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Flashcards in Clinical questions Deck (29):
1

Ab 8 year old girl present with leg swelling, pre orbital oedema and frothy urine

Minimal change disease

2

What is the initial treatment for minimal change disease?

Steroids

3

What is the treatment for minimal change disease which is resistant to steroids?

Cyclophosphamide

4

A 26 year old male who is on treatment for rheumatoid arthritis shows ++ protein and +blood.

Membranous nephropathy due to penicllamine or gold

5

What is the treatment for membrabous nephropathy?

Cyclophosphamide
Rituximab

6

What kidney disease are you most likely to get if you suffer from HIV?

Focal segmental glomerulosclerosis

7

An obese man present with frothy urine, haemature and hypertension.

Focal segmental glomerulosclerois

8

How do you treat focal segmantal glomerulosclerosis?

Prednisolone
Ciclosporin
Cyclophosphamide
Aziothioprine

9

A teenage boy presents with haematuria> he says he notices blood in his urine the last time he had a cold. On dipstick he has +blood and +protein.

IgA nephropathy

10

Which kidney disease is henoch schonlein purpura associated with?

IgA nephropathy

11

HHow do you treat IgA nephropathy?

Tight BP control with ACE
ARB

12

Which renal condition is most associated with red cell casts?

Rapidly progressive glomerulonephritis

13

What do you see on biopsy with rapidly progressive glomerulonephritis?

Crescents on biopsy

14

Give three ANCA +ve causes of RPGN?

Wegners granulomatosis
Microscopic polyangiitis
Systemic vasculitis

15

Give three ANCA -ve causes of PRGN

Goodpastures
Henoch schonlein
SLE

16

How do you treat goodpastures disease?

Steroids
Cyclophosphamide
Aziothioprine
Plasmapherisis

17

In what kidney disease do you get deposition of protein fragments and eosonophillic depositis in the mesangium?

Amyloidosis

18

What is the diagnositic criteria for overt diabetic nephropathy?

Persistent albuminuria (300mg/24h on at least 2 occasions separated by 3 - 6 months.

19

Describe the pathogenesis of diabetic nephropathy?

1. Haemodynamic changes cause an increase in GFR.
2. Glomerular basement membrane thickening.
3. mesangial expansion
4. proteinuria due to break down of podocytes.
5.Glomerulosclerosis with nodules

20

In which renal disease would you expect to see kimmelstiel wilson lesions (glomerulosclerosis with nodules)

Diabetic nephropathy

21

What is the treatment for diabetic nephropathy?

Glycaemic control
Anti hypertensives (ACE and ARB)
Lipid control

22

what is the blood pressure target for a patient with diabetes?

Under 130mmHg sysstolic

23

Small vessel vasculitis
Characterised by chronic rhinosinusitis, asthma, and prominent peripheral blood eosinophilia
Lung most commonly involved (asthma in > 95%)
2/3 have skin involvement (palpable purpura to subcutaneous nodules)

Churg strauss

24

Nasal crusting, sinusitis, persistent rhinorrhea, otitis media, oral/nasal ulcers, bloody nasal discharge
WG-evidence of bony/cartilage destruction (saddle nose)

Wegners granulomatosis

25

List the classes of renal disease seen in SLE

Class I: Minimal mesangial
Class II: Mesangial Proliferative

Class III: Focal Proliferative
Class IV: Diffuse Proliferative

Class V: Membranous

Class VI: Advanced sclerosing

26

How does SLE kidney disease commonyl present?

Proteinura

27

What do you aim for the blood pressure to be in patients with proliferative SLE?

130/80

28

What is the treatment for proliferative SLE?

ACEI
ARB
Cyclophasphamide
Prednisolone

29

When are ACE inhibitors contraindicated?

Bilateral renal artery stenosis