Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Third year > Week 14 - Renal > Flashcards

Week 14 - Renal Flashcards

1
Q

Define AKI?

A

Rapid decline in kidney excretory function over hours or days, recognised by a rise in serum ureas and creatinine.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is causes Muddy brown casts in urinalysis?

A

Acute tubular necrosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Define oliguria.

A

Urine output of <1ml/kg/hr in infants or <1ml/kg/hr in children or <400-500ml in 24hours in adults

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

List some drugs that are nephrotoxic.

A

NSAIDS, ACEi, gentamicin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What staging system do you use in AKI?

A

KDIGO

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is acute tubular necrosis?

A

Damage and necrosis of the epithelial cells of the renal tubules. Always due to undwrperfusion or direct toxicity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Give some toxins causing ATN.

A

Endogenous - myoglobin, haemoglobin, Ig, calcium, urate

Exogenous - Contrast, lithium, ACEi, NSAIDs, gentamicin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Define chronic kidney disease.

A

Kidney damage or GFR <60ml/min/1.73m2 for >/= 3 months. E.g. due to diabetic nephropathy, rebovascular disease. GN

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is the classification of CKD?

A

Stage 1: >/= 90 ml/min/1.73m2 - normal or increased with other evidence of kidney damage
Stage 2: 60-89ml/min - slightly reduced with other evidence of kidney damage
Stage 3 (a and b) - 30-59 - moderate decreased
Stage 4: 15-29 - severe decrease
Stage 5: <15 - established kidney failure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

How may anaemia come about in CKD?

A 
Damaged kidney not producing EPO
When eGFR<30
Trigger - <100g/L Hb
Target 100-120
Give Darbepoietin alfa
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are some complications of CKD?

A

Renal bone disease - Renal osteodystropy
CVD
Anaemia
Peripheral neuropathy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are some secondary causes of GN?

A 
Myeloma, CLL
ALD, IBD, coeliac 
HIV, malaria, hepatitis, antibiotics
TB, lung cancer
RA, lupus
NSAIDs, bisphosphonates
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What tests are in a GN screen?

A

ANCA, ANA/dsDNA, anti-GMB, Anti-PLA2R, complement, Ig, RF, hep B, C, HIV

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What might IgA nephropathy be associated with?

A

Synpharyngitis (upper RTI) or secondary to coeliac disease, cirrhosis, Henoch-schonlein purpura

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What does IgA nephropathy look like on histology?

A

Glomerular mesangial proliferation and IgA depositions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is the most common GM?

A

Membranous - presents with nephrotic syndrome
Secondary to malignancy, drug.
Anti-phospholipase A2 receptor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What does membranous Gn look like on histology?

A

IgG (immune complex) and complement depositions on GBM

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What GN is commonest in children?

A

Minimal change disease I

T cell cytokine mediated against glomerular epithelial cells.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What does minimal change disease I look like on histology?

A

Fusion foot processes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What may cause crescentic GN/rapidly progressive GN

A

ANCE vasculitis, lupus nephritis, good pasture’s syndrome (anti-GBM), HSP nephritis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What are some indications for RRT?

A

AEIOU
Acidosis (severe and unresponsive)
Electrolyte imbalance (severe and unresponsive hyperkalaemia)
Intoxication (overdose)
Oedema (severe and unresponsive pulmonary oedema)
Ureamia (seizures, reduced consciousness)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Signs of uraemia.

A

Itch, anorexia, restless legs, vomiting, weight loss, metallic taste - lemon yellow tinge

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

How does haemodialysis work?

A
  1. removal of solutes - diffusion
  2. removal of excess fluid - hydrostatic filtration
    Arterio-venous fistula
    4 hours X3
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What are some complications of haemodialysis?

A

Crash ‘acute hypotension’, air embolism, blood loss, hypokalaemia, cramps, fatigue, access problems

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Describe the process of Exchange in peritoneal dialysis.
Diffusion and osmotic filtration Dialysis solution high in glucose. It absorbs waste and extra fluid from inside your body. CAPD - continuous ambulatory PD APD - Automated PD
26
What are some complications of peritoneal dialysis?
Hernia, worsening of control of diabetes, peritonitis, hypoaluminaemia
27
What drugs might you use in immunosuppressive therapy in transplant?
Basiliximab - IL-2 receptor Tacrolimus - calcineurin inhibitor Mycophenolate mofetil - inhibits proliferation of T and B cells ± steroids - cyclosporin, azathioprine
28
What are the 5 R's in fluid management?
``` Resuscitate - to restore circulation Routine management Replace Redistribute Reassess ```
29
What are the clinical signs of hypovolaemia (shock)?
``` Hypotension SBP <100 Tachycardia >90 Peripherally cool Capillary refilll time > 2s NEWS >5 ```
30
How would you investigate Testicular cancer? | Seminoma
Scrotal US | Tumour markers - alpha-fetoprotein, Beta hCG, lactate dehydrogenase
31
Which HPV is penile cancer associated with?
16, 18, 21
32
What are some risk factors for bladder cancer?
Chronic inflammation - Stones, Schistosomiasis Cyclophosphamide, pioglitazone Hydrocarbon exposure - hair dyes, industrial paints Smoking ***
33
What is a key presentation of bladder cancer?
Painless Haematuria Need a cystoscopy and biopsy Transition cell carcinoma 90%
34
What are the Tx options for bladder cancer?
Radical cystectomy - removal of bladder& uterus/prostate Mitomycin C - DNA synthesis inhibitor - Chemo BCG therapy - immunotherapy - cell mediated immune response urgent Transurethral resection of bladder tumour
35
How might someone with renal cancer present?
Varicocele, lower limb oedema, Mass pain and Haematuria - triad systemic Sx - fever, fatigue, night sweats, weight loss Paraneoplastic syndrome - (hypercalacaemia - high PTH. polycythaemia - high EPO, hypertension - renin, rearranges LFTs - staffer's syndrome)
36
What is prostate cancer?
Adenocarcinoma, usually of peripheral zone PTEN, TP53, BRCA2 Gleason grading system
37
What Sx may indicate prostate cancer has metastasised?
Bone pain * - spinal cord compression | or renal failure - obstruction
38
What is renal clearance? (GFR)
The amount of plasma, cleared of substance per unit time. ml/min
39
What makes up Nephrotic syndrome?
1. Peripheral oedema 2. Proteinuria MORE than 3g/24 hours 3. Serum albumin LESS than 25g/L 4. hypercholesterolaemia
40
How does hyperglycaemia cause hypertension and renal failure?
Hyperglycaemia - Volume expansion - intraglomerular hypertension - hyper filtration - proteinuria - hypertension and renal failure
41
What defines bacteriuria?
> 10 ^5 colony forming bacteria | Need to treat in preschoolers and pregnancy as it can progress to pyelonephritis
42
How would you manage a UTI in pregnancy?
Amoxicillin and cefalexin for 7-10 days
43
What are some complications of using catheters?
CAUTI, risk of bladder cancer, obstrective-hydronephrosis, chronic renal failure, urinary tract stones
44
What antibiotics would you use to treat CAUTI?
Not severely ill - Oral levofloxacin | Severely ill - IV amoxicillin, genatmicin, ceftriaxone
45
How would you manage acute pyelonephritis? (upper UTI)
send urine ± blood culture ± imaging | Co-amoxiclav, ciproflxacin, trimpethoprim
46
What are the complications of orchitis?
Testicular infarction, abscess formation
47
How would you manage Fournier's gangrene?
1st line - surgical debridement | Pip-tazobactam + gentamicin + metronidazole ± clindamycin
48
How might renal artery stenosis present?
Increased BP Worsening renal function after ACEi/ARB in bilateral stenosis Resistant to treatment 'flash' pulmonary oedema - sudden onset
49
What drug can be used to help aid the spontaneous passage of stones?
Tamsulosin (alpha blocker)
50
What is renal agenesis?
Congenital absence of the renal parenchyma
51
What is renal hypoplasia?
Reduction in the number of nephrons
52
Define pyelonephritis.
Inflammation of the kidney due to a bacterial infection | Complication - renal abscess
53
What are metastatic complications of prostate cancer?
Spinal cord compression | Ureteric obstruction
54
What type of drug is Tolvaptan and what are indications?
Vasopressin V2 receptor antagonist APKD SE- hepatotoxicity, hypernatraemia
55
What types of polycystins are there?
PKD 1 on chrom 16 - Rapid progression to ESRD | PKD 2 on chrom 4 - Slower progression to ESRD
56
What is Alports syndrome?
X-linked - Collagen 4 defects (in BM) Microscopic Haematuria, proetineuria, ESRD 90% on dialysis/transplant by 40 Sensorineural hearing loss in childhood (deafness and eyes affected)
57
How would you diagnose the X-linked storage disease, Fabry's?
Its Alpha galactosidase A def Measure Alpha gal A activity in leukocytes Renal biopsy - inclusion bodies of Gb3
58
What are the drugs of choice for hypertension in CKD?
ACEi/ARB | Ramapril, captopril, valsartan, candestartan
59
What GN is associated with anti-phospholipase A2 receptor antibody?
Membranous (the receptor is on podocytes)
60
What are some causes of Crescentic / rapidly progressive GN?
``` ANCA vasculitis Good pastures syndrome (Anti-GBM) Lupus nephritis HSP nephritis Tx with Oral cyclophosphamide ```
61
What test is Gold standard for identifying stones?
CT KUB - Non-contrast scan of kidney, ureters and bladder
62
Diclofenac, an NSAID, is effective management for kidney stones, what does it do?
Reduces GFR, renal pressure and ureteric peristalsis
63
What important advice would you give to someone prescribing for a patient with renal artery stenosis?
Do not give ACEi or ARB as it worsens renal function in bilateral RA stenosis
64
What is amyloidosis?
Extracellular deposition of an insoluble protein in an abnormal fibrillar form, resistant to degradation Amyloid fibrils cause mesangial cell expansion
65
Acute pyelonephritis is an ascending upper UTI of moderate to severe infection and involving the renal pelvis. What characterises it, what management would you do and what antibiotics would you give?
Enlarged kidney and abscesses on the surface Send urine ± blood cultures ± imaging Co-amoxiclav, ciproflxacin, trimethoprim Uncomplicated 1-2 wks, complicated >/=2wks± radiological/surgical intervention
66
What is Fournier's gangrene?
A form of necrotising fasciitis affecting the external genitals. 1st line - surgical debridement

Third year (15 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions