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renal key notes Flashcards

1
Q

16 y/o low grade fever started a week ago, feeling fatigued, indicates pain in joints. visiting toilet more.

Urine dipstick shows trace proteins. Blood test shows raised eosinophils.

Likely diagnosis is:

A

Acute tubulointerstitial nephritis.

  • –> fever
  • –> skin rashes
  • –> raised eospinophils
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2
Q

Dysuria
Elevated white cell count
Raised leukocutes
Raised nitrites in urine

charactersitic of:

A

UTI

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3
Q

33 y/o female, A&E severe RHS flank pain/ pain started 3hrs ago, not constant. moving towards right iliac fossa. nauseas and has low grade fever.

most likley has?

A

Suspected renal stone.

Thus appropriate action would be abdominal USS.

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4
Q

Diabetic nephropathy always presents with:

A

increased proteinuria.

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5
Q

21 y/o female complains of urinary frequency, nocturia, constipation and polydipsia. symptoms started 2 weeks ago.

genreal malaise, some pain in her left flank.

most appropriate investigation is:

A

Patient has symptoms of hypercalcaemia.

measure calcium/

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6
Q

renal carcinoma characterised by what triad

A
  1. haematuria
  2. flank pain
  3. abdominal or flank mass

alongside malignancy symptoms

  • weight loss
  • malaise
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7
Q

67 y/o diabetic female, collapsed while going to toilet. did not lose consciousness, appears well.

Urine dipstick positive for glucose nitrates, leukocytes and haematuria

A

UTI

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8
Q

66 y/o poorly controlled T2DM, 2 day history of severe pain in RHS flank, nausea and fevers that come and go/

on examination patient appears unwell, sweaty and has visible rigors with temp of 38 degrees.

Urine dipstick positive for protein, blood, leukocytes and nitrates/

CT of abdomen reveals gas in renal parenchyma

likely diagnosis?

A

Pyelonephritis.

- GRAM NEGATIVE

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9
Q

describe the action of NSAIDs on glomerular filtration pressure?

A

vasoconstriction of afferent arteriole.

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10
Q

bladder’s lymphatic drainage is predominantly by:

A
  • external and internal iliac nodes
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11
Q

para-aoritc lymph nodes predominantly drain:

A
  • the ovaries and testes
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12
Q

ADH key facts

A
  • released from posterior pituitary
  • acts on aquaporin 2 channels in apical membranes
  • of DCT and collecting ducts
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13
Q

left testicular vein drains into…

A

left renal vein

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14
Q

in patients complaining of abdominal discomfort and nausea, with frequent epsiodes of kidney stones and UTIs. what anatomical abnormality may be found on imaging?

A
  • horse shoe kidney

- fused kidneys crossing anterior to aorta

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15
Q

18 month baby boy with recurrent urinary tract infections.

he is noted to have abnormal renal function.

USS performed showing bilateral hydronephrosis.

most likely underlying diagnosis

A

patient may have posterior urethral valves

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16
Q

46 yo female, acute intermittent sharp pain in RHS flank, haematuria, slight nausea, history of hyperparathyroidism. BMI of 28. restless and right flank tenderness.

What substance is most likely causing the pain in this patient?

A
  • renal colic caused by renal stones

- most renal stones are made up of calcium oxalate

17
Q

Rampiril

A

ACE inhibitor

18
Q

chancre

A

painless genital ulcer.

most commonly formed during primary stage of syphillis.

19
Q

majority of renal phosphate reabsorption occurs in the ….

A

PROXIMAL CONVOLUTED TUBULE

20
Q

which cells detect changes in salt concentrations and adapts the glomerular filtration rate accordingly?

A
  • macula densa
21
Q

Describe where principal cells are located and their role?

A
  • located in DCT

- have ADH and aldosterone receptors

22
Q

which cells are located in DCT and have aldosterone and ADH receptors?

A
  • principal cells
23
Q

Role of juxtaglomerular cells?

A
  • smooth muscle cells
  • mainly lcoated in afferent arteriole walls
  • baroreceptors
  • detect BP changes
  • secrete RENIN
24
Q

mechanisms a patient in hypovolemic shock may use to maintain BP

A
  • increase heart rate
  • peripheral vasoconstriction
  • arterioles are sites of highest resistance in CV system
25
Q

29 y/o male, polyuria, polydipsia, in hospital previously for a head injury.

water deprivation test was done.

pituitary MRI showed thickened pituitary stalk.

patient most likely has?

A
  • diabetes insipidus
26
Q

y wave on JVP

A

ventricular filling

emptying of right atrium

27
Q

arterial baroreceptors located

A

carotid sinus and aortic arch

28
Q

bladder recieves parasympathetic innervation from

A
  • pelvic splanchnic nerves
29
Q

what recieves venous drainage from the bladder and prostate?

A
  • vesicoprostatic venous plexus
30
Q

A 25-year-old man is injured in a road traffic accident. His right tibia is fractured and is managed by fasciotomies and application of an external fixator. Over the next 48 hours his serum creatinine rises and urine is sent for microscopy, muddy brown casts are identified. What is the most likely underlying diagnosis?

A

acute tubular necrosis.

31
Q

acute interstitial nephritis

A
  • usually occurs aar of drug toxicity

- no muddy brown casts

32
Q

A 63-year-old male presents with several episodes of haematuria. He suffers from COPD secondary to long term smoking. What is the most likely underlying cause?

A

transitional cell carcinoma of bladder strongly linked to smoking/

33
Q

Alport syndrome

A
  • X linked dominant
  • defect in type 4 collagen gene
  • abnormal glomerular basement membrane
34
Q

42 y/o female with diabetes. has been started on metformin. worried about how diabetes will affect kidneys longterm.

by which mechanism does the most damage to kidneys occur?

A
  1. non-enzymatic glycosylation of vascular membrane
  2. in large and medium vessels leads to atherosclerosis
  3. NEG in small vessels —-> hyaline arteriosclerosis
  4. sclerosis of renal efferent arteriole of glomerulus
  5. leads to nephropathy
35
Q

bladder receives sympathetic innervation from the?

A

superior and inferior hypogastric plexuses

36
Q

horseshoe kidneys become trapped under what which prevents their anterior ascent

A

inferior mesenteric artery

37
Q

in females the bladder is drained by

A
  • vesicouterine venous plexus
38
Q

40 y/p RUQ pain, radiates to RHS shoulder, nausea and vomiting. palpable abdominal mass, Murphy’s sign positive.

A
  • cholecystitis

- leads to post hepatic jaundice aar of biliary obstruction

39
Q

A 56-year-old male presents to rheumatology clinic with ongoing pain from his rheumatoid arthritis, he is initiated on a NSAID for pain control, what affect does this have on the kidneys?

A
  • afferent arteriole constriction

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