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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
What drugs would be associated with AKI with Hypercalcaemia?
Vitamin D and Oral Calcium
26
What drugs would be associated with AKI with high CK?
Statin and Cyclosporin
27
What histopathological findings would you expect to find in Rapidly Progressive GN?
Crescentic Change in the Bowman's Space
28
What histopathological findings would you expect to find in Acute Interstitial nephritis?
Eosinophils in the interstitium
29
What histopathological findings would you expect to find in Acute Tubular necrosis?
Mitotic Figures in the tubular epithelial Nuclei
30
What histopathological findings would you expect to find in Obstructive Uropathy?
Tubular Dilation
31
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
Plasma Creatitine Phosphokinase
32
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
Renal Ultrasound Scan
33
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
MRA of the Renal Arteries
34
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
Mesangial leucocytes & eosinophil infiltration on renal biopsy
35
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.
Pre-renal Failure
36
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.
Acute Tubular Necrosis
37
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.
Obstructive Uropathy
38
What is the aetiology of acute kidney injury in A 28year old male develops AKI with haematuria two weeks after a sore throat
Glomerulonephritis
39
What is the most likely cause of hypertension if there are Normal sized kidneys on renal US
Essential hypertension
40
What is the most likely cause of hypertension if there are Asymetrical kidneys with acute rise in serum creatinine after introduction of ACEI
Bilateral renal artery stenosis
41
What is the most likely cause of hypertension if there are Asymetrical kidneys with minimal/no change in serum creatinine after introduction of ACEI
Unilateral renal artery stenosis
42
What is the most likely cause of hypertension if there are Normal sized kidneys on USS, micro-aneurysms on fundoscopy
Diabetic nephropathy
43
What is the most useful marker in differentiating renal from pre-renal failure?
Urinary Na
44
What cardiac procedure could cause AKI in patients with renal disease?
Coronary Angiogram
45
What type of renal injury will result from Laxative Abuse?
Volume Depletion (pre-renal)
46
What type of renal injury will ACE inhibitors result in?
Dilation of efferent arteriole
47
What type of renal injury can NSAIDs result in?
Reduction of vasodilatory prostaglandins
48
What type of renal injury will Radiocontrast agents give?
Afferent arteriolar vasoconstriction/renal ischaemia
49
What drug can cause acute rhabdomyolysis?
Statins
50
The dose of which painkiller needs to be reduced in patients with chronic kidney disease?
Gabapentin
51
Which drug can cause post renal failure by inducing retroperitoneal fibrosis?
Bromocryptin (used in treatment of Parkinson's, Diabetes, pituitary tumours)
52
Which drug can cause urteric calcium stone formation?
Large doses of Vitamin D
53
What is the diagnosis?
Unilateral Renal Hydronephrosis
54
What is the Diagnosis?
? Bilateral Polycystic Kidneys
55
What is the Diagnosis?
Unilateral Renal Cell Carcinoma
56
What is the Diagnosis?
Unilateral Renal Stone
57
What is the Diagnosis?
Soft Tissue Shadow in the renal pelvis with hydronephrosis
58
What is the Diagnosis?
Normal Kidney Apperance
59
Describe what frothy (foamy) urine could suggest?
Nephrotic Syndrome
60
What could Cloudy Urine Suggest?
Acute Pyelonephritis
61
What does dark urine with red cell casts suggest?
Acute glomerulonephritis
62
What does Dark urine with no RBCs/RBC casts suggest?
Rhabdomyolysis
63
What does Macroscopic Haematuria with no RBC casts suggest?
Transitional Cell Carcinoma of Bladder
64
What are the clinical limitations of Plasma Urea Investigation?
Dispropotionately LOW in pts with liver disease Disporoportionately HIGH in pts with dehydration
65
What are the clinical limitations of Serum Creatinine Investigation?
Undergoes tubular secretion Increased in those with high muscle mass Used as a variable MDRD eGFR equation
66
What are the clinical limitations of a Intravenous Urogram?
Useful in investigating renal stone disease (? not a limitation though)
67
What are the clinical limitations of Urinary Sodium Investigation?
Invalid in patients on diuretics

Year 2 - Medicine (25 decks)

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