renal

Question 1

what is ATN

Answer 1

necrosis of the epithelial cells of the renal tubules

Question 2

most common cause of AKI

Answer 2

Acute tubular necrosis

Question 3

medications that can cause ATN

Answer 3

• Lithium
• NSAIDs eg Naproxen
• Heroin
• Gentamicin
• Radiology contrast dye

Question 4

specific finding on urinalysis?

Answer 4

muddy brown casts

Question 5

Management of ATN

Answer 5

• supportive fluids
• ## stopping nephrotoxic drugs

Question 6

histology finding in ATN

Answer 6

Sloughing of renal tubular epithelium causing dilatation & obstruction of tubules & some mild leucocyte infiltration

Question 7

factors causing renal ischaemia that can cause ATN?

Answer 7

• dehydration
• hypoperfusion
• thrombosis
• sepsis
• shock

Question 8

what is average urine output

Answer 8

0.5ml/kg/hour

Question 9

what do myocytes break down to release?

Answer 9

• Myoglobin
• Potassium
• Phosphate
• Creatine Kinase

Question 10

symptoms of rhabdmyolysis

Answer 10

• muscle aches & pain
• fatigue
• red/brown urine
• confusion

Question 11

Management of Rhabdomyolysis

Answer 11

• IV fluids
• IV sodium bicarb
• treat hyperkalaemia

Question 12

medications that can cause high potassium

Answer 12

• Aldosterone antagonists
• ACEi
• ARB
• Potass supplements

Question 13

ECG findings for hyperkalaemia

Answer 13

tall peaked T waves
flattened P waved
broad QRS complexes

Question 14

what temporarily drives potassium into cells?

Answer 14

Nebulised salbutamol

Question 15

most common cause of Glomerular pathology & CKD?

Answer 15

Diabetic nephropathy

Question 16

what usually triggers HUS - Haemolytic uraemic syndrome?

Answer 16

Shiga toxin

Question 17

HUS triad?

Answer 17

• Haemolytic anaemia
• AKI
• Thrombocytopaenia

Question 18

what causes haemolytic anaemia in HUS?

Answer 18

thrombosis form thoughout the body including in the kidney arterioles & capillaries - blood cells that pass through the clots get damaged

Question 19

what 2 bacteria form the Shiga toxin?

Answer 19

• Shigella

- E.Coli 0157

Question 20

what bacteria causes bloody diarrhoea?

Answer 20

E.coli 0157

Question 21

symptoms of HUS

Answer 21

• reduced urine output
• haematuria/dark brown urine
• lethargy & irritability
• confusion
• hypertension
• bruising

Question 22

which bacteria causes 75-90% UTIs?

Answer 22

Escherichia coli

Question 23

E coli is what type of bacteria?

Answer 23

gram negative baccilus

Question 24

risk factors for UTI

Answer 24

• recent intercourse
• diabetes
• SGLT 2
• history of UTIs
• spermicide use
• catheters

Question 25

symptoms of UTI

Answer 25

• dysuria
• frequency
• urgency
• incontinence
• haematuria
• n&v
• suprapubic pain

Question 26

UTI abx of choice in pregnancy

Answer 26

nitrofurantoin

Question 27

nitrofurantoin should be avoided in what?

Answer 27

renal impairment

Question 28

pre renal cause of AKI

Answer 28

• Hypovolaemia
• cardiac failure
• sepsis/systemic vasodilation
• hepatorenal syndorme
• renovascular disease
• ACEi
• atherosclerosis

Question 29

renal causes of AKI can be divided into what 3 categories?

Answer 29

• Vasculature
• Glomerular
• Tubulointersitial

Question 30

causes of post renal AKI?

Answer 30

• Urolithiasis
• Malignancy
• BPH

Question 31

what do patients with a pre renal cause of AKI usually present with?

Answer 31

• reduced CRT
• dry mucous membranes
• reduced skin turgor
• thirst
• dizziness
• reduced urine output
• orhtostatic hypotension

Question 32

RENAL DRS 26 pneumonic for assessment & management of AKI

Answer 32

R - record baseline Cr 
E - exclude obstructive causes 
N - stop Nephrotoxic drugs 
A - Assess fluid status 
L - losses/catheterisation 

D - dipstick: blood/protein
R - review medx
S - Screen

26 - creatinine rise for AKI diagnosis