Renal Buzzwords

Question 1

Muddy brown casts

Answer 1

Acute tubular necrosis

Question 2

urine sodium > 40 mmol/L

Answer 2

Acute tubular necrosis

Question 3

What should be stop in AKI?

Answer 3

Angiotensin II receptor antagonists should be stopped in AKI as may worsen renal function

Question 4

urine osmolality < 350 mOsm/kg

Answer 4

Acute tubular necrosis

Question 5

Differentiating between AKI and CKD?

Answer 5

Small kidneys on ultrasound usually helps to differentiate CKD from AKI (exceptions include ADPKD and early stages of diabetic nephropathy)

Question 6

What is an indication that kidney disease is chronic and not acute?

Answer 6

Hypocalcaemia

Question 7

What is an indication for dialysis?

Answer 7

Uraemia (encephalopathy or pericarditis) is an indication for dialysis

Question 8

What disease has a poor response to fluid challenge?

Answer 8

acute tubular necrosis

Question 9

How does the early stages of diabetic nephropathy present?

Answer 9

Enlarged kidneys on USS

Question 10

What is a complication of radiotherapy for prostate cancer?

Answer 10

proctitis

Question 11

Pregnant women with a UTI:

Answer 11

nitrofurantoin is first-line unless the woman is close to term

Question 12

Men with lower UTIs

Answer 12

Men with lower UTIs should be treated with either trimethoprim or nitrofurantoin unless prostatitis is suspected

Question 13

Urinary incontinence - first-line treatment:

Answer 13

urge incontinence: bladder retraining
stress incontinence: pelvic floor muscle training

Question 14

What should be suspected in patients with continuous dribbling incontinence after prolonged labour and from an area with limited obstetric services?

Answer 14

Vesicovaginal fistulae

Question 15

acute management of renal colic

Answer 15

Guidelines continue to recommend the use of IM diclofenac in the acute management of renal colic

Question 16

CKD: What should be corrected before prescribing erythropoiesis-stimulating agents?

Answer 16

Anaemia in CKD: correct iron deficiency before starting erythropoiesis-stimulating agents

Question 17

When should CKD patients be started on an ACEi?

Answer 17

Patients with chronic kidney disease should be started on an ACE inhibitor if they have an ACR > 30 mg/mmol

Question 18

What is prescribed to patients with stress incontinence who don’t respond to pelvic floor muscle exercises and decline surgical intervention?

Answer 18

Duloxetine

Question 19

old man, bone pain, raised ALP

Answer 19

Paget’s disease

Question 20

hyperCalcaemia, Renal failure, Anaemia (and thrombocytopenia) and Bone fractures/lytic lesions

Answer 20

CRAB - Multiple myeloma

Question 21

Ongoing loin pain, haematuria, pyrexia of unknown origin

Answer 21

Renal cell cancer

Question 22

Raised serum natiuretic peptides

Answer 22

Renal dysfunction (eGFR < 60) can cause a raised serum natriuretic peptides

Question 23

Nephrotic syndrome in children / young adults

Answer 23

minimal change glomerulonephritis

Question 24

IV calcium gluconate
insulin/dextrose infusion

Answer 24

All patients with severe hyperkalaemia (≥ 6.5 mmol/L) or with ECG changes:

Question 25

Acites

Answer 25

Use spiralactelone