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Flashcards in 1 - PM Deck (70):
1

why might you avoid hartmanns in AKI

it contains potassium

2

average potassium/sodium/chloride intake per 24 hrs

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

3

people with sepsis with show what type of results on ABG

metabolic acidosis due to raised serum lactate

4

IgA nephropathy vs post strep glomerulonephritis: protein

in post strep

5

IgA nephropathy vs post strep glomerulonephritis: Associated URTI

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

6

IgA nephropathy vs post strep glomerulonephritis: Haematuria

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

7

IgA nephropathy vs post strep glomerulonephritis:
proteinuria

Post strep glomerulonephritis

8

who tends to het IgA nephropathy

young men

9

ESRF

end stage renal failure

10

time frame for acute graft/organ rejection

acute < 6 months

11

symptoms of acute renal graft rejection

infection like

12

symptoms of chronic renal graft rejection

insidious, decline in renal function

13

diagnose of renal transplant rejection

renal biopsy

14

time frame for hypreacute graft rejection

min - hours

15

Cause for hyper acute graft rejection

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

16

Type of hypersensitivity for hype acute graft rejection

type II - Ab driven

17

Type of hypersensitivity for acute graft rejection

type 4 - T cell driven

18

Type of hypersensitivity for chronic graft rejection

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

19

ECG changes seen in hyperkalaemia

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

20

Drug causes of hyperkalaemia (6)

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

21

Diagnosis: Child with frothy urine, facial/periorbital swelling

Minimal change disease

22

fused podocytes on electron microscopy suggests

Non-proliferative glomerulonephritis

23

non-proliferative glomerulonephritis causes

nephrotic syndrome

24

proliferative glomerulonephritis causes

nephritic syndrome

25

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

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

26

You see crescents on histology and is often seen in

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

27

The most common cause of glomerulonephritis in adults is

IgA disease

28

treatment of minimal change disease

steroids, cyclophosphamide is the next step for steroid resistant cases

29

Triad seen on nephrotic syndrome

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

30

worsening renal function, together with muddy brown casts

acute tubular necrosis.

31

classical triad of renal cell carcinoma:

haematuria, loin pain, abdominal mass

32

haematuria + left varicocele

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

33

IgA nephropathy is also called .

Berger's disease

34

eGFR variables - CAGE

Creatinine, Age, Gender, Ethnicity

35

CKD stage 1:

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

CKD stage 2:

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

37

CKD stage 3a:

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

38

CKD stage 3b:

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

39

CKD stage 4:

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

40

CKD stage 5:

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

41

Most likely diagnosis of teen/child with nephrotic syndrome

minimal change glomerulonephritis

42

Nephrotic syndrome pathophysiology is driven by

immune complexes and compliment

43

minimal change treatment

steroids

44

normal eGFR

> 90

45

first line screening test for polycyctsic kidney disease

abdo US

46

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

severe hypokalemia (<2.5)

47

ECG changes seen in hypokalaemia include:

U waves
T wave flattening
ST segment changes

48

Rhabdomyolysis typically features

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

common childhood kidney malignancies

Wilms' nephroblastoma

50

Wilms' nephroblastoma - age range

< 5 yrs

51

nephritic syndrome:

haematuria and hypertension

52

nephrotic syndrome:

proteinuria and oedema

53

drugs associated with nephrotic syndrome

gold and penicillamine

54

4 types of nephrotic syndromes

- minimal change glomerulonephritis (causes 80% in children, 30% in adults)
- membranous glomerulonephritis
- focal segmental glomerulosclerosis
- membranoproliferative glomerulonephritis

55

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

serum creatinine
age
gender
ethnicity

56

Factors which may affect the eGFR result

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

57

drug given in hyrperkalemia to stabilise of the cardiac membrane

intravenous calcium gluconate

58

thiazide diuretics can cause what 3 things

hypokalaemia
hyprecalcaemia
gout

59

ACE inhibitors should do what to K+ levels?

should raise them

60

Conns syndrome is

primary hyperaldosteronism - adrenal adenoma

61

nephritic syndrome symptoms

haematuria, proteinuria, and hypertension

62

examples of nephritic syndromes

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

63

what is alport syndrome and how may it present

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

64

what will be seen on biopsy in good pastures

crescents and linear IgG immunofluroescents

65

hypercalcaeia ECG changes

shortened QT interval +/- flattened T waves

66

Nephritic syndrome features

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

nephrotic syndrome protein loss

> 3g/24hrs

68

nephritic syndrome: permanent damage?

yes

69

nephritic syndrome most commonly caused by what 2 things

IgA and Post Strep

70

test results for urinary obstruction will show what

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