Renal plz last one

Question 1

In young people what will cause renal artery stenosis?

And what is the treatment?

Answer 1

Fibromuscular dysplasia

Balloon Angioplasty

*ACE inhibitors are contraindicated in renal artery stenosis as they maintain kidney perfusion

Question 2

What metabolic changes occur with dialysis?

Answer 2

Amyloidosis

Dyslipidaemia

Secondary hyperparathyroidism

Question 3

List three causes of bilateral enlarged kidneys:

Answer 3

Bilateral Hydronephrosis

Renal cell carcinomas or tumours (tubal sclerosus)

Polycystic kidney disease

Question 4

Which disease is minimal change disease corrloaed with?

Answer 4

Hodgkin’s lymphoma

Question 5

When should protein: creatinine ratio be done?

Answer 5

Early morning

Question 6

What general investigations can be conducted into nephritic syndrome?

Answer 6

Nephritic is characterised by blood in the urine and thus has a wide range of causes. General investigations include:

Bloods:

• FBC (anaemia)
• U&Es
• LFTs (hypoalbuminemia)
• Anti-Streptolysin O antibodies
• Complement levels
• Autoimmune markers

Orifices:
- PCR (early morning)

X-rays:
- US of kidneys (identify parenchymal abnormalities)

Special tests:
- Percutaneous biopsy

Question 7

What are some symptoms of minimal change disease?

Answer 7

Discomfort related to swelling:

• puffy eyes
• skin break down

Abdominal discomfort

Tiredness

Foamy urine

Increased infections

Question 8

What are some differentials to nephrotic syndrome?

Answer 8

Malnourishment (low albumin)

Liver disease (poor albumin)

Excess protein loss through burns or injuries

Question 9

What is general management of nephrotic syndrome?

Answer 9

Steroids
Dietary sodium restriction and Fluid management
Prophylactic antibiotics
Vaccinations

Question 10

In RA list two causes that could lead to nephrotic syndrome:

Answer 10

Amyloidosis

NSAID use

Question 11

How is poly arteritis nodosa diagnosed?

Answer 11

Renal Angiography

Renal biopsy

*can also look for Hep B serology

Treated:

• Azathioprine
• steroids
• HTN control

Question 12

What are the three types of renal tubular acidosis syndromes and what do you expect to see?

Answer 12

Type II: Defect in PCT

• reduced HCO3- absorption
• Fanconni syndrome
• Heavy mental poisnoning
• Acetazolaimide (blocks carbonic anhydrase)

Type I:

• Distal tube
• build up of H+ and K+
• Lithium
• Sjorgens syndrome

Type IV:

• Aldosteronism defect
• build up of H+ and K+