1
Q
adverse effect of spironolactone that is more distressing for men?
A
gynaecomastia
2
Q
NICE recommended analgesic for renal colic
A
75 milligrams of the NSAID diclofenac sodium given by injection into the muscle
3
Q
AKI nice guidelines
A
This guideline tells what increases the risk of AKI:
- Emergency surgery, ie, risk of sepsis or hypovolaemia
- Intraperitoneal surgery
- CKD, ie if eGFR < 60
- Diabetes
- Heart failure
- Age >65 years
- Liver disease
- Use of nephrotoxic drugs
4
Q
Diagnosing an acute kidney injury
A
- not based on history and examination.
- diagnosed by blood test and urine output and depends on your age.
- rise of 26 microM in creatinine over 48 hr
OR
Rise of 50% in creatinine over 7 days
OR
Fall in how much urine you pee out converted from an absolute figure to a rate the rate being less than 0.5mL kg per hour for more than 6 hours in adults/ 8 hrs in children
OR
25% rise in creatinine + fall in egfr in children
5
Q
Emergency referral
A
Refer to a nephrologist if any of the following apply:
- Renal tranplant
- ITU patient with unknown cause of AKI
- Vasculitis/ glomerulonephritis/ tubulointerstitial nephritis/ myeloma
- AKI with no known cause
- Inadequate response to treatment
- Complications of AKI
- Stage 3 AKI (see guideline for details)
- CKD stage 4 or 5
- Qualify for renal replacement hyperkalaemia / metabolic acidosis/ complications of uraemia/ fluid overload (pulmonary oedema)
6
Q
Spot diagnosis question painless haematuria and a 65 plus year old man who has a urine Dip result negative for nitrates
A
Transitional cell carcinoma
7
Q
A child under 5 years old presenting with painless haematuria and a one sided abdominal mass urine dip results and negative for a urinary tract infection
A
Wilms nephroblastoma
