Renal & Uro

Question 1

acute interstitial nephritis presentation:

Answer 1

5 P’s

• pee
• pain (NSAIDs)
• PPI
• rifamPicin
• penicillin ( & cephalosporin)

also have a rash, fever, AKI, eosinophilia

Question 2

which antibody is raised in post-streptococcal glomerulonephritis

Answer 2

raised antistreptolysin O titer (ASOT)

Question 3

pts with CKD are at risk of developing ____

Answer 3

AKI

Question 4

gold standard diagnostic investigation for diagnosis

in glomerulonephritides

Answer 4

renal biopsy

Question 5

1. infection/ sore throat for the past two days is which nephropathy?
2. infection/ sore throat a couple weeks before is which nephropathy?

Answer 5

1. past two days- IgA nephropathy

2. couple weeks ago - post-infectious streptococcal nephropathy

Question 6

which med can cause an isolated rise in creatinine levels (everything else is normal- urea, Na, K)

Answer 6

trimethoprim

Question 7

what is the most appropriate renal replacement therapy management for a pt who is approaching end stage renal disease?

Answer 7

peritoneal dialysis

• also can do at home, so easier

Question 8

muscle pain, swelling, dark red/ brown urine, then goes into ventricular tachycardia- cause of arrhythmia?

Answer 8

hyperkalemia

dx is rhabdomyolysis

Question 9

first-line treatment in the management of BPH

Answer 9

initiation of alpha-blocker ( eg- Tamsulosin)

Question 10

haemolytic anemia (jaundice) + thrombocytopenia + renal failure (oliguria) following a bbq (meat) i.e E. coli infection - dx?

Answer 10

haemolytic uraemic syndrome (HUS)

Question 11

which med makes kidney function worse and should be stopped in AKI till the person’s kidney function improves?

Answer 11

1. Suspend nephrotoxic drugs: NSAIDs, aminoglycosides e.g. gentamicin, ACE inhibitors/ARBs, and diuretics.
2. Suspend renally excreted drugs: metformin, lithium, digoxin.
3. Adjust renally excreted drugs e.g. opioids.

Question 12

what should you check in a pt with autosomal dominant polycystic kidney disease as part of long term follow up?

Answer 12

BP - increased risk of hypertension

Question 13

what are the indications for dialysis in a pt with AKI

Answer 13

Indications for acute dialysis can be remembered by the mnemonic AEIOU:

1. Acidosis (severe metabolic acidosis with pH of less than 7.20)
2. Electrolyte imbalance (persistent hyperkalaemia of more than 7 mM
3. Intoxication (poisoning)
4. Oedema (refractory pulmonary oedema)
5. Uraemia (encephalopathy or pericarditis).

Question 14

nephrotic syndrome - what is it + features + treatment

Answer 14

it is a syndrome secondary to an increase in serum protein

features: proteinuria (>3-3.5g/day) + oedema+ hypoalbuminaemia+ hyperlipidaemia + lipiduria

treat with high dose systemic steroids like prednisolone

Question 15

prominent spike & dome pattern on silver staining in renal biopsy - dx?

Answer 15

membranous glomerulopathy

Question 16

painless haematuria is _________ until proven otherwise

Answer 16

bladder cancer