Renal Revision 1

Question 1

indications for dialysis?

Answer 1

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Question 2

dysequillibrium syndrome?

Answer 2

bringing urea down too quick can cause fluid shift into the brain causing cerebral oedema
can happen if too big a dialysis session done as first dialysis (ie need to start slow - maybe only 90 mins - for first dialysis)

Question 3

anticoagulation in dialysis?

Answer 3

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Question 4

bloods if concerned about GN?

Answer 4

renal immunology:

• ANCA, MPO, PR3 (small vessel vasculitis)
• complement
• CTD screen (connective tissue disorder screen - eg lupus etc)
• anti-GBM antibody

Question 5

tests if concerned about myeloma?

Answer 5

serum immunoglobulins
protein electrophoresis
urine bence jones protein

Question 6

types of thrombotic microangiopathy?

Answer 6

haemolytic uraemic syndrome
TTP
DIC

Question 7

haemolysis screen used when anaemic without history of blood loss etc or any identifiable cause of Hb loss?

Answer 7

blood film
haptoglobins (reduced in haemolysis)
reticulocyte count
LDH

Question 8

differentials for AKI?

Answer 8

obstruction
acute GN
myeloma
thrombotic microangiopathy
end stage kidney disease
sepsis/shock
nephrotoxic drugs

Question 9

renal artery stenosis?

Answer 9

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1.5cm difference between kidneys

Question 10

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Answer 10

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Question 11

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Answer 11

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Question 12

anaemia of chronic disease?

Answer 12

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Question 13

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Answer 13

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Question 14

what is anti-GBM antibody seen in?

Answer 14

goodpastures disease??

Question 15

presentation of goodpastures?

Answer 15

rapidly progressive GN
oliguria
anuria
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Question 16

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Answer 16

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Question 17

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Answer 17

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Question 18

how is goodpastures managed?

Answer 18

plasma exchange?
get rid of plasma with antibodies and replace with new plasma
IV steroids for 3 days then switch to oral prednisolone (immunosuppression)
can also give cyclophosphamide or rituximab over a longer time period to immunosuppress

Question 19

other meds given in goodpastures if immunosuppressed?

Answer 19

co-trimoxazole prophylaxis for PJC risk
bone protection (alphacalcidol, calcium etc)
GI protection (PPI)