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FRACP NOSH 2020 > Renal > Flashcards

Renal Flashcards

1
Q

What is the enzyme involved in activation of Vitamin D?

A

1-alpha hydroxylase

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2
Q

What is the active form of Vit D?

A

1,25-dihydroxyvitamin D - calcitriol

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3
Q

What are the main hormones that increase phosphate excretion?

A

FGF 23

PTH

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4
Q

Where is phosphate mostly reabsorbed in kidney?

A

PCT

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5
Q

What is the effect of Vit D on phosphate?

A

Increased serum phosphate via increased renal reabsorption

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6
Q

What are the indications for calcitriol in CKD-MBD?

A

Persistent hypocalcaemia -> if phosphate now normal

Persistent elevated PTH

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7
Q

What is the main cause of adynamic bone disease in CKD-MBD?

A

Iatrogenic -> over-suppression of PTH

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8
Q

What is the main cause of adynamic bone disease in CKD-MBD?

A

Iatrogenic -> over-suppression of PTH

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9
Q

Main way to differentiate primary and tertiary hyperparathyroidism?

A

Phosphate is low in Primary PTH

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10
Q

What is PLA2R ab present in?

A

Membranous nephropathy

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11
Q

What are the main differences in presentation between contrast-induced nephropathy and cholesterol emboli?

A

Cholesterol emboli ->

  • more delayed presentation
  • minimal renal recovery
  • transient eosinophilia and hypocomplementaemia
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12
Q

Which GN demonstrates

“subepithelial electron dense deposits” with “spike and dome” appearance on EM?

A

Membranous GN

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13
Q

What condition is closely associated with collapsing variant FSGS?

A

HIV

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14
Q

In which GN is “tram tracking” of GBM seen?

A

Membranoproliferative GN

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15
Q

Kimmelstein Wilson lesions on renal biopsy = ?

A

Diabetic nephropathy

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16
Q

Most likely GN to recur post transplant?

A

Type 2 MPGN

17
Q

Most common type of infection in first 6 months post renal Tx?

A

Urinary tract infections

18
Q

What is the treatment for wound healing in calciphylaxis?

A

Sodium thiosulphate and sevelamer

19
Q

What are the large vessel vasculitides?

A

Takayasu arteritis

GCA

20
Q

Which immune cell is most important in pathogenesis of GCA?

A

CD4 T cells

21
Q

In GCA, which layer of the affected arteries are most affected by inflammatory infiltrate?

A

Media

22
Q

What is the treatment for GCA with visual involvement?

A

Pulse methylpred, then de-escalate to high dose oral steroids

23
Q

What minimum duration of steroids should generally be given for PMR to reduce risk of relapse?

A

12 months

24
Q

What is the steroid-sparing agent of choice in PMR if required?

A

Methotrexate

25
Q

How long do the histological changes of GCA persist after commencement of therapy?

A

1 week

26
Q

Which mab has a role in GCA?

What is its unique AE?

A

Tocilizumab

IL-6 receptor antagonist
Used in combination with prednisolone

AE: Lower intestinal perforation (contraindicated in hx of diverticulosis)

27
Q

What are the main medium vessel vasculitides?

A

Polyarteritis nodosa

Kawasaki Disease

28
Q

What is the first line treatment for Kawasaki Disease?

What is the main aim of treatment?

A

IVIG

To prevent formation of coronary artery aneurysms

29
Q

What are some of the common skin manifestations of PAN? (4)

A
  • cutaneous or subcutaneous nodules
  • palpable purpura
  • livedo reticularis
  • skin infarction
30
Q

Which virus has a strong association with PAN?

A

Hep B

31
Q

What is the common demographic of those affected by PAN?

A

Middle aged men

32
Q

Which HLA is associate with GCA?

A

HLA DR4

33
Q

What is the difference between demographic of those affected by GCA vs Takayasu?

A

Takayasu - young, under 40

GCA - over 50

34
Q

What are the classic symptoms of mesenteric ischaemia?

A

Sitophobia
Postprandial abdo pain
Weight loss

35
Q

What is the common neurological manifestation of PAN?

A

Mononeuritis multiplex

36
Q

Which type of cryoglobulinaemia has the highest cryocrit?

A

Type 1 (monoclocal gammopathies)

37
Q

What type of GN is associated with cryoglobulinaemia?

A

MPGN

FRACP NOSH 2020 (18 decks)

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