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Summer 2015 > Renal EMQs > Flashcards

Renal EMQs Flashcards

1
Q

Pt presents with ARF, fever, night sweats, dysuria & loin pain.

Whats the most approprite Ix?

A

Urine microscopy- casts and culture

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2
Q

Elderly pt. develops ARF 4 days after hip surgery.

Whats the most appropriate Ix?

A

Urinary Na

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3
Q

Pt w/ nocturia, polyuria, hesitancy and developing a gradual rise in serum urea and creatinine.

Most appropriate Ix?

A

Physical exam and bladder scan

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4
Q

What is the likely E- abnormality after MDMA ingestion?

A

Hyponatraemia

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5
Q

What is the likely E- abnormality in a pt with ARF after strenous exercise?

A

Hypocalcaemia

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6
Q

What is the E- abnormality in a pt in the recovery phase of ARF due to rhabdo?

A

Hypercalcaemia

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7
Q

What is th E- abnormality in a pt after the introducion of ACEi in pt wth CHF?

A

Hyperkalaemia

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8
Q

What is the E- abnormality in pt with chronic laxative abuse?

A

hypokalaemia

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9
Q

What condition is assoc. RBC casts?

A

Glomerulonephritis

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10
Q

What condition is assoc. with WBC casts?

A

Pyelonephritis

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11
Q

What condition is assoc. w/ fatty casts?

A

Nephrotic syndrome

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12
Q

What condition is assoc. w/ pigmented casts?

A

Rhabdomyolysis

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13
Q

Biochemical abnormality in athlete doing 1st marathon?

A

High creatine kinase

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14
Q

Biochemical abnormality in pt using ACEi for HTN?

A

Hyperkalaemia

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15
Q

Biochemical abnormality in ecstasy user?

A

Hyponatraemia

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16
Q

Biochemical abnormality in pt with prostatic carcinoma?

A

Metabolic acidosis

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17
Q

Biochemical abnormality in pt having chemo for bulky sarcoma of rt thigh?

A

Hyperuricaemia

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18
Q

What drug combination -> AKI with hyperkalaemia?

A

Spirinolactone w/ ACEi

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19
Q

What drug combination -> KI w/ hypercalcaemia?

A

Vit D w/ oral Ca

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20
Q

What drug combination -> AKI w/ high CK?

A

Statin & cyclosporin

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21
Q

What drug combination -> AKI w/ hyponatraemia?

A

Loop diuretic & thiazide

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22
Q

What histopathological findings occur with rapidly progressive glomerulonephritis?

A

Crescentic change in the bowman’s space

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23
Q

What histopathological findings occur with acute interstitial nephritis?

A

Eosinophils in the interstitium

24
Q

What histopathological findings occur with acute tubular necrosis?

A

Mitotic figures in the tbular epithelial nuclei

25
Q

What histopathological findings occur with obstructive uropathy?

A

Tubular dilatation

26
Q

What test would establish the cause of injury in 24 yo construction worker in an accident. Thighs trapped under rubble for several hours. Has AKI and swollen thigh?

A

Plasma creatine phosphokinase

27
Q

What test would establish the cause of injury in 39 yo w/ advanced ovarian carcinoma and bulky pelvic and retroperitoneal disease w/ high serum creatinine. Urinary catheter = 75ml in 6 hours w/ macroscopic haematuria?

A

Renal ultrasound

28
Q

What test would establish the cause of injury in 63yo w/ normal serum creatinine on lisinopril 20mg/day for HTN.

4/52 later serum creatinine 330 and K 5.8?

A

MRA of renal arteries

29
Q

What test would establish the cause of injury in 41 yo male w/ amoxicillin for chest infection. 2/52 later developed poor appetite and wt loss. Serum creatinine 250?

A

Mesangial leukocytes & eosinophil infiltration on renal biopsy

30
Q

What’s the aetiology of the AKI in 71 yo m w/ permanent ileostromy following pan colectomy for UC w/ recent wt. loss. Oral barium study has ^ stoma output (>3L/day). Creatinine = 220

A

Pre-renal failure

31
Q

What test would establish the cause of injury in 76 yo F w/ AKI post hip replacement. Tx with normal saline post-op and 240mg gentamicin?

A

Acute tubular necrosis

32
Q

What test would establish the cause of injury in 55 y.o. after a course of pelvic radiotherapy for advanced cervical cancer. 2/52 developed oliguria w/ haematuria. Serum creatinine 350.

A

Obstructive uropathy

33
Q

What test would establish the cause of injury in 28 yo w/ AKI w/ haematuria for 2/52 after a sore throat?

A

Glomerulonephritis

34
Q

Whats the most likely cause of HTN

Normal sized kidneys on renal USS

A

Essential HTN

35
Q

Whats the most likely cause of HTN

Asymmetrical kidneys with acute rise in serum creatinine after intro of ACEi?

A

Bilateral renal artery stenosis

36
Q

Whats the most likely cause of HTN

Asymmetrical kidneys with minimal/no change in serum creatinine after ACEi?

A

unilateral renal artery stenosis

37
Q

Whats the most likely cause of HTN

Normal sized kidneys on USS, microaneurysms on fundoscopy?

A

Diabetic nephropathy

38
Q

What is useful in differentiating renal from pre-renal failure?

A

Urinary Na

39
Q

What may cause AKI in pt with renal disease?

A

Coronary angiogram

40
Q

What is safe to perform in Pt. w/ renal impairment to Ix obstruction?

A

Renal USS

41
Q

What values may be falsely low in pt. with increased muscle mass?

A

eGFR

42
Q

How does the following cause renal injury?

Laxative abuse

A

Volume depletion

43
Q

How does the following cause renal injury?

ACEi

A

Dilatation of the efferent arteriole

44
Q

How does the following cause renal injury?

NSAIDs

A

Reduces vasodilatory PGs

45
Q

How does the following cause renal injury?

Radiocontrast agents

A

Afferent arteriolar vasoconstricton/ renal iscaemia

46
Q

What drug can cause acute rhabdo?

A

Statins

47
Q

What requires a dose reduction in Pt. w/ chronic kidney disease?

A

Gabapentin

48
Q

What may cause post-renal failre by inducing retroperitoneal fibrosis?

A

Bromocryptin

49
Q

What may cause ureteric calcium stone formation?

A

Large doses o vit C

50
Q

What can cause frothy urine?

A

Nephrotic syndrome

51
Q

What can cause cloudy urine?

A

Acute pyelonephritis

52
Q

What can cause dark urine with red cell casts?

A

Acute post-strep glomerulonephritis

53
Q

What can cause dark urine with no red cell or red cell casts?

A

rhabdomyolysis

54
Q

What can cause macroscopic haematuria with no red cell casts?

A

transitional cell carcinoma of the bladder

55
Q

Pt. presents with ARF, chest symptoms, urine dipstick shows blood+++ and protein+++.

Whats the most appropriate Ix?

A

Renal biopsy

Summer 2015 (2 decks)

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