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Module 2 > Renal > Flashcards

Renal Flashcards

1
Q

Interstitial nephritis is most commonly caused by

A

Nephrotoxic drugs

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2
Q

5 nephrotoxic drugs

A

Hyperkalaemia-causing

  1. ACEi/ARBs
  2. NSAIDs
  3. Digoxin

Hypernatraemia-causing
4. Lithium

Other
5. Ionising CT scan contrast

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3
Q

Where do carbonic anhydrase inhibitors act?

A

Proximal convoluted tubule

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4
Q

MOA of carbonic anhydrase inhibitors at the proximal convoluted tubule

A

Prevent NaHCO3 reabsorption to reduce Na reabsorption

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5
Q

Where do osmotic diuretics act?

A

Proximal convoluted tubule and thick descending limb

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6
Q

MOA of osmotic diuretics at the proximal convoluted tubule/thick descending loop

A

Prevent water reabsorption by increasing solute concentration - decrease blood pressure by reducing volume

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7
Q

Loop diuretics act at the

A

Thick ascending limb

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8
Q

MOA of loop diuretics at the thick ascending limb

A

Prevent cation and Cl- reabsorption leading to volume loss and renin release

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9
Q

What do furosemide/bumetanide/loop diuretics promote the release of?

A

Renin from thick ascending limb

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10
Q

Where do thiazide diuretics act?

A

Distal convoluted tubule

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11
Q

MOA of thiazide diuretics at the distal convoluted tubule

A

Promote excretion of K by inhibiting Na excretion. Reduce Ca but increase Mg. Increase urea absorption leading to raised uric acid.

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12
Q

Where do potassium sparing diuretics act?

A

Collecting duct

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13
Q

Amiloride and triamterene inhibit excretion of what cation?

A

K

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14
Q

MOA of spironolactone

A

Inhibit aldosterone binding to aldosterone receptor, preventing Na/K pump mRNA translation and thus loss of K

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15
Q

5 questions/areas to rule out in someone with haematuria

A
  1. Infection: Ask about associated LUTI or UUTI symptoms
  2. Recent trauma/surgery
  3. Drug history - Anticoagulants, NSAIDs, furosemide, rifamycin, methyl-dopa, cephalosporins.
  4. Smoking history
  5. Foreign travel - schistosomiasis
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16
Q

What 3 points define an AKI?

A
  1. Increase in creat > 25 mmol/l in 48 hours
  2. Increase in creat > 50% in 7 days
  3. < 0.5 ml/kg/hour urine output for > 6 hours
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17
Q

Main cause of pre-renal AKI and what findings are seen on bloods?

A

Renal hypo perfusion

Normal creat, high urea

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18
Q

Renal AKI findings on bloods and diagnostic tool

A

Raised creat and raised urea

Biopsy of kidneys

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19
Q

Acute tubular necrosis causes what electrolyte imbalance?

A

Hypercalcaemia

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20
Q

Post-renal AKI is caused by

A

Outflow obstructions

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21
Q

Most common electrolyte imbalance with an AKI

A

Hyperkalaemia

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22
Q

CKD is defined as

A

Impaired renal function for > 3 months with 2 eGFR tests reporting declining renal function < 60 ml/min +/- A score > 3 mg/mol

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23
Q

2 congenital causes of CKD

A

Polycystic kidney disease and Alport’s syndrome

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24
Q

Pruritus, anaemia, anorexia and muscle cramps are signs of

A

CKD

25
Q

CKD 3 causes what 3 electrolyte/hormonal imbalances

A

Hypocalcaemia, hyperphosphataemia, increased PTH

26
Q

The A score measures

A

Albumin:Creatinine ratio (proteinuria)

27
Q

3 findings on a spinal x-ray in someone with CKD

A
  1. Osteosclerosis at vertebrae ends
  2. Osteomalacia
  3. Osteoporosis

‘Rugger jersey’

28
Q

Stage 2 CKD is

A

Mild: eGFR 60-89

29
Q

Stage 3a CKD is

A

Moderate: eGFR 45-59

30
Q

Stage 3b CKD is

A

Moderate: 30-44

31
Q

Severe CKD is

A

Stage 4: 15-29

32
Q

Rhabdomyolysis releases what 4?

A

Myoglobinuria
Potassium
Phosphate
CK

33
Q

5 RF for rhabdomyolysis

A

Extreme exercise, fall with a long lie, MDMA/ecstasy, crush injuries, seizures

34
Q

Dark coke-coloured urine is a sign of

A

Rhabdomyolysis

35
Q

What causes the AKI in rhabdomyolysis and how can it be managed?

A

Myoglobinurea - sodium bicarbonate

36
Q

4 signs/symptoms of nephritic syndrome

A

Haematuria
Oliguria
Proteinuria
Fluid retention

37
Q

IgA Nephropathy/Berger’s affects where and who?

A

Mesangial cells

Young adults 24-48 hours post URTI

38
Q

Membranous glomerulonephritis affects where and what is it triggered by?

A

Basement membrane

Hepatitis B/malaria/SLE

39
Q

Goodpasture Syndrome affects where and causes what 2 symptoms?

A

Basement membrane in kidney and lungs

AKI and haemoptysis

40
Q

Nephrotic syndrome presents with what 5 signs/symptoms

A
  1. Proteinuria/hypalbuminaemia
  2. Oedema
  3. Hypercholesterolaemia
  4. Hypertension
  5. Hyper-coagulopathy
41
Q

Red cast cells are seen in

A

Nephritic syndrome

42
Q

Most common glomerulonephrosis in children

A

Minimal change disease

43
Q

Hyaline casts in the urine suggest

A

Loss of albumin

44
Q

Frothy urine and oedema in a child can be a sign of

A

Minimal change disease

45
Q

Complication of glomerulonephrosis

A

Thrombosis

46
Q

Autosomal dominant PKD presents in

A

Adulthood

47
Q

Autosomal recessive PKD presents in

A

Neonates/antenatal scans

48
Q

Vasculitis that is triggered by URTI/gastroenteritis in children?

A

HSP - IgA

49
Q

HSP presents with what 3?

A

Rash, polyarteritis, haematuria

50
Q

Churg-Strauss presents with what 2?

A

Severe asthma and eosinophilia

51
Q

Wegener’s/granulomatosis with polyangiitis presents with what 3?

A
  1. Crusty nasal secretions
  2. Epistaxis
  3. Perforated nasal septum - saddle shaped
52
Q

Signs/symptoms of Kawasaki Disease (name 3)

A
  1. Strawberry tongue
  2. Red fingers/toes
  3. Fever
53
Q

What antibodies are commonly seen in vasculitis?

A

ANCA - Anti-neutrophil cytoplasmic antibodies

54
Q

P-ANCA/MPO is seen in

A

Churg Strauss and Microscopic Polyangiitis

55
Q

C-ANCA/PR3 is seen in

A

Wegener’s

56
Q

Flank pain, weight loss and haematuria are signs of

A

RCC

57
Q

Common complication of CKD/RCC

A

Anaemia

58
Q

Wilms tumour is

A

A nephroblastoma of the kidney

Module 2 (7 decks)

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