Renal Problems

Question 1

JVP versus arterial pulse

Answer 1

Compressible versus palpable
Two peaks per cycle versus one
Inward versus outward movement
Varies with patient position versus does not

Question 2

Renal replacement therapy options

Answer 2

Peritoneal or haemodialysis

Renal transplant

Question 3

Clinical syndromes due to glomerulonephritis (5)

Answer 3

-Nephrotic syndrome: oedema, proteinuria, hypoalbuminaemia
Leakage of fluid from fluid into vascular space slower capillary oncotic pressure
-Nephritic syndrome: haematuria, proteinuria associated with HT and peripheral oedema
- RPGN: haematuria, proteinuria + crescents on renal biopsy, AKI leading to CKD
- asymptomatic urine abnormalities- proteiuria w/o oedema/HT. Low grade GN

Question 4

Classification of RPGN

Answer 4

anti-GBM (Goodpastures), liner IgG on BM
Immune complex (SLE, IgA nephropathy)
Pauci-immune: ANCA +ve and -ve (+ve vasculitis)

Question 5

Goodpastures therapy

Answer 5

Prednisone, cyclophosphamide, haemodialysis

Question 6

Two most common risk factors for essential hypertension

Answer 6

Increased salt intake and raised BMI

Question 7

Definition of resistant HT

Answer 7

not optimal BP, following treatment with 3 drugs, one of which is a diuretic

Question 8

Causes of resistant hypertension

Answer 8

Suboptimal drug conc (note diuretic cornerstone)
Non compliance
competing drug/sodium (NSAIDs, OCP)
White coat HT (stress)
secondary HT