Renal

Question 1

AKI, haemolytic anaemia, thrombocytopenia following bloody diarrhoea
most likely what?

Answer 1

haemolytic uraemia syndrome

Question 2

most common cause of haemolytic uraemic syndrome

Answer 2

E.coli 0157

Question 3

patient extremely restless with pain radiating loin to groin

Answer 3

Urinary tract stone

calcium oxalate most common

Question 4

definitive investigation for urinary tract stone

Answer 4

non-contrast CT

Question 5

initial management of urinary tract stone

Answer 5

IM Diclofenac - discharge with follow up if resolves pain

- if pain persists or an obstruction present – ureteric stent

Question 6

how are urinary tract stones >1cm treated

Answer 6

lithotripsy

Question 7

hayline casts are made of what

Answer 7

Tamm-Horsfall protein

Question 8

what things can cause hyaline casts in urine

Answer 8

loop diuretics
exercise
fever

Question 9

what is erythropoietin

Answer 9

haematopoietic growth factor that stimulates production of erythrocytes
secreted by kidney in response to cellular hypoxia

Question 10

what is erythropoietin used to treat?

in what patients won’t it work?

Answer 10

anaemia in CKD – will improve exercise tolerance

won’t work in patients with iron deficiency

Question 11

side effects of erythropoietin

Answer 11

HTN -- encephalopahty + seizures
bone aches
flu symptoms 
skin rashes
red call aplasia

Question 12

criteria for urgent referral for patient with haematuria

Answer 12

aged >45 with

• unexplained frank haematuria without UTI
• frank haematuria that persists post UTI treatment

aged >60 with
- unexplained non visible haematuria + dysuria or increased WBC count

Question 13

when is dialysis indicated in an AKI

Answer 13

hyperkalaemia
acidosis
pericarditis
encephalopathy – confusion / lethargy

Question 14

how much water, electrolytes and glucose are required for maintenance per day

Answer 14

25-30ml/kg/day of water
1mmol/kg/day K,Na,Cl
50-100g glucose

Question 15

causes of CKD

Answer 15

diabetic nephropahty 
chronic glomerulonephritis 
chronic pyelonephritis 
HTN 
adult polycystic kidney disease

Question 16

young female who develops AKI after starting an ACEi

most likely diagnosis?

Answer 16

fibromuscular dysplasia

Question 17

string of beads appearance on MR angiography

Answer 17

fibromuscular dysplasia

Question 18

HTN that is difficult to control, chronic kidney disease

high plasma renin, high sodium, low potassium

Answer 18

renal artery stenosis

• caused by atherosclerosis
• secondary aldosteronism

Question 19

what is the most common viral infection in solid organ transplant recipients

Answer 19

cytomegalovirus

Question 20

how is contrast induced nephropathy prevented in at risk patients

Answer 20

IV 0.9% saline pre and post procedure

Question 21

what drug is used to prevent ascites in patients with liver disease

Answer 21

spironolactone

Question 22

if spironolactone is causing gynaecomastia, what drug can be used instead

Answer 22

eplerenone

Question 23

Congo red staining: apple green birefringence

Answer 23

amyloidosis

Question 24

common presenting features of amyloidosis

Answer 24

breathlessness
weakness
hepatomegaly 
proteinuria 
decreased renal function

Question 25

how is reflux nephropathy investigated

Answer 25

micturating cystoscopy

Question 26

what things will cause enlarged kidneys on USS

Answer 26

autosomal dominant polycystic kidney disease
diabetic nephropathy
amyloidosis
HIV associated nephropathy

Question 27

appearance of kidneys on USS in CKD

Answer 27

shrunken kidneys

Question 28

things that cause a raised anion gap acidosis

Answer 28

lactic acidosis 
diabetic ketoacidosis 
alcohol
renal failure 
salicylates poisoning

Question 29

what vascular event is there an increased risk of in nephrotic syndrome? why?

Answer 29

venous thromboembolism due to loss of antithrombin 3

Question 30

what are patients receiving haemodialysis for CKD most likely to die from

Answer 30

ischaemic heart disease

Question 31

low urine osmolality that returns to normal after desmopressin is given

Answer 31

cranial diabetes insipidus

Question 32

rise in urea disproportionally bigger than rise in creation most likely indicates what?

Answer 32

dehydration