Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

revision > renal > Flashcards

renal Flashcards

1
Q

most common infection in solid organ trasnplant

A

cytomegalovirus tx ganciclovir

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

ATN fx

A 
Acute tubular necrosis
Urine sodium		> 40 mmol/L
Urine osmolality	< 350 mOsm/kg
Fractional sodium excretion*		> 1%
Response to fluid challenge	Poor
Serum urea:creatinine ratioNormal
Fractional urea excretion**		>35%
Urine:plasma osmolality		< 1.1
Urine:plasma urea		< 8:1
Specific gravity		< 1010
Urine		Brown granular casts
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

cause of peritonitis in peritoneal dialysis

A

staphylococcus epidermidis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

causes of polyuria

A 
Common (>1 in 10)
diuretics, caffeine &amp; alcohol
diabetes mellitus
lithium
heart failure

Infrequent (1 in 100)
hypercalcaemia
hyperthyroidism

Rare (1 in 1000)
chronic renal failure
primary polydipsia
hypokalaemia

Very rare (<1 in 10 000)
diabetes insipidus
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

mechanism of thiazide for nephrogenic DI

A

In simple terms DI leads to the production of vast amounts of dilute urine which is dehydrating and raises the plasma osmolarity, stimulating thirst. The effect of the thiazide causes more sodium to be released into the urine. This lowers the serum osmolarity which helps to break the polyuria-polydipsia cycle.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

alports syndrome

A

Alport’s syndrome usually presents in childhood. The following features may be seen:
microscopic haematuria
progressive renal failure
bilateral sensorineural deafness
lenticonus: protrusion of the lens surface into the anterior chamber
retinitis pigmentosa
renal biospsy: splitting of lamina densa seen on electron microscopy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

complication of mephrotic syndrome

A

higher risk of VTE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

acute interstitial nephritis

A

caused by drugs

presence of white cells in urine as they infiltrate- differentiates from ATN

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

s/e of epo

A

accelerated hypertension potentially leading to encephalopathy and seizures (blood pressure increases in 25% of patients)
bone aches
flu-like symptoms
skin rashes, urticaria
pure red cell aplasia* (due to antibodies against erythropoietin)
raised PCV increases risk of thrombosis (e.g. Fistula)
iron deficiency 2nd to increased erythropoiesis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

maximum K+ infusion rate

A

The maximum recommended rate of potassium infusion via a peripheral line is 10 mmol/hour, whereas rates above 20 mmol/hour require cardiac monitoring

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

urea creatinine ratio raised in

A

pre renal causes of AKI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

proteinuria and hepatomegaly

A

amyloidosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

post strep vs iga nephropathy

A

iga delayed 1-2days, post strep 1-2weeks
iga macroscopic haematuria young males
PSGN Proteinuria low complement
both: recent urti, haematuria

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

screening for polycystic kidneys

A

The screening investigation for relatives is abdominal ultrasound:

Ultrasound diagnostic criteria (in patients with positive family history)
two cysts, unilateral or bilateral, if aged < 30 years
two cysts in both kidneys if aged 30-59 years
four cysts in both kidneys if aged > 60 years

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

ADPKD fx

A 
Features
hypertension
recurrent UTIs
abdominal pain
renal stones
haematuria
chronic kidney disease

Extra-renal manifestations
liver cysts (70% - the commonest extra-renal manifestation): may cause hepatomegaly
berry aneurysms (8%): rupture can cause subarachnoid haemorrhage
cardiovascular system: mitral valve prolapse, mitral/tricuspid incompetence, aortic root dilation, aortic dissection
cysts in other organs: pancreas, spleen; very rarely: thyroid, oesophagus, ovary

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

drugs causing interstitial nephritis

A 
drugs: the most common cause, particularly antibiotics
penicillin
rifampicin
NSAIDs
allopurinol
furosemide
17
Q

Membranous glomerulonephritis histology

A

basement membrane thickening on light microscopy
subepithelial spikes on sliver stain
positive immunohistochemistry for PLA2

18
Q

causes of haematuria

A

Causes of transient or spurious non-visible haematuria
urinary tract infection
menstruation
vigorous exercise (this normally settles after around 3 days)
sexual intercourse

Causes of persistent non-visible haematuria
cancer (bladder, renal, prostate)
stones
benign prostatic hyperplasia
prostatitis
urethritis e.g. Chlamydia
renal causes: IgA nephropathy, thin basement membrane disease

19
Q

matabolic acidosis with normal anion gap

A

gastrointestinal bicarbonate loss: diarrhoea, ureterosigmoidostomy, fistula
renal tubular acidosis
drugs: e.g. acetazolamide
ammonium chloride injection
Addison’s disease (with hyperkalaemia due to low aldo)

20
Q

kidney size in diabetic nephropathy

A

Chronic diabetic nephropathy will have large/normal sized kidneys on ultrasound whereas most patients with chronic kidney disease have bilateral small kidneys

21
Q

fibromuscular dysplasia fx

A

Renal artery stenosis secondary to atherosclerosis accounts for around 90% of renal vascular disease, with fibromuscular dysplasia being the most common cause of the remaining 10%.

Epidemiology
90% of patients are female

Features
hypertension
chronic kidney disease or more acute renal failure e.g. secondary to ACE-inhibitor initiation
‘flash’ pulmonary oedema

22
Q

calcium acetate

A

calcium-based binder used to treat hyperphosphataemia. This patient is suffering from symptoms of hypercalcaemia as a result of a side effect of using a calcium-based binder. Patients with chronic kidney disease (CKD) may suffer from hyperphosphataemia since the kidneys are unable to excrete excess phosphate. Calcium-based binders are used to reduce phosphate levels in patients with CKD. Symptoms of hypercalcaemia include ‘bones, stones, groans and psychic moans’.

23
Q

Hereditary haemochromatosis causes

A

cranial diabetes insipidus

24
Q

acute vs chronic graft rejection

A

Acute rejection occurs within 6 months and typically presents with signs and symptoms of infection. The diagnosis can only be confirmed with biopsy of the transplanted kidney. The best initial management is to increase the steroid dose. Chronic rejection presents insidiously with deteriorating renal function. This can occur after 6 months from transplant.

25
Q

HSP fx

A

palpable purpuric rash (with localized oedema) over buttocks and extensor surfaces of arms and legs
abdominal pain
polyarthritis
features of IgA nephropathy may occur e.g. haematuria, renal failure

26
Q

staging of AKI

A

Stage Creatinine Urine production
1 Increase 1.5-1.9x baseline < 0.5ml/kg/h for >6 consecutive hours
2 Increase 2.0-2.9x baseline < 0.5ml/kg/h for >12 consecutive hours
3 Increase > 3x baseline or >354 µmol/L < 0.3ml/kg/h for > 24h or anuric for 12h

27
Q

contraindication for peritoneal dialysis

A

crohns

28
Q

causes of crescentic glomerulonephritis

A

Causes
Goodpasture’s syndrome
Wegener’s granulomatosis
others: SLE, microscopic polyarteritis

Features
nephritic syndrome: haematuria with red cell casts, proteinuria, hypertension, oliguria
features specific to underlying cause (e.g. haemoptysis with Goodpasture’s, vasculitic rash or sinusitis with Wegener’s)

29
Q

bisphosphonates used in ckd why

A

to prevent draggin of Ca from bones in hyperphsophataemia

30
Q

rxfor ascites

A

spironolactone

31
Q

causes of DI

A 
Causes of cranial DI
idiopathic
post head injury
pituitary surgery
craniopharyngiomas
histiocytosis X
DIDMOAD is the association of cranial Diabetes Insipidus, Diabetes Mellitus, Optic Atrophy and Deafness (also known as Wolfram's syndrome)
haemochromatosis

Causes of nephrogenic DI
genetic: the more common form affects the vasopression (ADH) receptor, the less common form results from a mutation in the gene that encodes the aquaporin 2 channel
electrolytes: hypercalcaemia, hypokalaemia
drugs: demeclocycline, lithium
tubulo-interstitial disease: obstruction, sickle-cell, pyelonephritis

32
Q

left varicolcele associated ith

A

renal cell carcinoma

33
Q

path proteins lost in nephrotic syndrome

A

Loss of antithrombin-III, proteins C and S and an associated rise in fibrinogen levels predispose to thrombosis. Loss of thyroxine-binding globulin lowers the total, but not free, thyroxine levels.

34
Q

how to differentiate Primary and secondary aldosteronism

A

looking at the renin levels. If renin is high then a secondary cause is more likely, i.e renal artery stenosis.

35
Q

hyaline casts

A

loop diuretics

36
Q

stop ACEi in ckd pt when…

A

AKI

GFR less than 30

revision (24 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions