Renal vascular disease Flashcards

1
Q

Renovascular disease def

A

Stenosis of renal artery or its branches

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2
Q

Causes of renovascular disease

A

Atherosclerosis

Fibromscular dysplasia (young)

Takayasu’s arteritis

Antiphospholipid

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3
Q

Signs of renovasc disease

A

Resistant HTN

Rapid onset pulmonary oedema

Worseining GFR after ACEi/ARBi

Bruits (abdo/femoral/carotid)

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4
Q

Ix for renovascular disease

A

USS: one artery smaller than the other

Doppler/MRI/CT: reduced renal blood flow

Renal angiogrpahy: gold standard (invasive so do others first)

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5
Q

Rx of renovascular disease

A

antihypertensives

transluminal angioplasty +/- stent

Revascularisation surgery

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6
Q

Haemolytic uraemic syndrome (HUS) pathophysiolgy

A

Endothelial damage causes clot formation, platelet consumption and fibrin strand deposition esp in renal microvasulature

Strands cause mechanical destruction of RBC

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7
Q

HUS main complications

A

Thrombocytopaenia

AKI

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8
Q

Cause of HUS

A

E coli O157 (90%), produces verotoxin, damaging endothelial cells

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9
Q

Common presentation of HUS

A

Young children eating undercooked meat

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10
Q

HUS sx

A

abdo pain

bloody diarrhoea

AKI

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11
Q

Blood results for HUS

A

Low platelet, Hb, fragmented RBC

Clotting normal

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12
Q

Rx of HUS

A

Dialysis if AKI

Refer to experts

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13
Q

Thrombotic thrombocytopenic purpura (TTP) pathophysiology

A

Genetic or acquired deficiency in a protease (ADAMTS13)

Protease normally cuts vWF

Larger vWF multimers

Leads to easier thrombi formation

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14
Q

TTP causes

A

Idiopathic 40%

Autoimmune (SLE)

Cancer

Pregnancy

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15
Q

Blood results of TTP

A

Low platelet, Hb

Fragmented RBC on film

Clotting normal

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16
Q

Rx of TTP

A

urgernt referral to haematology

urgent plasma exchange

steroids in non-responders to plasma exchange

Eculizumab (new)

17
Q

Where are cholesterol emboli from

A

Mostly from aorta’s atheromatous plaques

Blocks renal circulation

18
Q

Signs of cholesterol emboli

A

Fever

Uncontrolled rise in BP

Livido reticularis

19
Q

Cholesterol emboli prognosis

A

Often progressive and fatal