renal clinical skills

Question 1

what are the top 2 risk factors of CKD?

Answer 1

diabetes and hypertension

Question 2

asterixis is a sign of early renal disease? true or false?

Answer 2

false (asterixis is a sign of end-stage renal disease)

Question 3

what do normal bowel sounds sound like?

Answer 3

low-pitched clicks followed by gurgles

Question 4

what causes petechiae in CKD?

Answer 4

thrombocytopenia

Question 5

what does frothy urine with protein indicate?

Answer 5

nephrotic syndrome

Question 6

what do nitrites present in urinalysis indicate?

Answer 6

presence of gram negative bacteria (UTI)

Question 7

what does increased specific gravity indicate?

Answer 7

dehydration –> more concentrated urine due to increased water reabsorption

Question 8

waist circumference of more than ___ (females and males) is associated with increased risk of CVD

Answer 8

females: >80cm
males: >94cm

Question 9

what presentation might be seen in uraemia?

Answer 9

lethargy, itching and fishy odour

Question 10

what causes “fishy odour” in CKD patients?

Answer 10

build up of waste (uraemia)

Question 11

what are kayser-fleischer rings a sign of?

Answer 11

wilson’s disease

Question 12

Acute renal failure is always associated with which of the following?
A. Raised plasma K+ concentration
B. Raised plasma phosphate concentration
C. Reduction in urine output
D. Reduction in glomerular filtration rate
E. The presence of red blood cells in the urine

Answer 12

d. reduction in GFR

Question 13

Simon, a 24-year-old electrician, reports he has had urinary symptoms since yesterday evening. Which of the following symptoms would be more suggestive of a urethral stone, and not a urinary tract infection (UTI), being the cause of his symptoms?
a. Frequency
b. urgency
c. retention
d. nocturia

Answer 13

retention

Question 14

When examining Wendy, a 45-year-old teacher, you note she has a palpable mass in her left upper abdomen. Which of the following features makes this more likely to be due to an enlarged left kidney, rather than splenomegaly?
a. On breathing, the mass is felt to move infro-medially
b. When percussing over the mass, the note is resonant
c. When palpating the mass, a notch is felt
d. When palpating the mass, no upper border is felt

Answer 14

b. when percussing over the mass, the note is resonant

When percussing over a kidney, the overlying bowel would make the note sound resonant, whereas a splenic mass would sound dull.