Renal Pass Med

Question 1

What is the most common extrarenal manifestation of ADPKD

Answer 1

Liver cysts

Question 2

First line option for renal replacement is

Answer 2

Peritoneal dialysis

Question 3

First line for peritoneal dialysis in Crohns

Answer 3

Haemodialysis

Question 4

When is haemofilyration used

Answer 4

Only in the acute setting for very sick patients

Question 5

How long before treatment do patients need an av fistula created

Answer 5

8weeks

Question 6

What is continuous ambulatory peritoneal dialysis

Answer 6

Infected into abdo stays in for 4-8 hours then drained

Question 7

What is automated peritoneal dialysis

Answer 7

Machine does it overnight performing 3-5 exchanges over 8-10 hours

Question 8

In AKI how long should the 500mls 0.9% saline be administered over

Answer 8

15 mins

Question 9

Sterile polyuria and white cell casts in the setting of rash and fever should raise the suspicion of ………,, which is commonly due to ……….

Answer 9

Acute interstitial nephritis

Antibiotic therapy

Question 10

Myoglobinuria causes renal failure by

Answer 10

Tubular cell necrosis

Question 11

What are the variables used to calculate eGFR

Answer 11

Cage

Creatinine
Age
Gender
Ethnicity

Question 12

What happens to sodium in prerenal uraemia

Answer 12

Kidneys hold onto it to preserve volume

Question 13

Why is prophylactic LMWH needed in nephrotic syndrome

Answer 13

Increased risk of VTE

Question 14

How do you investigate AKI of unknown cause

Answer 14

Renal US

Question 15

Hyaline casts may be seen if the patient is taking

Answer 15

A loop diuretic

Question 16

How do you calculate maintenance fluid in children

Answer 16

100ml/kg for the first 10kg then 50ml/kg for the next 10kg and 20ml/kg for every subsequent kg

Question 17

What are the adult requirements for maintenance therapy

Answer 17

25-30ml/kg/day plus 1 MMIs/kg/ day

And approx 50-100g/day glucose to limit starvation keyosis

Question 18

What is the difference between cranial and nephrogenic diabetes insipid is

Answer 18

Cranial - unable to produce sufficient amounts of ADH (treat withe desmopresson)

Nephrogenic - Kidneys inability to respond to vasopressin (treat with a thiazide)

Question 19

How do you prevent contast induced nephropathy

Answer 19

Saline pre and post procedure

Question 20

What is the triad of HUS

Answer 20

AKI
Haemolytic anaemia
Thrombocytopenia

Question 21

Does DKA have a high or low anion gap

Answer 21

High

Question 22

What cancers are of increased risk after kidney transplant

Answer 22

Skin (SCC)
Lymphoma
Cervical cancer

Question 23

What is the most common cause of peritonitis secondary to peritoneal dialysis

Answer 23

Coag neg staph

Question 24

How long does it take for an AV fistula to develop

Answer 24

6 to 8 weeks

Question 25

What type of renal failure can statins cause

Answer 25

Rhabdo

Question 26

Nice guidelines suggest referring to a nephrologist from primary care if eGFR falls

Answer 26

Below 30 or progressively by >15 in a year

Question 27

What is the potassium requirement per day

Answer 27

1 mmol/kg/day

Question 28

What should be given as maintenance and how fast

Answer 28

500ml 0.9% NaCl at 30ml/kg/hr

Question 29

What is dialysis disequilibrium syndrome

Answer 29

Cerebral oedema

Question 30

When administer calcium gluconate in hyperkalaemia

Answer 30

>6.5 or ECG changes

Question 31

What is the recommended rate of potassium infusion

Answer 31

10mmol/hr

Question 32

What type of DI can haemochromatosis cause

Answer 32

Cranial

Question 33

What overdose typically presents as n+v tinnitus and headache

Answer 33

Aspirin overdose

Question 34

What can cause patients to not respond to epo

Answer 34

Iron deficiency

Question 35

What is the definition of severe hypokalaemia

Answer 35

<2.5

Question 36

How do you treat hypokalaemia

Answer 36

Mild to moderate can be treated with oral potassium Severe can be treated with IV therapy and cardiac monitoring carefully

Question 37

Stage 1 AKI

Answer 37

Increase of 1.5-1.9 times baseline | <0.5ml/kg/hr for >6 hrs consequtiverly

Question 38

Stage 2 AKI

Answer 38

Increase of 2-2.9 times baseline | <0.5ml/kg/hr for >12 hrs consequtiverly

Question 39

Stage 3 AKI

Answer 39

Increase of >3 times baseline or creatinine >354 | <0.3ml/kg/hr for >24 hrs consequtiverly or anuric for 12 hours

Question 40

What can spironolactone be switched to if the patient has troublesome gynaecomastia

Answer 40

Eplerenone

Question 41

Which stages of CKD need supporting evidence of damage

Answer 41

1 and 2

Question 42

What is the first indicator of diabetic nephropathy

Answer 42

Microalbuminuria