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Med c > Renal Medicine > Flashcards

Renal Medicine Flashcards

1
Q

3 stages of a kidney biopsy

A
  1. Hematoxylin- eosin stain for messangial expansion
    2- fluorescinn stain for igA deposition
    3- electron microscopy
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2
Q

IgA nephropathy

What type of disease is it, and what is its clinical presentation

A

Also known as bergers or synonaryngitic glomerulonephritis

Type of proliferative glomerulonephritis

Occurs 1-2 days after URTI

Presents with nephritic syndrome with mild proteinuria

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3
Q

Post streptococcal glomerulonephritis clinical presentation

A

Nephritic syndrome 1-3 weeks after streptococcal infection

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4
Q

Goodpastures disease aetiology and presentation

A

Anti glomerular basement membrane antibodies attack kidney and lungs

Causes glomerular nephritis ( nephritic syndrome haematuria) and haemoptysis

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5
Q

Most common cause of glomerulonephritis overall

Presentation

A

Membranous glomerulonephritis

Bimodal district in 20s and 60s

Presents with nephrotic syndrome

Spike and dome appearance on biopsy

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6
Q

Minimal change disease

Presentation

Aetiology

A

Most common cause of nephrotic syndrome in kids

Lack of histological change with pods yet effacement

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7
Q

Thin basement disease presentation and aetiology

A

Microscopic haematuria with no other loss of kidney function

Caused by thinning of basement membrane

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8
Q

Alports syndrome presentation

A

Glomerulonephritis causing haematuria

Sensorineural hearing loss

Eye disease

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9
Q

Most common cause of adult nephrotic syndrome

A

Focal segmental glomeruloscleoris

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10
Q

Criteria of nephrotic syndrome

A

24 hour urinary protein >3G

Serum albumin <25g/L

Hypercholestriaemia

Peripheral oedema

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11
Q

Most common cause of AKI

A

Acute tubular necrosis

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12
Q

What casts are seen in acute tubular necrosis

A

Muddy brown casts

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13
Q

Causes of acute tubular necrosis

A

Ischaemia - shock, sepsis and dehydration

Nephrotoxicity- gentamicin, radiology contrast, and NSAIDS

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14
Q

Presentation of acute intistitial nephritis

A

AKI and hypertension

Classic triad of rash, fever and arthralgia

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15
Q

Causes of acute interstitial nephritis

A

Hypersensitivity reaction to infection or drugs

NSAIDS, abx and rifampicin

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16
Q

Presentation of nephritic syndrome

A

Haematuria, hypertension, oliguria

17
Q

Treatment of nephrotic syndrome

A

Treat underlying cause

ACE I

LMWH

Pneumococcal vaccines and infection surveillance

Statins

High dose corticosteroids

18
Q

What is released in rhabdomyolysis

A

Myoglobin
Phosphate
Potassium
CK

19
Q

Causes of rhabdomyolsis

A

Prolonged immobility
Seizures
Crush injury
Vigorous excessive

20
Q

AKI stages

A

1- creatinine rise 1.5 -1.9 x, creatinine rise by 26.5 or oliguria of <0.5ml/kg/hr for 6 hours

2- rise in creatinine 2-3 times and oliguria 0.5 ml/kg/hr for 12 hours

3- 3x increase in creatinine or oliguria <0.3ml/kg/hr

21
Q

What drugs must be stopped in AKI

A

DAMN + opioids, lithium and LMWH

Diuretics
AceI/ARB/Aminoglycosides (gentamicin)
Metformin
NSAIDS

22
Q

Which drugs don’t worsen renal impairment but have increased risk of toxicity in AKI

A

Metformin
Lithium
Digoxin

23
Q

What cell casts are seen in AIN

A

White cell casts

24
Q

What renal tests should all diabetics have annually

A

Annual urinary albumin creatinine ratio

Should not be more than 2.5

Manage with dietary protein control, tight glycemic control and BP mx with potential ACEI

25
Q

Indication for acute dialysis (AEIOU)

A

Acidosis
Electrolyte annormality
Intoxication
Oedema
Uraemia

26
Q

which type of PKD is more common

What are some complications

How is it managed

A

Autosomal dominant is far more common and presents earlier

Associated with sub arrack bleeds, chronic loin pain, stones and haematuria
HTN and cvd

Can use tolvaptan, which is a a vasopresser receptor 2 antagonist

Med c (3 decks)

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