Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Pass Med finals pack > renal medicine > Flashcards

renal medicine Flashcards

1
Q

what is erythropoietin?

A
  • growth factor

- stimulates production of erythrocytes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

When is Erythropoietin secreted?

A
  • secreted by kidney

- in response to cellular hypoxia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Alport syndrome is due to…

A
  • defecet in gene coding for type IV collagen

- results in an abnormal glomerular basement membrane

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

medical condition involving the death of tubular epithelial cells that form renal tubules of kidney

A

acute tubular necrosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

what might be seen in urinalysis of a patient with acute tubular necrosis

A

‘muddy brown casts’

high K+

deranged renal function

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

causes of AKI are divided into what three categories

A

Prerenal : ishcaemia

Intrinsic : toxins

Post renal : obstruction, backing up

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Pre-renal causes of AKI

A

ISCHAEMIA

  • hypovolaemia secondary to diarrhoea / vomiting
  • renal artery stenosis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Intrinsic causes of AKI

A

glomerulonephritis

acute tubular necrosis (ATN)

acute interstitial nephritis

rhabdomyolysis

tumour lysis syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

post renal causes of AKI

A
  • kidney stone in ureter or bladder
  • benign prostatic hyperplasia
  • external compression of ureter
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

what is a recognised cause of diabetes insipidus ?

A
  • lithium
  • lithium desensitizes the kidneys ability to respond to ADH in the collecting ducts
  • demeclocycline
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

what is antithrombin III?

A
  • protease
  • inhibits coagulation by inhibiting activity of thrombin
  • nephrotic syndrome associated with a loss of antithrombin III
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

31 y/o male

  • has ongoing renal condition
  • suffers haematuria and loin pain
  • caused his underlying anaemia
  • numerous echogenic spaces in kidneys
  • mother had condition

indicative of:

A

autosomal dominant polycystic kidney disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

most common extra-renal manifestation of ADPKD is :

A

liver cysts

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

20 y/o female

pc: 5 day hx painless light brown urine. 3 episodes over 5 days.

no dyspareunia, urgency or pain.

afebrile

pmh: previous URTI

urine dip: positive for ketones and blood

indicative of:

A

post streptococcus glomerulonephritis

symptoms, previous illness and proteinuria point to PSGN

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

post streptococcus glomerulonephritis is caused by:

A

immune complex (IgG, IgM and C3) deposition in the glomeruli.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Alport’s syndrome characterised by:

A
  • haematuria
  • sensory hearing loss
  • ocular disturbances
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Causes of a normal anion gap metabolic acidosis are ABCD:

A

Addisons

Bicarb loss

Chloride

Drugs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

obesity hypoventilation will cause what type of respiratory picture

A

respiratory acidosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

describe some complications of nephrotic syndrome?

A
  • increased VTE risk
  • increased risk of infections
  • cardiovascular complications
  • anaemia
  • acute renal failure
  • hypovolaemic crisis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

triad of nephrotic syndrome

A
  1. proteinuria ( > 3g/24hr)
  2. hypoalbuminaemia ( < 30g/L)
  3. oedema
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

why does nephrotic syndrome predispose an increased risk of VTE?

A
  • loss of anti-thrombin-III, proteins C and S
  • an associated rise in fibrinogen levels
  • both predispose to thrombosis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

complications of corticosteroids

A
  • obesity
  • growth retardation
  • papilloedema
23
Q

how can primary and secondary aldosteronism be differentiated

A

look at renin levels

if renin is high then secondary cause more likely: renal artery stenosis

24
Q

55 y/o male

pc: progressive weakness, dyspnoea, hepatomegaly, proteinuria and worsening renal function

which condition explains all the patient sysmptoms?

A

amyloidosis

25
Q

what is amyloidosis?

A
  • describes the extraceullar deposition of an insoluble fibrillar protein termed amyloid
  • accumulation leads to tissue / organ dysfunction
26
Q

fibromuscular dysplasia features?

A
  • hypertension
  • CKD or more acute renal failure
  • ‘flash’ pulmonary oedema
  • 90% patients are female
27
Q

Henoch-Schonlein purpura (HSP) is a

A

IgA mediated small vessel vasculitis

28
Q

Blood in the urine means do what investigation?

A

Cystoscopy for bladder cancer

29
Q

typical symptoms of acute interstitial nephritis?

A

fever and rash

30
Q

acute interstitial nephritis is classically caused by

A

acute interstitial nephritis

31
Q

what is the preferred method of access for haemodialysis?

A

arteriovenous fistulas

32
Q

ecg changes

  • tall tented T waves
  • flattened P waves
  • shortened QT interval

indicate:

A

hyperkalaemia

33
Q

role of calcium resonium in management of patient?

A

removes potassium from body

34
Q

which of the following medication should be stopped due to risk of worsening renal function:

  • aspirin
  • lithium
  • metformin
  • naproxen
  • simvastatin
A

NSAIDs should be stopped in AKI : so naproxen

35
Q

41 y/o

discharged from hospital post community acquired pneumonia, managed at home with penicillin.

a day later:
pc: low grade fever, widespread erythematous rash and paint throughout her joints and lower back

initial blood slow significantly elevated creatine.

diagnosis:

A

acute interstitial nephritis presents with allergic type picture

  • raised urinary WCC
  • IgE and eosinophils
  • impaired renal function
36
Q

urine findings in patient with acute interstitial nephritis

A

raised urinary white cells

eosinophils

IgE

37
Q

40 y/o male pc bone and joint pain.

pmh: polycystic kidney disease

vitamin D deficiency

low PTH

patient has:

A
  • secondary hyperparathyroidism
  • kidney function has decreased
  • kidneys aren’t able to convert enough vitamin D into the active form
38
Q

In the bloods, urea is more than twice the normal range whilst creatinine is only just above the upper limit; this is indicative of

A

dehydration

39
Q

following histology is indicative of:

basement membrane thickening on light microscopy

subepithelial spikes on sliver stain

positive immunohistochemistry for PLA2

A

membranous glomerulonephritis

40
Q

Normocytic anaemia, thrombocytopaenia and AKI following diarrhoeal illness - consider

A

haemolytic uraemic syndrome

supportive management
- fluids, blood transfusion and dialysis if required

41
Q

classical triad of renal cell carcinoma:

A
  1. haematuria
  2. loin pain
  3. abdominal mass
42
Q

features of renal carcinoma besides the classic triad of haematuria, loin pain and abdominal mass

A
  • pyrexia of unknown origin
  • left varicocele (due to occlusion of left testicular vein)
  • endocrine effects: may secrete erythropoietin (polycythaemia, PTH, hypercalcaemia, renin, ACTH)
43
Q

few signs and symptoms of anaemia?

A

tachycardia

fatigue

pallor

aortic flow murmur.

44
Q

The mainstay of rhabdomyolysis treatment is

A

rapid IV fluid rehydration

45
Q

Sterile pyuria and white cell casts in the setting of rash and fever should raise the suspicion of

A

acute interstitial nephritis, which is commonly due to antibiotic therapy

46
Q

Nephrotic syndrome is associated with a hypercoagulable state due to…

A

loss of antithrombin III via the kidneys

47
Q

The anion gap is calculated by:

(sodium + potassium) - (bicarbonate + chloride)

A normal anion gap is 8-14 mmol/L

It is useful to consider in patients with a metabolic acidosis:

A

The anion gap is calculated by:

(sodium + potassium) - (bicarbonate + chloride)

A normal anion gap is 8-14 mmol/L

It is useful to consider in patients with a metabolic acidosis:

48
Q

what drug may be used in high doses to help prevent formation of ascites in patients with chronic liver disease

A

spironlactone

49
Q

most common cause of peritonitis secondary to peritoneal dialysis

A
  • staphylococcus epidermis
50
Q

for a patient who is hyperkalaemic and has associated ECG changes, describe the first priority treatment:

A

IV calcium gluconate: to stabilise the myocardium

insulin/dextrose infusion: short-term shift in potassium from ECF to ICF

other treatments such as nebulised salbutamol may be given to temporarily lower the serum potassium

51
Q

what might you use for the removal of calcium from the body?

A
  1. calcium resonium
  2. loop diruetics
  3. dialysis
52
Q

Haemolytic uraemic syndrome - classically caused by what organism?

A

E-coli

53
Q

state four eGFR variables:

A

CAGE

C- creatinine

A- age

G- gender

E- Ethnicity

Pass Med finals pack (40 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions