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Year 2 - Medicine > Week 227 - Acute Renal Failure > Flashcards

Week 227 - Acute Renal Failure Flashcards

1
Q

Name some drugs that can cause HYPOKALAEMIA

A

Thiazide diuretics Loop diuretics

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2
Q

Name some drugs that can cause HYPERKALAEMIA

A

ACE Inhibitors Angiotensin receptor blockers Spironolactone

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3
Q

What drug can cause a falsely elevated serum creatinine?

A

Trimethoprim

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4
Q

Long term of which drugs can cause irreversible renal damage?

A

Aminoglycosides (e.g. gentamycin) NSAIDs

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5
Q

What drugs can cause high serum uric acid/urate stones?

A

Chemotherapy for bulky tumours

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6
Q

What drugs can cause rhabdomyolysis/High CK?

A

Statins Calcineurin inhibitors (Cyclosporin, tacrolimus)

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7
Q

What is the most appropriate investigation that will help determine the cause of renal disease in a patient presented with ARF, chest symptoms, urine dipstick showed blood +++& protein+++

A

Renal Biopsy

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8
Q

What is the most appropriate investigation that will help determine the cause of renal disease in a patient presented with ARF, fever, night sweats, dysuria, & loin pain

A

Urine microscopy looking for white cell casts, urine culture

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9
Q

What is the most appropriate investigation that will help determine the cause of renal disease in an elderly patient developing ARF 4 days after hip surgery

A

Urinary Na

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10
Q

What is the most appropriate investigation that will help determine the cause of renal disease in a patient with symptoms of polyuria, nocturia, hesitancy developing a gradual rise of serum urea & creatinine

A

Physical examination & bladder scan

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11
Q

What electrolyte abnormality likely to be associated with Ingestion of MDMA (Ecstasy)

A

Hyponatraemia

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12
Q

What electrolyte abnormality likely to be associated with ARF after strenuous exercise

A

Hypocalcaemia

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13
Q

What electrolyte abnormality likely to be associated with Recovery phase of ARF due to rhabdomyolysis

A

HYPERcalcaemia

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14
Q

What electrolyte abnormality likely to be associated with ARF after introduction of ACEI in a patient with chronic heart failure

A

Hyperkalaemia

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15
Q

What electrolyte abnormality likely to be associated with Chronic Laxative Abuse

A

Hypokalaemia

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16
Q

In what pathological conditions are you likely to see RBC Casts?

A

Glomerulonephritis

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17
Q

In what pathological conditions are you likely to see WBC Casts?

A

Pyelonephritis

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18
Q

In what pathological conditions are you likely to see Fatty Casts?

A

Nephrotic Syndrome

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19
Q

In what pathological conditions are you likely to see Pigmented Casts?

A

Rhabdomyolysis

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20
Q

What biochemical abnormality is most likely to be associated with An athlete participating in a marathon tournament for the first time?

A

High Creatinine Kinase

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21
Q

What biochemical abnormality is most likely to be associated with The use of Angiotensin receptor blocker (ARB) for treatment of hypertension?

A

Hyperkalaemia

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22
Q

What biochemical abnormality is most likely to be associated with Ecstasy use?

A

Hyponatraemia

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23
Q

What biochemical abnormality is most likely to be associated with Prostatic carcinoma?

A

Metabolic acidosis

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24
Q

What biochemical abnormality is most likely to be associated with Chemotherapy for a bulky sarcoma of right thigh?

A

Hyperuricaemia

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25
Q

What drugs would be associated with AKI with Hypercalcaemia?

A

Vitamin D and Oral Calcium

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26
Q

What drugs would be associated with AKI with high CK?

A

Statin and Cyclosporin

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27
Q

What histopathological findings would you expect to find in Rapidly Progressive GN?

A

Crescentic Change in the Bowman’s Space

28
Q

What histopathological findings would you expect to find in Acute Interstitial nephritis?

A

Eosinophils in the interstitium

29
Q

What histopathological findings would you expect to find in Acute Tubular necrosis?

A

Mitotic Figures in the tubular epithelial Nuclei

30
Q

What histopathological findings would you expect to find in Obstructive Uropathy?

A

Tubular Dilation

31
Q

What test would you choose for A 24-yr-old construction worker has sustained a construction accident. His thighs have been trapped under a pile of rubble for several hours. He arrived to the A& E with AKI & swollen right thigh

A

Plasma Creatitine Phosphokinase

32
Q

What test would you choose for A 39-yr-old woman with advanced ovarian carcinoma with bulky pelvic and retroperitoneal disease is admitted with high serum creatinine. Urinary catheter produced 75 mls in 6 hours. Urinalysis showed macroscopic haematuria

A

Renal Ultrasound Scan

33
Q

What test would you choose for A 63 yrs male, with normal serum creatinine, started on lisinopril 20 mg/day for treatment of hypertension. 4 weeks later, routine tests showed serum creatinine 330, K 5.8

A

MRA of the Renal Arteries

34
Q

What test would you choose for A 41 yrs male treated with amoxicillin for chest infection, two weeks later developed poor appetite & weight loss. Blood tests showed a serum creatinine of 250umol/l

A

Mesangial leucocytes & eosinophil infiltration on renal biopsy

35
Q

What is the aetiology of acute kidney injury in A 71 yrs male with a permanent ileostomy following pan colectomy (1999) for UC is being investigated for a recent onset weight loss. Following an oral barium study, he reported increased stoma output (>3 litres/ day), a previously normal s. creatinine was found to be 220 umol/l.

A

Pre-renal Failure

36
Q

What is the aetiology of acute kidney injury in A 76 yrs old female developed AKI post elective hip replacement. Preoperatively she was treated with normal saline (1 litre/12hrs), and a single dose of genatmicin 240mg.

A

Acute Tubular Necrosis

37
Q

What is the aetiology of acute kidney injury in A 55 yrs female has completed a course of pelvic readiotherapy for the treatment of advance cervical cancer. Two weeks later, she developed oliguria, urine test showed hematuria, S creatinine 350umol/l.

A

Obstructive Uropathy

38
Q

What is the aetiology of acute kidney injury in A 28year old male develops AKI with haematuria two weeks after a sore throat

A

Glomerulonephritis

39
Q

What is the most likely cause of hypertension if there are Normal sized kidneys on renal US

A

Essential hypertension

40
Q

What is the most likely cause of hypertension if there are Asymetrical kidneys with acute rise in serum creatinine after introduction of ACEI

A

Bilateral renal artery stenosis

41
Q

What is the most likely cause of hypertension if there are Asymetrical kidneys with minimal/no change in serum creatinine after introduction of ACEI

A

Unilateral renal artery stenosis

42
Q

What is the most likely cause of hypertension if there are Normal sized kidneys on USS, micro-aneurysms on fundoscopy

A

Diabetic nephropathy

43
Q

What is the most useful marker in differentiating renal from pre-renal failure?

A

Urinary Na

44
Q

What cardiac procedure could cause AKI in patients with renal disease?

A

Coronary Angiogram

45
Q

What type of renal injury will result from Laxative Abuse?

A

Volume Depletion (pre-renal)

46
Q

What type of renal injury will ACE inhibitors result in?

A

Dilation of efferent arteriole

47
Q

What type of renal injury can NSAIDs result in?

A

Reduction of vasodilatory prostaglandins

48
Q

What type of renal injury will Radiocontrast agents give?

A

Afferent arteriolar vasoconstriction/renal ischaemia

49
Q

What drug can cause acute rhabdomyolysis?

A

Statins

50
Q

The dose of which painkiller needs to be reduced in patients with chronic kidney disease?

A

Gabapentin

51
Q

Which drug can cause post renal failure by inducing retroperitoneal fibrosis?

A

Bromocryptin (used in treatment of Parkinson’s, Diabetes, pituitary tumours)

52
Q

Which drug can cause urteric calcium stone formation?

A

Large doses of Vitamin D

53
Q

What is the diagnosis?

A

Unilateral Renal Hydronephrosis

54
Q

What is the Diagnosis?

A

? Bilateral Polycystic Kidneys

55
Q

What is the Diagnosis?

A

Unilateral Renal Cell Carcinoma

56
Q

What is the Diagnosis?

A

Unilateral Renal Stone

57
Q

What is the Diagnosis?

A

Soft Tissue Shadow in the renal pelvis with hydronephrosis

58
Q

What is the Diagnosis?

A

Normal Kidney Apperance

59
Q

Describe what frothy (foamy) urine could suggest?

A

Nephrotic Syndrome

60
Q

What could Cloudy Urine Suggest?

A

Acute Pyelonephritis

61
Q

What does dark urine with red cell casts suggest?

A

Acute glomerulonephritis

62
Q

What does Dark urine with no RBCs/RBC casts suggest?

A

Rhabdomyolysis

63
Q

What does Macroscopic Haematuria with no RBC casts suggest?

A

Transitional Cell Carcinoma of Bladder

64
Q

What are the clinical limitations of Plasma Urea Investigation?

A

Dispropotionately LOW in pts with liver disease

Disporoportionately HIGH in pts with dehydration

65
Q

What are the clinical limitations of Serum Creatinine Investigation?

A

Undergoes tubular secretion

Increased in those with high muscle mass

Used as a variable MDRD eGFR equation

66
Q

What are the clinical limitations of a Intravenous Urogram?

A

Useful in investigating renal stone disease (? not a limitation though)

67
Q

What are the clinical limitations of Urinary Sodium Investigation?

A

Invalid in patients on diuretics

Year 2 - Medicine (25 decks)

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