AMK > Renal > Flashcards

Renal Flashcards

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1
Q

FSGS investigations

A

light: scarring of glomeruli
electron: effacement of podocytes
IF: nothing

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2
Q

uric acid stones

A

hyperuricemia (gout)

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3
Q

acute interstitial nephritis is caused by:

A

hypersensitivity, rheumatological conditions

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4
Q

management of kidney stones >2cm

A

percutaneous ureterolithotomy

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5
Q

Managing renal stones in three ways

A

Less than 5mm conservative
Less than 2cm shock wave lithotripsy
2cm more nephrolithotomy

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6
Q

inheritance of Von Hippel Lindau

A

autosomal dominant

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7
Q

medullary sponge kidney
cause, Px, Dx

A

congenital
cystic dilatation of the collecting tubules in the kidney
increased risk of UTIs and kidney stones
grape-like appearance on ultrasound

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8
Q

Potter syndrome

A

Oligohydramnios and resultant pulmonary hypoplasia with in utero renal failure

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9
Q

acute tubular necrosis is caused by:

A

drugs (aminoglycosides, NSAIDs), radiocontrast

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10
Q

what does albumin:creatinine test for?
who to test

A

protein in the urine
test all people with diabetes + everyone without diabetes but have GFR<60

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11
Q

when are immunomodulatory drugs given in renal cancer

A

stage 4 (metastasis)

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12
Q

indications of acute dialysis

A

AEIOU
acidosis (<7.2)
electrolyte abnormalities (refractory hyperkalaemia)
intoxication e.g. alcohol, lithium
overload (fluid)
uremia (encephalopathy)

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13
Q

Normal anion gap

A

8-14

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14
Q

Moa of thiazide and thiazide like diuretics

A

Blocks Na Cl cotransporter in DCT

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15
Q

2 MOAS of potassium sparing diuretics

A

Inhibits aldosterone (spironolactone, eplenerone)
Inhibits ENAC (amiloride) so increased excretion of Na

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16
Q

Mx of minimal change

A

steroids

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17
Q

What medication can help to reduce kidney stones caused by hypercalciuria

A

Indapamide (thiazide like diuretic )
Increases calcium reabsorption so less excreted in urinary tract

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18
Q

most common site for developing prostate cancer

A

peripheral zone of the prostate

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19
Q

fanconi syndrome

A

Fanconi Sydnrome = proximal tubule dysfunction leading to poor electrolyte absorption

hypokalemia, acidosis

proteinuria, glycosuria

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20
Q

causes of renal papillary necrosis

A

sickle cell anaemia
diabetes mellitus
acute pyelonephritis
chronic paracetamol use

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21
Q

management of cryptorchid testis

A

orchidectomy (remove it)

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22
Q

testicular cancer markers (4)

A

AFP + pALP +bHCG
LDH raised in seminoma

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23
Q

Alports

A

defect in gene for type 4 collagen
Px: renal failure, hearing loss, retinitis pigmentosa

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24
Q

chronic reflux nephropathy

A

kidney scarring resulting from vesico-ureteric reflux

chronic UTIs in childhood
scarring and reduced size in one kidney
raised creatinine and hypertension

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25
3 drugs to treat proteinuria
1. ACEIs 2. SGLT2 inhibitors 3. finerenone (mineralocorticoid receptor antagonist)
26
POst strep GN investigation
light: electron: electron dense "humps" (immune complexes) IF: IgG and C3 deposits
27
muddy brown casts
acute tubular necrosis
28
henoch schlonhein purpura
abdominal pain arthalgia non-blanching rash
29
struvite stones
chronic UTIS
30
goodpastures
Anti GBM antibodies against type 4 collagen Px: heaemoptysis (lung haemorrhage) + nephritic syndrome
31
calcium phosphate stones
hypercalcemia, hyperparathyroidism
32
2 side effects of potassium sparing diuretics
Hyperkalemia Gynacomastia
33
assoc with ADPKD
berry aneurysms in the circle of willis hypertension urinary sx liver cysts abdominal mass
34
inheritance of Alports
X linked recessive (most)
35
Mx of pyelonephritis
IV gentamicin / ciprofloxacin
36
2 examples of loop diuretics
Furosemide Bumetanide
37
Membranous nephropathy aetiology
IgG complex deposition in the sub epithelial space
38
criteria to be on renal transplant waiting list
expected to be alive in 5 years needing dialysis in 6 months
39
pain relief for kidney stones 1st line
IM diclofenac
40
more common form of PKD
autosomal dominant
41
Granulomatosis with polyangiitis / wegener’s
URT = saddle shaped nose deformity, epistaxis LRT = haemoptysis Renal failure cANCA!!!!!!
42
combo of immunosuppression after kidney transplant
tacrolimus mycophenalate mofetil prednisolone
43
Post strep glomerulonephritis
Nephritic syndrome 1-2 weeks after URTI
44
fever, uncontrollable shaking, flank/abdominal tenderness gas in the renal parenchyma
pyelonephritis
45
indications of calcium gluconate vs insulin&dextrose
calcium gluconate is used for cardioprotection in hyperkalemia insulin and dextrose used to lower potassium need both!!!!!!
46
4 side effects of thiazide like diuretics
Hypokalemia Hypercalcemia High glucose Gout
47
First line test for HUS
Blood film
48
Membranous nephropathy investigations
Light : ball and spike pattern with silver stain Electron : sub epithelial deposits Immuno: diffuse IgG uptake
49
haemolytic uremic syndrome
caused by shiga toxin ( e coli 0157 / shigella) AKI + thrombocytopenia + haemolytic anaemia)
50
IGA nephropathy investigations
IgA deposits, mesangial proliferation
51
persisten hypertension not responding to ACEi
renal artery stenosis more common in older people
52
2 examples of thiazide like diuretics
Indapamide Chlorthalidone
53
symptoms of acute tubulointerstitial nephritis
fever eosinophilia rash
54
when is radical nephrectomy done
stage 2/3
55
most common cause of peritonitis from peritoneal dialysis
staph epidermidis
56
when is partial nephrectomy done
stage 1
57
pain radiating from loin to groin
renal stones
58
1 example of thiazide diuretic
Bendroflumethiazide
59
What cancer is increased risk after a renal transplant
Squamous cell carcinoma of the skin
60
Where do potassium sparing diuretics work
DCT and collecting duct
61
acute vs chronic rejection of kidney transplant
acute <6 months. fever, graft pain, sudden rise in creatinine chronic >6months. gradual creatinine rise, fibrosis and tubular atrophy
62
management of stones <2cm
extracorporeal shock wave lithotripsy
63
side effects of MMF
gastro, bone marrow suppression
64
gold standard Dx for kidney stones
CT KUB
65
pathophis of type 1,2,4 renal tubular acidosis
(Distal) Type 1 = cannot excrete H+ hypokalemia, severe acidosis (Proximal) Type 2 = cannot absorb HCO3- hypokalemia, less acidosis Type 4 = reduced aldosterone function hyperkalemia, no significant acidosis
66
Most common viral infection in solid organ transplants and mx
Cytomegalovirus Ganciclovir
67
Loop diuretic moa
Blocks Na K 2Cl co transporter in thick ascending loop of henle
68
renal biopsy in alports
splitting of the lamina dense shows a basket weave appearance
69
when is radiofrequency ablation done in renal cancer
non surgical stage 1/2
70
What level of K+ should treatment be started immediately? What to do if not reached this threshold?
>6.5 start treatment Less than : do ECG
71
renal transplant. oliguria, swelling at the transplant site within hours. what has happened and what is the mx?
hyperacute graft rejection remove the transplanted kidney
72
irregular testicular mass lesion bHCG and AFP are not elevated what could it. be?
testicular seminoma
73
focal segmental glomerulosclerosis cause
dead podocytes fall off causing the basement membrane and GBM to stick to each other = SCARRING
74
two types of ATN and causes
toxic: drugs e.g. aminoglycosides, bisphosphonates, myoglobin ischaemic: renal artery stenosis, hypoperfusion
75
calcium oxalate stones
fat malabsorption (crohns, pancreatic insufficiency)
76
4 side effects of loop diuretics
Hypokalemia Hypocalcemia Kidney stones Gout
77
Recommended potassium intake for normokalemic pt
1 mmol/ kg
78
management of kidney stones <0.5cm
paracetamol drink water stone passes spontaneously within 1-3 weeks
79
Churg strauss (eosinophilic granulomatosis and polyangitis)
Asthma Rash Renal failure pANCA!!!!!!!
80
ideal dialysate (urea, cret, bicarb, K)
0 urea 0 creat high bicarb low K
81
what drugs cause AKI
diuretics, aminoglycosides, metformin, NSAIDs, lithium, ACEis, ARBS, digoxin
82
what should be prescribed to reduce progression of CKD caused by ADPKD how does it work
tolvaptan reduces cyst formation and renal insufficiency
83
square envelope shaped crystals are caused by... + what vitamin increases the risk of this
calcium oxalate vitamin c
84
cystine
cystinuria autosomal recessive
85
how to calculate osmolality
Serum osmolality is 2 x(Na) + Urea + glucose
86
antibiotics of choice for UTI in pregnancy
nitrofurantoin
87
diagnosis of acute tubular necrosis (x2)
muddy brown casts in urinalysis fraction of excreted sodium >3%
88
best initial screening investigation for renal hypertension
abdo duplex ultrasound
89
IgA nephropathy
Bergers sydnrome Nephritic syndrome 1-2 days after a URTI
90
Urinalysis in interstitial nephritis x2
Eosinophilia White cell casts
91
most common nephrotic syndrome in children
minimal change disease
92
prolonged diarrhoea causes what acid base disturbance
metabolic acidosis with hypokalaemia
93
Sharp rise in creatinine following ACE inhibitor initiation could indicate?
bilateral renal artery stenosis
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