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Renal > 1 - PM > Flashcards

1 - PM Flashcards

1
Q

why might you avoid hartmanns in AKI

A

it contains potassium

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2
Q

average potassium/sodium/chloride intake per 24 hrs

A

approximately 1 mmol/kg/day of potassium, sodium and chloride

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3
Q

people with sepsis with show what type of results on ABG

A

metabolic acidosis due to raised serum lactate

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4
Q

IgA nephropathy vs post strep glomerulonephritis: protein

A

in post strep

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5
Q

IgA nephropathy vs post strep glomerulonephritis: Associated URTI

A

Both, time frame different tho.
IgA: 1-2 days
Post strep: 1-2 weeks **think post = longer after

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6
Q

IgA nephropathy vs post strep glomerulonephritis: Haematuria

A

Both can get it, but in IgA it is usually macroscopic

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7
Q

IgA nephropathy vs post strep glomerulonephritis:

proteinuria

A

Post strep glomerulonephritis

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8
Q

who tends to het IgA nephropathy

A

young men

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9
Q

ESRF

A

end stage renal failure

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10
Q

time frame for acute graft/organ rejection

A

acute < 6 months

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11
Q

symptoms of acute renal graft rejection

A

infection like

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12
Q

symptoms of chronic renal graft rejection

A

insidious, decline in renal function

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13
Q

diagnose of renal transplant rejection

A

renal biopsy

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14
Q

time frame for hypreacute graft rejection

A

min - hours

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15
Q

Cause for hyper acute graft rejection

A

due to pre-existent antibodies against donor HLA type 1 antigens (a type II hypersensitivity reaction)

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16
Q

Type of hypersensitivity for hype acute graft rejection

A

type II - Ab driven

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17
Q

Type of hypersensitivity for acute graft rejection

A

type 4 - T cell driven

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18
Q

Type of hypersensitivity for chronic graft rejection

A

both antibody and cell mediated mechanisms cause fibrosis to the transplanted kidney (chronic allograft nephropathy)

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19
Q

ECG changes seen in hyperkalaemia

A

tall-tented T waves, small P waves, widened QRS leading to a sinusoidal pattern and asystole

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20
Q

Drug causes of hyperkalaemia (6)

A 
potassium sparing diuretics
ACE inhibitors 
angiotensin 2 receptor blockers
spironolactone
ciclosporin
heparin
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21
Q

Diagnosis: Child with frothy urine, facial/periorbital swelling

A

Minimal change disease

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22
Q

fused podocytes on electron microscopy suggests

A

Non-proliferative glomerulonephritis

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23
Q

non-proliferative glomerulonephritis causes

A

nephrotic syndrome

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24
Q

proliferative glomerulonephritis causes

A

nephritic syndrome

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25
Q

thickening of the glomerular basement membrane and is mostly idiopathic but may be associated with

A

ystemic lupus erythematosus, hepatitis B, malignancy, or the use of gold or penicillamine.

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26
Q

You see crescents on histology and is often seen in

A

Goodpasture’s syndrome and systemic vasculitis (Wegeners and microscopic polyangitis).

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27
Q

The most common cause of glomerulonephritis in adults is

A

IgA disease

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28
Q

treatment of minimal change disease

A

steroids, cyclophosphamide is the next step for steroid resistant cases

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29
Q

Triad seen on nephrotic syndrome

A
  1. Proteinuria (> 3g/24hr) causing
  2. Hypoalbuminaemia (< 30g/L) and
  3. Oedema
30
Q

worsening renal function, together with muddy brown casts

A

acute tubular necrosis.

31
Q

classical triad of renal cell carcinoma:

A

haematuria, loin pain, abdominal mass

32
Q

haematuria + left varicocele

A

renal cell carcinoma. varicocele due to occlusion of left testicular vein

33
Q

IgA nephropathy is also called .

A

Berger’s disease

34
Q

eGFR variables - CAGE

A

Creatinine, Age, Gender, Ethnicity

35
Q

CKD stage 1:

A

Greater than 90 ml/min, with some sign of kidney damage on other tests (if all the kidney tests* are normal, there is no CKD)

36
Q

CKD stage 2:

A

60-90 ml/min with some sign of kidney damage (if kidney tests* are normal, there is no CKD)

37
Q

CKD stage 3a:

A

45-59 ml/min, a moderate reduction in kidney function

38
Q

CKD stage 3b:

A

30-44 ml/min, a moderate reduction in kidney function

39
Q

CKD stage 4:

A

15-29 ml/min, a severe reduction in kidney function

40
Q

CKD stage 5:

A

Less than 15 ml/min, established kidney failure - dialysis or a kidney transplant may be needed

41
Q

Most likely diagnosis of teen/child with nephrotic syndrome

A

minimal change glomerulonephritis

42
Q

Nephrotic syndrome pathophysiology is driven by

A

immune complexes and compliment

43
Q

minimal change treatment

A

steroids

44
Q

normal eGFR

A

> 90

45
Q

first line screening test for polycyctsic kidney disease

A

abdo US

46
Q

Symptoms include weakness, leg cramps, palpitations secondary to cardiac arrhythmias and ascending paralysis.

A

severe hypokalemia (<2.5)

47
Q

ECG changes seen in hypokalaemia include:

A

U waves
T wave flattening
ST segment changes

48
Q

Rhabdomyolysis typically features

A

fall + long lie/sustained epileptic fit cute renal failure with disproportionately raised creatinine
elevated CK
myoglobinuria
hypocalcaemia (myoglobin binds calcium)
elevated phosphate (released from myocytes)

49
Q

common childhood kidney malignancies

A

Wilms’ nephroblastoma

50
Q

Wilms’ nephroblastoma - age range

A

< 5 yrs

51
Q

nephritic syndrome:

A

haematuria and hypertension

52
Q

nephrotic syndrome:

A

proteinuria and oedema

53
Q

drugs associated with nephrotic syndrome

A

gold and penicillamine

54
Q

4 types of nephrotic syndromes

A
  • minimal change glomerulonephritis (causes 80% in children, 30% in adults)
  • membranous glomerulonephritis
  • focal segmental glomerulosclerosis
  • membranoproliferative glomerulonephritis
55
Q

eGFR: Modification of Diet in Renal Disease (MDRD) equation, which uses the following variables:

A

serum creatinine
age
gender
ethnicity

56
Q

Factors which may affect the eGFR result

A

pregnancy
muscle mass (e.g. amputees, body-builders)
eating red meat 12 hours prior to the sample being taken

57
Q

drug given in hyrperkalemia to stabilise of the cardiac membrane

A

intravenous calcium gluconate

58
Q

thiazide diuretics can cause what 3 things

A

hypokalaemia
hyprecalcaemia
gout

59
Q

ACE inhibitors should do what to K+ levels?

A

should raise them

60
Q

Conns syndrome is

A

primary hyperaldosteronism - adrenal adenoma

61
Q

nephritic syndrome symptoms

A

haematuria, proteinuria, and hypertension

62
Q

examples of nephritic syndromes

A

IgA nephropathy (children)
Post strep (children)
Goodpartures (adults)
SLE

63
Q

what is alport syndrome and how may it present

A

Nephritic syndrome: Hereditary nephritis - abnormal type IV collagen, get splitting of basement membrane

64
Q

what will be seen on biopsy in good pastures

A

crescents and linear IgG immunofluroescents

65
Q

hypercalcaeia ECG changes

A

shortened QT interval +/- flattened T waves

66
Q

Nephritic syndrome features

A

Haematuria is the predominant feature
Proteinuria is generally <3 g/24 hours (that is, not nephrotic range)
Hypoalbuminaemia and oedema can occur
Acute renal impairment is common with reduced urine output and elevated urea and creatinine.

67
Q

nephrotic syndrome protein loss

A

> 3g/24hrs

68
Q

nephritic syndrome: permanent damage?

A

yes

69
Q

nephritic syndrome most commonly caused by what 2 things

A

IgA and Post Strep

70
Q

test results for urinary obstruction will show what

A

much higher plasma urea compared to creatinine (urea can be reabsorbed into blood)

Renal (2 decks)

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