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?

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?

24
Q

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

A

Methotrexate

25
How long do the histological changes of GCA persist after commencement of therapy?
1 week
26
Which mab has a role in GCA? What is its unique AE?
Tocilizumab IL-6 receptor antagonist Used in combination with prednisolone AE: Lower intestinal perforation (contraindicated in hx of diverticulosis)
27
What are the main medium vessel vasculitides?
Polyarteritis nodosa Kawasaki Disease
28
What is the first line treatment for Kawasaki Disease? What is the main aim of treatment?
IVIG To prevent formation of coronary artery aneurysms
29
What are some of the common skin manifestations of PAN? (4)
- cutaneous or subcutaneous nodules - palpable purpura - livedo reticularis - skin infarction
30
Which virus has a strong association with PAN?
Hep B
31
What is the common demographic of those affected by PAN?
Middle aged men
32
Which HLA is associate with GCA?
HLA DR4
33
What is the difference between demographic of those affected by GCA vs Takayasu?
Takayasu - young, under 40 | GCA - over 50
34
What are the classic symptoms of mesenteric ischaemia?
Sitophobia Postprandial abdo pain Weight loss
35
What is the common neurological manifestation of PAN?
Mononeuritis multiplex
36
Which type of cryoglobulinaemia has the highest cryocrit?
Type 1 (monoclocal gammopathies)
37
What type of GN is associated with cryoglobulinaemia?
MPGN