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Formative Revision > Renal OH NO > Flashcards

Renal OH NO Flashcards

1
Q

Significant feature of nephrotic syndrome

A

Protein loss

prOtein= nephrOtic

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2
Q

Significant feature of nephritic syndrome

A

Haematuria

blood loss due to Inflammation= nephrItic

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3
Q

Gold standard investigation to confirm nephrotic syndrome

A

24hr urine collection

>3g/day diagnoses

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4
Q

Level of protein in 24hr urine collection diagnostic of nephrotic syndrome

A

> 3g/day

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5
Q

Most common nephrotic picture in children?

A

Minimal Change Disease

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6
Q

What is the change in Minimal Change Disease?

A

Podocytes fuse

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7
Q

Treatment for Minimal Change disease

A

Steroids

Cyclophosphamide if steroid resistant

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8
Q

Test for amyloidosis in kidney

A

Congo red staining (apple green birefringence)

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9
Q

What nephrotic picture is Anti-PLA2r antibodies associated with?

A

Membranous Glomerulopathy

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10
Q

Complications of nephrotic syndrome (4)

A

Thromboembolism
Infection risk
Renal impairment
Atherosclerosis (high lipids)

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11
Q

Back pain and renal failure

Diagnosis?

A

Myeloma

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12
Q

Tests for myeloma? (3)

A

Urine Bence Jones protein
Serum Electrophoresis
Serum Free Light Chains (Kappa & Lambda)

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13
Q

What happens in myeloma

A

Abnormal plasma cells overproduce immunoglobulin

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14
Q

Who gets Granulomatosis with Polyangiitis?

A

Old people

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15
Q

Difference between microscopic polyangiitis and granulomatous polyangiitis?

A

GPA has upper resp tract involvement (sinuses + nasal cavity)

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16
Q

GPA antibodies

A

cANCA

Anti -PR3

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17
Q

MPA Antibodies

A

pANCA

Anti-MPO

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18
Q

Why is complement low in lupus?

A

Used up in complexes

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19
Q

Cannon balls on CXR

A

Renal mets

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20
Q

Loin to Groin pain. What is it?

A

Renal Colic

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21
Q

UTI & travel to India. Likely organism?

A

Carbapenemase producing klebsiella/ enterobacteriae

dem shits resistant

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22
Q

What does Proteus sp. UTI cause?

A

Foul urine

Renal Calculi

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23
Q

Beading of the renal artery suggests

A

Fibromuscular Dysplasia

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24
Q

UTI with foul smelling urine and renal calculi causative organism?

A

Proteus Sp.

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25
Q

What is proven by RBC casts in urine

A

Haematuria is due to glomerular cause

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26
Q

Muddy brown casts of epithelial cells

A

Acute Tubular Necrosis

pathognomic

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27
Q

Saddle nose

A

GPA (due to URT granuloma/involvement)

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28
Q

Cut surface like a potato

A

Testicular seminoma

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29
Q

Blue dot sign suggests

A

Testicular torsion

agghhhhh

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30
Q

Who gets Goodpasture’s Syndrome

A

Young people

presence of anti-GBM antibodies

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31
Q

Painless Haematuria is probably

A

Malignancy

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32
Q

Renal failure, eye problems and bilateral sensorineural deafness. Diagnosis?

A

Alport syndrome

disorder in type IV collagen found at all of these sites

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33
Q

Patient with renal failure and family history of stroke and renal failure. Diagnosis?

A

Polycystic Kidney Disease

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34
Q

Why is PKD associated with stroke?

A

Causes berry aneurysms

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35
Q

String bead renal artery. Diagnosis?

A

Fibromuscular dysplasia

36
Q

Muddy brown casts in urine

A

Acute Tubular Necrosis (ATN)

37
Q

What is an AKI, define it

A

Sudden decrease in kidney function

38
Q

Main side effect of AKI?

A

Hyperkalaemia

AKI = a K high!

39
Q

Treat AKI Hyperkalaemia? (2)

A
  1. Calcium gluconate (cardioprotective)
  2. Insulin IV (forces K into cells)
  3. +/- nebulised salbutamol
40
Q

What is the assumed pathology in kids with a nephrotic picture?

A

Minimal Change Disease

41
Q

Treatment of minimal change disease

A

Oral steroids (94% remission)

42
Q

What happens in Focal Segmental Glomerulosclerosis? (FSGS)

A

Ig/ complement deposition causes scarring/sclerosis

43
Q

Treatment of FSGS?

A

Corticosteroids

44
Q

What is Membranous Nephropathy?

A

Autoimmune inflammation of glomeruli

45
Q

Antibody found in >75% Membranous Nephropathy

A

Anti-PLA2r

PLAYErrrrrrr

46
Q

What is seen on silver stain of Membranous Nephropathy? (2)

A

Thickened basement membrane

Spike and Dome on Electron Microscopy

47
Q

Best treatment for Membranous Nephropathy?

A

Immunosuppressants

eg Rituximab knocks out B cells

48
Q

What does Rituximab do?

A

Knocks out B cells

49
Q

What disease is IgA nephropathy associated with?

A

Henoch Schonlein Purpura

50
Q

Describe Hencoh Schonlein purpura? (3)

A

Non-blanching rash of lower limbs
Vasculitis
Abdominal Pain

51
Q

Classical description of IgA nephropathy?

finding and trigger

A

Micro-haematuria following strep throat or tonsilitis

52
Q

What is seen on renal biopsy in IgA Nephropathy? (2)

A

IgA deposits

Mesangial Cell Proliferation

53
Q

What is Rapidly Progressive Glomerulonephritis? (RPGN)

A

Rapid decline of kidney function leading to requiring dialysis in days/weeks

54
Q

What is classically seen on renal biopsy in RPGN?

A

Glomerular crescents

55
Q

Thickened Basement Membrane with Spiked Dome appearance. Diagnosis?

A

Membranous GN

56
Q

Heroin user presents with oedema & proteinuria. Likely diagnosis?

57
Q

Tram track immune deposits on renal biopsy. Diagnosis?

A

Membranoproliferative GN

58
Q

What is SNHL in Alport Syndrome due to?

A

Disordered type IV collagen

59
Q

Most common nephrotic picture in adults?

A

Membranous Nephropathy

60
Q

Facial feature in membranoproliferative glomerulonephritis?

A

Partial lipodystrophy (precedes renal disease by years)

61
Q

For how long must investigations be abnormal to diagnose CKD?

62
Q

What is the most common kidney malignancy in adults?

A

Renal Cell Carcinoma

63
Q

What is the most common kidney malignancy in children?

A

Nephroblastoma

64
Q

What renal pathology is associated with sickle cell anaemia?

A

Renal Papillary Necrosis

due to infarcted sickle cells

65
Q

Which drugs can cause Acute Interstitial Nephritis? (3)

A

NSAIDs
Antibiotics (Beta Lactams and sulphonamides)
Loop/ Thiazide diuretics

66
Q

Urine finding seen in Acute Interstitial Nephritis?

A

Eosinophils

67
Q

At what measurement of creatinine is dialysis indicated?

A

Creatinine never indicates dialysis

68
Q

What percentage of cardiac output goes to the kidneys?

69
Q

Does Angiotensin ii have greater effect on afferent or efferent glomerular arterioles?

70
Q

Kimmelstiel-Wilson nodules are highly suggestive of?

A

Diabetic Nephropathy

71
Q

Thickened GBM with IgG under podocytes. Diagnosis?

A

Membranous Nephropathy

72
Q

Spike and Dome appearance. Diagnosis?

A

Membranous Nephropathy

73
Q

Heroin user presents with Nephrotic Syndrome. Likely diagnosis?

74
Q

Basket Weave appearance of GBM suggests what?

A

Alport’s Syndrome

thinning and spitting of GBM due to disordered type IV collagen

75
Q

Tram-track renal biopsy. Diagnosis?

A

Membranoproliferative Glomerulonephritis (MPGN)

76
Q

Major viral cause of Membranoproliferative Glomerulonephritis (MPGN)?

A

Hepatitis C

77
Q

Haematological malignancy associated with Minimal Change Disease?

A

Hodgkin’s Lymphoma

78
Q

How long after URTI symptoms does IgA Nephropathy present?

A

1-2 days

A first letter of alphabet, days much shorter than weeks as seen in Post-Strep GN

79
Q

How long after URTI symptoms does Post-Strep Glomerulonephritis present?

80
Q

Nitrites in urine indicate what?

81
Q

Treat a 3mm ureteric stone?

A

Watchful waiting up to 5mm

82
Q

Treat a 7mm ureteric stone? (2)

A

Shockwave Lithotripsy
or if discussed
Medical treatment 5-10mm (eg alpha blocker to expulse stone)

83
Q

When is surgery indicated for a ureteric stone? (2)

A

Pain not tolerated

Stone unlikely to pass

84
Q

When is Percutaneous Nephrolithotomy indicated?

A

Stone is bigger than 2cm

85
Q

What is the most invasive surgery for ureteric/renal stones?

A

Percutaneous Nephrolithotomy

86
Q

First line treatment for the majority of renal/ureteric stones?

A

Shockwave Lithotripsy

87
Q

Main causes of Renal Artery Stenosis? (2)

A

Atherosclerosis

Fibromuscular Dysplasia

Formative Revision (50 decks)

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