Renal

Question 1

Biochemical abnormalities seen in renal artery stenosis

Answer 1

high creatinine, low K+, high HCO3-

Question 2

Causes of nephrotic syndrome

Answer 2

Minimal change
FSGS
Membranous glomerulonephritis (ICM)
Mesangiocapillary glomerulonephritis

2; Diabeties, SLE, amyloid, HBV/HCV

Question 3

Causes of nephritis syndrome

Answer 3

IgA nephropathy
Mesangiocapillary glomerulonephritis

2; Anti-GBM disease, SLE, Post strep glomerulonephritisSmall-vessel vasculitis, cryoglobulinaemia

Question 4

BUN ratio in pre renal and renal azotemia

Answer 4

20: 1 pre renal
10: 1 renal

Question 5

Most common glomerulonephritis

Answer 5

IgA nephropathy. Occurs a few days after resp tract infection

Question 6

Causes of CKD

Answer 6

DM, hypertension, idiopathic, glomerulonephritis, pyelonephritis, vasculitides, PKD, reflux nephropathy, obstructive nephropathy

Question 7

Storage/irritative symptoms

Answer 7

Frequency, urgency, nocturia, dysuria

Question 8

Voiding/obstructive

Answer 8

Hesitancy, incomplete emptying, poor stream, straining

Question 9

How do you investigate renal artery stenosis

Answer 9

USS, CT angiogram or MRA

gold standard; digital subtraction renal angiography

Question 10

What do you do if there are any red flags of bladder cancer

Answer 10

Cytoscopy

Question 11

AKI causes

Answer 11

See notes

Question 12

Small vessel causes of AKI

Answer 12

HUS, TTP, DIC

Question 13

What’s the deal with HUS?

Answer 13

A microangiopathy
Progressive renal failure
MAHAnemia
Decreased platelets

Most common, particularly in under 5s is E.coli O157;H7

Pain, low hb, low platelets, bloody diarrhoea

Question 14

What’s the deal with TTP

Answer 14

MAHA, Uremia, thrombocytopenia, FEVER, NEUROLOGICAL
10-50yrs
deficiency of protease so large vWF multimers form

seizures, hemiparesis, decreased consciousness and vision

Treat with plasma exchange therapy, splenectomy in refractory cases, corticosteroids

Question 15

What’s the deal with glomerulonephritis?

Answer 15

Inflammation of glomeruli and nephrons
BP; normal to malignant hypertension
Urine dipstick; protein, blood
Renal function

Question 16

Causes of nephritic glomerulonephritis

Answer 16

IgA, henoch schonlein purpura, Anti-GBM, post strep, pauci-immune

Question 17

Causes of nephrotic glomerulonephritis

Answer 17

Minimal change, FSGS, Membranous nephropathy(most common), Membranoproliferative glomerulonephritis

Question 18

Management of glomerulonephritis

Answer 18

BP management, ACEi, ARB, steroids, treat cause

Question 19

Why does myeloma cause renal failure?

Answer 19

Hypercalcemia, paraprotein deposition

Question 20

Important nephrotoxic agents

Answer 20

NSAID, aminoglycosides (gentamicin, streptomycin), contrast agents, ACE-i, ARBs

Question 21

CKD consequences

Answer 21

Homeostatic function; acidosis, hyperkalemia
Hormonal function; anaemia, renal bone disease
CVD; vascular calcifications, uraemic cardiomyopathy
Uremia and death

(secondary hyperparathyroidism)

Question 22

Renal osteodystrophy treatment

Answer 22

calichew, calcium acetate, cinacalcet

Question 23

Most common UTI

Answer 23

E.coli

Question 24

What investigation in complicated UTI?

Answer 24

Renal USS/IV urography

Question 25

UTI treatments

Answer 25

Uncomplicated; ceflaxin or nitrofurantoin
male; cefalexin or ciprofloxacin
pyelonephritis/urosepsis; co-amoxiclav IV +/- amikaxin +/-gentamicin

Question 26

Triad for renal cell carcinoma

Answer 26

haematuria, loin pain, abdominal mass

Question 27

Symptoms of bladder cancer

Answer 27

Painless macroscopic haematuria. FUND

FLAWS

Question 28

Define nephritic syndrome

Answer 28

Haematuria, hypertension, decreased GFR