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Year 2 > Renal Treatment > Flashcards

Renal Treatment Flashcards

1
Q

Hyperkalemia treatment

A

1st: Calcium gluconate (stabilises cardiac membrane)

Then

-Insulin 50mls 50% dextrose 30 m (puts potassium back into ICS from ECS)

-Saba neb (90 min) (not necessary)
- sodium bicarbonate for acidotic patients

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2
Q

when do you use dialysis

A

Severe acidosis ph<7.15
hyperkalaemia, persistently >7
pericardial rub/encephalopathy cause by uraemia
pulmonary oedema + oliguria
Uraemia: >40

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3
Q

what is CMV transplant patient treatment

A

kidney transplant-

prophylaxis po valangoclovir (unless both donor & recipient are CMV neg)

IV gangiclovir if evidence of CMV infection

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4
Q

IgA nephropathy <500-1000 mg/day proteinuria
and normal GFR treatment

A

no treatment. follow up to check renal function

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5
Q

IgA nephropathy >1g/day proteinuria and normal/slightly inc GFR
treatment

A

this describes moderate IgA nephropathy:

initial treatment with ace
failure to respond: immunsupression with corticosteroids

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6
Q

Myeloma treatment
include the tx for renal failure caused by myeloma

A

Chemotherapy, stem cell transplant

For renal failure- dialysis (supportive)

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7
Q

minimal change disease mainstay of treatment
(2 lines)

A

oral corticosreroids

2nd: cyclophosphamide is the next step for steroid resistent cases

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8
Q

CKD mineral bone disease treatment

A

aim of treatment is to reduce phosphate and pth

1st line: low phosphate diet

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9
Q

primary membranous nephropathy tx

A

all patients should recieve an ACE inhibitor/ARB

severe/progressive disease: corticosteroid + cyclophosphamide

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10
Q

treatment for peritonitis

A

vancomycin + ceftazidime added to dialysis fluid
or
vancomycin added to dialysis fluid + ciprofloxacin by mouth

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11
Q

GPA treatment

A

initial: give methylprednisolone to halt disease and

definitive: cyclophosphamide (this takes a short while to kick in hence the steroids) and plasma exchange

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12
Q

GPA treatment in old/immunocrompimised

A

ritiximab and plasma exchange

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13
Q

focal segmental glomerulonephritis treatment

A

oral steroids

2nd: ciclosporin/cyclophosphamides

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14
Q

Most important management for urinary incontinence

A

1st line:

Lifestyle modification- weight loss, stop smoking, avoid constipation, modify fluids intake, stop drinking caffeine

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15
Q

1st line pharmacological treatment for urinary incontinence

A

Oxybutynin- (anti-mucarininc receptor)

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16
Q

acute retention tx

A

urological emergency:
catheter and alpha blocker!

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17
Q

acute renal colic Tx for small stone

A

diclofenac IM/ PR + opiate

give alpha blocker for small stones that are expected to pass

do CT scan 3 weeks later

18
Q

torsion of testes tx

A

surgical, unwind tests have to do surgery on both tests as inc chance of other test being affected

(just reminder u get a blue dot on torsion of testes)

19
Q

epidydmitis treatment

A

analgesia + scrotal support+ bed rest

ofloxacin 400mg/day for 14 days

20
Q

paraphimosis tx

A

under penile block, manual compression of glans with distal traction on oedematous skin

might have to dorsal slit

21
Q

fourniers gangrene tx

A

antibiotic and surgeical debridement

22
Q

renal cell carcinoma treatment for T1a (3-4cm)

A

elderly and unfit: surveillance

elderly and fit: ablation

some younger patients also receive ablation

partial nephrectomy

23
Q

renal cell carcinoma tx for >3-4cm

A

elderly and unfit: surveillance

elderly and fit: ablation

some younger patients also receive ablation
young:

partial nephrectomy

radical nephrectomy

(same as small tumour tx except radical nephrectomy also used)

24
Q

gold standard treatment for larger renal cell carcinoma tumours (>7cm)

A

laproscopic radical nephrectomy

25
Q

HSP treatment

A

analgesia and supportive treatment for nephropathy.

after discharge patients have to monitor bp and urine dipstick at home and then followed up 7 days post discharge.

if there is any proteinuria then patients will have check ups every 3 months

26
Q

when to treat hyperkalemia/ initial management

A

if >6.5mmol then straight away treat (calcium gluconate etc.)

if <6.5 but above normal then carry out ECG first. l

27
Q

scleroderma renal crisis treatment

A

1st line is ace

28
Q

tx for AL amyloidosis

A

immunosupression- steroids, chemo, stem cell transplant

29
Q

tx for AA amyloidosis

A

treat underlying cause

30
Q

post streptococcal glomerulonephritis tx

A

supportive, monitor fluid balance

good prognosis

31
Q

Anti-GBM/goodpastures tx

A

IV prednisolone, cyclophosphamide and plasmapheresis

32
Q

Microscopic polyangitis tx

A

plasmapheresis acutely to remove P-anca

long term presdnisolone and cyclophosphamide

33
Q

what should all patients with chronic kidney disease be prescribed

A

statin, to prevent CVD

34
Q

hypertensive chronic kidney disease management

A

statins for all
1st ace
2nd: + furosemide

35
Q

churg strauss mx

A

high dose corticosteroids then taper down (over months/years)

36
Q

at what cut off value should diabetics with CKD start on an ACE

A

albumin ratio of >2.5mg in men or >3.5 mg in women

37
Q

SLE renal flare tx

A

treat the hypertension
1st line: cyclophosphamide + corticosteroids
2nd: mycophenylate + corticosteroid

38
Q

pain relief for renal stones

A

diclofenac IM/PR

39
Q

Haemolytic uraemic syndrome treatment

A

1st: supportive: fluids, dialysis and bloods if required

plasma exchange for v complicated cases and cases not associated with diarreah
or
eculizumab

40
Q

when to stop giving a newly prescribed ACE inhibitor

A

if after two weeks creatinine has risen by 30% or more from baseline then stop ACE!

Year 2 (50 decks)

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