Nephrology Flashcards
(101 cards)
1
Q
How long does it take an AV fistula to mature
A
6-8 weeks
2
Q
Phosphate in CKD
A
Decreases
3
Q
Nephrotic syndrome and reduced antithrombin III increases the risk of
A
VTE
4
Q
Imaging for polycystic kidney
A
Ultrasound
5
Q
4 things associated with polycystic kidney
A
Cerebral aneurysm
Liver and ovarian cysts (HEPATOMEGALY)
Diverticulosis
(liver cysts are most common)
6
Q
Cause of secondary hyperparathyroidism
A
CKD induced
7
Q
Risk of secondary hyperparathyroid
A
Fragility fractures
8
Q
Thyroxine in nephrotic syndrome
A
Reduced
9
Q
Example of nephrotic
A
Membranous glomerulonephritis
10
Q
Cause of chronic hypocalcaemia
A
Chronic kidney disease
11
Q
What are the genetics of alport syndrome
A
X linked
12
Q
4 features of alports syndrome
A
Microhaematuria
Renal failure
Sensorineral deafness
Eye: retinitis pigmosa and lenticonus (splitting of the lamina densa)
13
Q
What cancer does a renal transplant increase the risk of
A
Skin SCC
14
Q
Which type of renal failure gives an increased serum urine: creatinine ratio
A
Pre renal
15
Q
Can anaemia cause a murmur
A
Yes
16
Q
Feature and cause of secondary aldosteronism
A
Increased renin
Renal artery stenosis
17
Q
What condition is anti GBM found in
A
Goodpastures
18
Q
2 associations with goodpastures
A
Haemoptysis
AKI (protein/blood)
19
Q
Treatment of DKA
A
Fixed rate insulin infusion
20
Q
Antidote for opioid
A
Naloxone
21
Q
Antidote for benzo
A
Flumezenil
22
Q
3 features of an aspirin overdose
A
N+V, tinnitus, headache
23
Q
Treatment of an aspirin overdose
A
IV sodium bicarb
24
Q
Metabolic disturbance in vomiting and diarrhoea
A
Vomiting: alkalosis
Diarrhoea: acidosis
25
What is polycystic kidney disease associated with
Subarachnoid haemorrhage
26
To diagnose CKD on eGFR
You need 2 results
27
3 features of minimal change glomerulonephritis
Oedema
Proteinuria
Reduced albumin
28
treatment of minimal change glomerulonephritis
Prednisolone
29
Urine finding in acute tubular necrosis
Muddy brown casts
30
Side effect of spironolactone
Gynaecomastia
| switch to eplerenone
31
What medication should you stop in AKI
ACEi
32
What will iron deficiency anaemia fail to respond to
EPO
33
Urine finding in interstitial nephritis
```
White cell casts
IgE eosinophils (allergic)
```
34
what will acute tubular necrosis give a poor response to
a fluid challenge
35
would you biopsy minimal change?
only if the steroid response is poor
36
treatment of CKD mineral bone disease
Correct phosphate
| reduce phosphate in diet and give phosphate binder
37
urine change in pre-renal disease
Increased osmolarity of urine
38
two findings in membranous glomerulopnephritis
Basement membrane has thick epithelial spikes
| Positive PLA2
39
What does myoglobinurina lead to
Tubular cell necrosis
40
What would you give before CT to redcue the contrast risk
IV NaCL (0.9%)
41
Treatment of pulmonary oedema in AKI
Haemodialysis
42
Investigation for polycystic kidneys
Ultrasound
43
3 diagnostic features of fibromuscular dysplasia
Sting of beads
AKI after ACEi
Young female
44
Most common cause of death if CKD on haemodialysis
IHD
45
4 side effects of erythropoietin
```
HTN
Flu
Pure red blood cell aplasia
Encephalopathy
Skin rash
```
46
5 features of amyloidosis
```
Weakness
Breathlessness
Reduced renal function
Proteinuria
Hepatosplenomegaly
```
47
4 features of acute interstitial nephritis
Sterile pyuria
White cell casts
fever and rash
Post ABx
48
Treatment of high potassium
Calcium resonium REMOVES potassium
| Insulin SHIFTS potassium
49
Mesenteric infarct
METABOLIC ACIDOSIS
50
AKI Stage 1
↑ creatinine 1.5-1.9 times, or
| ↓ urine output <0.5 mL/kg/hr for ≥ 6 hours
51
AKI Stage 2
↑ creatinine 2-2.9 times, or
| ↓ urine output <0.5 mL/kg/hr for ≥ 12 hours
52
AKI Stage 3
↑ creatinine 3 times, or
| ↓ urine output <0.5 mL/kg/hr for ≥ 24 hours
53
Diabetes insipidus bloods
high plasma osmolality and a low urine osmolality
54
Medication to treat ascites
Spironolactone
55
Diagnosing an AKI
↑ creatinine > 26µmol/L in 48 hours
↑ creatinine > 50% in 7 days
↓ urine output < 0.5ml/kg/hr for more than 6 hours
56
Haemolytic uraemic syndrome - blood cells
Fragmented
57
What is the most important antigen to match on renal transplant
DR
58
How does autosomal dominant polycystic kidney disease present
Abdominal pain and early satiety
59
Method of access for haemodialysis
Arteriovenous fistulas
60
What will happen to urinary sodium in acute tubular necrosis (renal AKI)
Raised urinary sodium
61
Role of calcium gluconate in hyperkalaemia
Stabilises the myocardium
| It does NOT change electrolyte levels
62
triad of renal cell carcinoma
flank pain, flank mass and haematuria
63
Testicular mass like 'a bag of worms'
Varicocele
64
How does bladder cancer present
Painless haematuria
65
Severe hyperkalaemia with ECG changes
IV calcium gluconate AND
| insulin/dextrose infusion
66
No blood in urine
Nephrotic
67
Most common cause of nephrotic syndrome in children and adults
Children: Minimal change
Adult: Focal segmental or membranous glomerulopathy
68
Acute graft failure (renal)
Asymptomatic
| Rising creatinine, pyuria and proteinuria
69
Nephrotic syndrome is associated with a hypercoagulable state due to loss of antithrombin III via the kidneys
No FHx
70
Most common cause of acute interstitial nephritis
Antibiotic use
71
Screening for polycystic kidney disease
Ultrasound
72
ABG in salicylate poisoning
Raised anion gap metabolic acidosis
73
fever, arthralgia and lethargy with haemoptysis and dyspnoea
Goodpasture - positive ANCA
| Granulomatosis with polyangiitis - negative ANCA, positive antiGBM
74
Chronic kidney disease with ACR below 30
ACEi
75
Outcome of minimal change nephropathy
Good response to steroids but can have later recurrent episodes
76
Which medications should be stopped in AKI
Aminoglycosides, ACE inhibitors/ ARBs, diuretics, and NSAIDs that are not at cardioprotective doses
77
Medication which can cause interstitial nephritis
NSAIDs
78
Cause of vitamin D deficiency in polycystic kidneys
Secondary hyperparathyroidism
79
Dehydration or rhabdomyolysis in an elderly patient with AKI
Dehydration: pre-renal so raised urea:creatinine ratio
Rhabdomyolysis: shows on urine dip
80
eGFR is inaccurate in people with large muscle mass
81
Renal impairment in Henoch-Schonlein
Full recovery
82
Lithium is a recognised cause of nephrogenic diabetes insipidus (polyuria)
83
Which nephrotic syndrome is associated with malignancy
Membranous nephropathy
84
What should all patients with CKD be prescribed
Statin
85
Difference between post strep glomerulonephritis and IgA nephropathy
Post strep: 1-2 weeks after URTI
| IgA: 1-2 days after URTI
86
Diabetes insipidus osmolarity
High plasma osmolarity and low urine osmolarity
87
Contraindication to peritoneal dialysis
Crohns
88
Pharmacological treatment for x-linked nephrogenic diabetes insipidus
Chlorothiazide
89
Pharmacological treatment of cranial diabetes insipidus
Desmopressin
90
Alport syndrome
Renal failure
Leioyomas
Seisioneural hearing loss
91
Confusion, reduced urine with dark urine with increased muscle use
Acute tubular necrosis
92
unexplained visible haematuria without UTI
urgent 2ww for urological cancer
93
Systemic lupus erythematosus with proteinuria on urinalysis
Lupus nephritis
94
Most common cause of peritonitis secondary to peritoneal dialysis
Staph epidermidis
95
anion gap in DKA
high
96
Diagnosis of haemachromatosis
Serum ferriitn
97
Chronic HIV-associated nephropathy will have large/normal sized kidneys on ultrasound whereas most patients with chronic kidney disease have bilateral small kidneys
98
Patients with chronic kidney disease should be started on an ACE inhibitor if they have an ACR > 30 mg/mmol
99
Exercise can cause haematuria
100
Penicillin can cause acute interstitial nephritis
101
Patient with CKD taking calcium-based binders can have problems including hypercalcaemia and vascular calcification
