renal zero to finals conditions

Question 1

risk factors for AKI

Answer 1

over 65
liver and heart disease
medications such as NSAIDS
sepsis
diabetes

Question 2

NICE guidelines for AKI

Answer 2

Rise in creatinine of more than 25 micromol/L in 48 hours
Rise in creatinine of more than 50% in 7 days
Urine output of less than 0.5 ml/kg/hour over at least 6 hours

Question 3

pre-renal causes of AKI

Answer 3

Anything that causes inadequate blood flow
dehydration
shock
heart failure

Question 4

renal causes of AKI

Answer 4

Due to intrinsic disease-
Acute tubular necrosis
Glomerulonephritis
Acute interstitial nephritis
Haemolytic uraemic syndrome
Rhabdomyolysis

Question 5

post renal causes of AKI

Answer 5

Obstruction to the outflow
Kidney stones
Tumours (e.g., retroperitoneal, bladder or prostate)
Strictures of the ureters or urethra
Benign prostatic hyperplasia (benign enlarged prostate)
Neurogenic bladder

Question 6

investigations for AKI

Answer 6

Urinalysis assesses for protein, blood, leucocytes, nitrites and glucose:

Question 7

treating AKI

Answer 7

IV fluids for dehydration and hypovolaemia
Withhold medications that may worsen the condition
Withhold/adjust medications that may accumulate with reduced renal function (e.g., metformin and opiates)
Relieve the obstruction in a post-renal AKI
Dialysis may be required in severe cases

Question 8

most common cause of intrinsic kidney disease

Answer 8

acute tubular necrosis

Question 9

causes of chronic kidney failure

Answer 9

Diabetes
Hypertension
Medications (e.g., NSAIDs or lithium)
Glomerulonephritis
Polycystic kidney disease

Question 10

signs of CKD

Answer 10

fatigue, pallor, foamy urine (proteinuria)

Question 11

investigations of CKD

Answer 11

eGFR
proteinuria
haematuria

Question 12

management of renal bone disease

Answer 12

Low phosphate diet
Phosphate binders
Active forms of vitamin D (alfacalcidol and calcitriol)
Ensuring adequate calcium intake

Question 13

what is golmerulonephritis

Answer 13

Glomerulonephritis refers to inflammation of the glomeruli in the kidneys. The glomerulus is the first part of the nephron. It filters fluid out of the capillaries and into the renal tubule.

Question 14

nephritic syndrome

Answer 14

Haematuria
Oliguria (significantly reduced urine output)
Proteinuria (protein in the urine), but less than 3g per 24 hours
Fluid retention

Question 15

nephrotic syndrome

Answer 15

damage to the basement membrane and become highly permeable and causes proteinuria

Question 16

signs of nephrotic syndrome

Answer 16

Proteinuria (more than 3g per 24 hours)
Low serum albumin (less than 25g per litre)
Peripheral oedema
Hypercholesterolaemia

Question 17

most common cause of nephrotic syndrome in children is

Answer 17

minimal change disease

Question 18

The top causes of nephrotic syndrome in adults are:

Answer 18

Membranous nephropathy
Focal segmental glomerulosclerosis

Question 19

Case: 2-5 year old with proteinuria, low albumin and oedema

Answer 19

minimal change diserase- nephrotic syndrome

Question 20

IgA nephropathy

Answer 20

patient in 20s with haematuria
caused by proliferation of mesangial cells ( found in centre of glomerulus and support the capillaries)

Question 21

membernous nephropathy common nephrotic syndrome

Answer 21

Membranous nephropathy involves deposits of immune complexes in the glomerular basement membrane, causing thickening and malfunctioning of the membrane and proteinuria. Histology shows IgG and complement deposits on the basement membrane.

Question 22

good pasture syndrome antibodies

Answer 22

anti- GBM

Question 23

microscopic polyangiitis

Answer 23

MPO- antibodies

Question 24

granulomatosis with polyangiitis

Answer 24

PR3- antibodies

Question 25

what is good pastures syndrome

Answer 25

antibodies attack glomerulus on basement membrane causing pulmonary haemorrhage

Question 26

scale for hyperkalaemia

Answer 26

normal- 3.5-5.3
mild- 5.4-6
moderate- 6.6.5
severe- over 6.5

Question 27

conditions that cause hyperkalaemia

Answer 27

Acute kidney injury
Chronic kidney disease (stage 4 or 5)
Rhabdomyolysis
Adrenal insufficiency
Tumour lysis syndrome

Question 28

medications that can cause hyperkalaemia

Answer 28

Aldosterone antagonists
ACE inhibitors
Angiotensin II receptor blockers
NSAIDs

Question 29

ECG changes in hyperkalaemia

Answer 29

tall peaked T waves
absent p waves
prolonged PR interval
broad QRS complex

Question 30

treatment for severe hyperkalaemia

Answer 30

insulin- drive insulin from ECF to ICF dextrose infusion- prevent hypo when on insulin
IV calcium gluconate- stabilises cardiac muscle cells