolucent

MRCP (17 decks)

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