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Year 4 Finals > Renal/Nephrology > Flashcards

Renal/Nephrology Flashcards

1
Q

How may nephrotoxicity due to contrast media by prevented?

A

IV fluid therapy with 0.9% sodium chloride for 12 hours pre and post procedure

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2
Q

In patients at risk of nephrotoxicity due to contrast media, which medication should be withheld for minimum of how long?

A

Metformin for minimum 48 hours

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3
Q

Metformin can increase the risk of which metabolic abnormality?

A

Lactic acidosis

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4
Q

What is the most common cause of AKI?

A

Acute tubular necrosis

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5
Q

Acute interstitial nephritis can be caused by what antibiotic?

A

Penicillin

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6
Q

Eosinophilia in the context of AKI suggests what?

A

Acute interstitial nephritis

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7
Q

Muddy brown casts in the urine are suggestive of what?

A

Acute tubular necrosis

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8
Q

Fill in the blank:
Creatinine kinase should be at least __ times upper limit to support a diagnosis of rhabdomyolysis

A

5

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9
Q

What levels of urinary sodium may we expect in pre renal AKI vs acute tubular necrosis?

A

Pre renal - low (kidneys hold on to sodium to preserve volume, still working/not source of problem)
Acute tubular necrosis - high

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10
Q

Good response to fluid challenge suggests the problem lies where in AKI?

A

Pre renal

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11
Q

Protein on urine dipstick suggests the problem lies where in AKI?

A

Intrinsic

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12
Q

Blood on urine dipstick suggests the problem lies where in AKI?

A

Post renal

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13
Q

What is the most common cause of inherited kidney disease?

A

Autosomal dominant polycystic kidney disease

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14
Q

What are the target Hb levels for patients with CKD?

A

10-12g/dL

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15
Q

Pruritus in CKD occurs secondary to build up of what?

A

Urea

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16
Q

What type of anaemia is observed in CKD?

A

Normochromic normocytic

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17
Q

What is the biggest risk factor for CKD induced anaemia?

A

Reduction in EPO

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18
Q

What test should be used to quantify proteinuria in CKD?

A

Albumin creatinine ratio

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19
Q

In CKD, we can expect high or low levels of:
1. Vitamin D
2. Calcium
3. Phosphate

A
  1. Low vitamin D
  2. Low calcium
  3. High phosphate
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20
Q

What type of hyperparathyroidism is observed in CKD?

A

Secondary

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21
Q

How should mineral bone disease in CKD be managed first line?

A

Reduce dietary phosphate

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22
Q

What drug may be used in steroid resistant minimal change disease?

A

Cyclophosphamide

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23
Q

Which type of glomerulonephritis may only be seen under electron microscopy?

A

Minimal change disease

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24
Q

At what ACR level should CKD patients be started on an ACE inhibitor?

A

Over 30mg/mmol

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25
Q

What is the first line treatment for minimal change disease?

A

Prednisolone

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26
Q

How long after infection does haematuria develop in:
1. IgA nephropathy
2. Post strep glomerulonephritis

A
  1. 1-2 days
  2. 1-2 weeks
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27
Q

In hyperaldosteronism, high renin levels suggests the cause is primary or secondary?

A

Secondary

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28
Q

Sevelamer is what kind of drug?

A

Phosphate binder

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29
Q

What is the screening method for adult polycystic kidney disease?

A

Ultrasound

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30
Q

Fill in the blanks:
CKD can be diagnosed with an eGFR below __, on 2 occasions __ months apart.

A
  1. 60
  2. 3
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31
Q

Which neurology complication are adult polycystic kidney disease patients at risk of?

A

Subarachnoid haemorrhage

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32
Q

HIV is most associated with which type of glomerulonephritis?

A

Focal segmented

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33
Q

Malignancy is most associated with which type of glomerulonephritis?

A

Membranous nephropathy

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34
Q

Local spread of bladder cancer is most commonly assessed using what?

A

Pelvic MRI

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35
Q

Painless macroscopic haematuria is suggestive of what?

A

Bladder cancer

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36
Q

What is the most common histological type of bladder cancer?

A

Transitional

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37
Q

What is the most common type of testicular cancer?

A

Germ cell

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38
Q

What is the biggest risk factor for testicular cancer?

A

Infertility

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39
Q

Germ cell testicular cancers may secrete what 3 markers?

A

AFP, hCG, LDH

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40
Q

What is the first line diagnostic investigation for testicular cancer?

A

Ultrasound

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41
Q

What is the first line investigation for prostate cancer?

A

Multi parametric MRI

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42
Q

What is the upper limit of PSA testing?

A

4ng/ml

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43
Q

What is the most common histological type of prostate cancer?

A

Adenocarcinoma

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44
Q

Which zone of the prostate is most commonly affected in prostate cancer?

A

Peripheral

45
Q

Which grading system is used for prostate cancer?

46
Q

Which group of lymph nodes does prostate cancer spread to first?

47
Q

What is the standard treatment for localised prostate cancer?

A

Radical prostatectomy

48
Q

Following a UTI, how long should we wait until carrying out a PSA test?

A

6 weeks after treatment finished

49
Q

Why should LHRH analogues be co-prescribed with anti-androgens?

A

Due to risk of tumour flare

50
Q

What is the typical age range testicular cancer may present in?

A

15-35 years old

51
Q

Raised AFP excludes what type of testicular cancer?

52
Q

Schistosomiasis increases the risk of what type of bladder cancer?

53
Q

What is the diagnostic method of choice in bladder cancer?

A

Cystoscopy with biopsy

54
Q

What is the most common complication of radiotherapy administered for prostate cancer?

55
Q

Fill in the blank:
Patients aged ___ and above with ___ ___ should be referred on a 2 week wait for bladder cancer.

A
  1. 60
  2. Painless haematuria
56
Q

Kimmelstein-Wilson nodules on histology are suggestive of what?

A

Diabetic nephropathy stage 4

57
Q

How often should an ACR be carried out in diabetic nephropathy patients?

58
Q

Which macronutrient should be restricted in diabetic nephropathy patients?

59
Q

Diabetic nephropathy patients should aim for BP of?

A

Under 130/80

60
Q

An ACR value of what warrants therapy with ACE inhibitors or an ARB?

A

3mg/mmol or more

61
Q

What is the maintenance fluid value for adults?

A

25-30ml/kg/hour

62
Q

What is the maintenance value for potassium, sodium and chloride?

A

1mmol/kg/day

63
Q

What 2 blood findings does TURP syndrome present with?

A

Hyponatraemia and hyper ammonia

64
Q

What class of BPH drugs cause a decrease in prostate volume?

A

5-alpha reductase inhibitors
(Finasteride)

65
Q

What class of BPH drug is indicated in patients with lower urinary tract symptoms?

A

Alpha 1 antagonists
(Tamsulosin)

66
Q

What is the most common kidney stone composition?

A

Calcium oxalate

67
Q

Staghorn calculi are most commonly composed of what?

A

Struvite (magnesium, ammonia, phosphate)

68
Q

Which type of renal stones are associated with chronic infection?

69
Q

Which colonic surgical procedure is associated with the development of uric acid stones?

70
Q

Which type of diuretic is associated with:
1. Increased risk of calcium renal stones
2. Decreased risk of calcium renal stones

A
  1. Increased risk - loop diuretics
  2. Decreased risk - thiazide diuretics
71
Q

Which imaging modality should be used in suspected renal stones in pregnant women and children?

72
Q

How should a patient who is asymptomatic with a renal stones under 5mm be managed?

A

Watchful waiting

73
Q

When should percutaneous nephrolithotomy be considered in renal stones?

A

If stones over 20mm

74
Q

A renal stone of 5-10mm should be managed how?

A

Shockwave lithotripsy

75
Q

Alpha blockers should be considered in what type of stones?

76
Q

Renal stones 10-20mm should be managed how?

A

Ureteroscopy

77
Q

Cholestyramine and pyroxidine may be used in prevention of what type of stones?

78
Q

What is the most useful initial diagnostic test in haemolytic uraemic syndrome?

A

Blood film

79
Q

Hyaline casts in urine are associated with which class of drugs?

A

Loop diuretics

80
Q

What is the maximum recommended infusion rate of potassium?

A

10mmol/hour

81
Q

Autosomal dominant adult polycystic kidney disease is associated with what cardiac defect?

A

Mitral valve prolapse

82
Q

What is the treatment of choice for nephrogenic diabetes insipidus?

A

Thiazide diuretics

83
Q

What is the treatment of choice for cranial diabetes insipidus?

A

Desmopressin

84
Q

How may contrast induced nephrotoxicity be prevented in patients with CKD?

A

IV fluid therapy with 0.9% sodium chloride, 1ml/kg/hour for 12 hours pre and post scan

85
Q

What is the most common bacterial cause of haemolytic uraemic syndrome?

86
Q

In CKD, deficiency in what should be corrected before administering EPO stimulating agents for anaemia?

87
Q

Low levels of what hormone may be seen in nephrotic syndrome?

88
Q

What is the most common histological subtype of renal cell carcinoma?

A

Clear cell

89
Q

Varicocele is associated with what type of cancer?

A

Renal cell

90
Q

Combination of cholestasis and renal cell carcinoma is known as what?

A

Stauffer syndrome

91
Q

Partial nephrectomy can be carried out in renal cell cancers of what size?

92
Q

How many mmol of potassium are there per litre of Hartmann’s solution?

93
Q

Infusion rate of potassium should not exceed what?

A

20mmol per hour

94
Q

What is the standard fluid challenge value?

A

500mls of 0.9% sodium chloride

95
Q

Administering large volumes of 0.9% sodium chloride increases risk of what acid/base disorder?

A

Hyperchloraemic metabolic acidosis

96
Q

Prolonged diarrhoea is associated with what acid/base disturbance?

A

Hypokalaemic metabolic acidosis

97
Q

Sensorineural hearing loss is associated with which genetic renal disorder?

A

Alports syndrome

98
Q

Haemolytic uraemic syndrome is most commonly caused by which bacteria?

99
Q

What is the preferred method of access for haemodialysis?

A

Arteriovenous fistula

100
Q

What is the investigation of choice for suspected diabetes insipidus?

A

Water deprivation test

101
Q

What is the most common and important viral infection following renal transplant?

A

Cytomegalovirus

102
Q

Which method of anticoagulation is recommended in nephrotic syndrome?

A

Low molecular weight heparin

103
Q

Which electrolyte imbalance indicated kidney disease is chronic rather than acute?

A

Hypocalcaemia

104
Q

Haemoptysis in the context of AKI suggests what?

A

Anti-GBM disease (Goodpasture’s)

105
Q

What investigation is warranted in cases of AKI with unknown aetiology?

106
Q

Nephrogenic diabetes insipidus can be caused by which antipsychotic medication?

107
Q

Nephrotic syndrome is associated with thrombosis due to deficiency of what?

A

Antithrombin III

108
Q

What is the most common organism to infect a peritoneal dialysis site?

A

Staph epidermis

109
Q

Congo red staining on renal biopsy can reveal what?

A

Amyloidosis

Year 4 Finals (15 decks)

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