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Clinical Medicine > nephrology 🏥 > Flashcards

nephrology 🏥 Flashcards

(51 cards)

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1
Q

pre-renal causes of AKI

A

hepatorenal syndrome

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2
Q

intra-renal causes of AKI

A

acute tubular necrosis
nephrotoxic drugs
acute pyelonephritis
intratubular obstruction
coagulopathies

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3
Q

post renal causes of AKI

A

renal tract obstruction -e.g stones or tumours

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4
Q

presentation of hepatorenal syndrome

A

renal failure and liver disease

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5
Q

what causes acute tubular necrosis

A

ischaemic event or nephrotoxic drugs
Rhabdomylosis
Cisplatin
Methotrexate
Ethylene glycol

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6
Q

examples of nephrotoxic drugs

A

ct contrast medium
NSAIDs
abx
analgesics
ACEis
ARBs
gentamicin

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7
Q

presentation of acute tubular necrosis

A

muddy brown cast on urinalysis
poor response to fluid challenge
hyponatraemia

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8
Q

how does acute pyelonephritis present

A

UTI sx
flank pain
messed up kidney function tests
cloudy urine

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9
Q

tx pyelonephritis

A

ceflasporin

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10
Q

distinguish between nephritic and nephrotic

A

nephritic - protein and blood in urine
nephrotic - protein in urine

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11
Q

name nephritic contidions

A

IgA nephropathy
post-strep glomerulonephritis
Granulomatosis with polyangiitis (wegener)
Eosinophilic (churg-strauss)
Anti GMB antibody disease(good pasture syndrome)
Alpert syndrome

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12
Q

how does IgA nephropathy present

A

Gross haematuria 1-2 days after URTI

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13
Q

how does post strep glomerulonephritis present

A

7-14 days after a strep infection - unlike IgA nephropathy this occurs weeks after an infection
Usually occurs in children unlike IgA too
Tea urine

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14
Q

how does rapidly progressive glomerulonephritis present

A

renal failure
haematuria
OLIGOURIA
hypertension

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15
Q

what would a renal biopsy show for progressive glomerulonephritis

A

severe inflammation with necrotising crescent formation

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16
Q

tx rapidly progressive glomerulonephritis

A

high dose immunosuppression

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17
Q

causes of rapidly progressive glomerulonephritis

A

goodpastures syndrome
Wegeners granulomatosis

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18
Q

features of good pastures syndrome

A

anti glomerular basement membrane antibodies attach the kidney and lungs
Antibodies against type IV collagen results in in pulmonary haemorrhage - haemopytsis and haematuria as the collagen in the lung and glomerular basement membrane are damaged

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19
Q

mx good pastures syndrome

A

steroids, plasma exchange and cyclophosphamide

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20
Q

name nephrotic syndromes

A

minimal change nephropathy
membranous glomerulonephritis

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21
Q

describe minimal change nephropathy

Study These Flashcards
A

80% of nephrotic syndromes in children
typically present with oedema and facial swelling
Proteinuria

22
Q

mx minimal change nephropathy

Study These Flashcards
A

high dose prednisolone

23
Q

describe membranous glomerulonephritis

Study These Flashcards
A

most common nephrotic syndrome in adults
biopsy will show thickening of basement membrane
circulating phospholipase A2 receptor antibody

24
Q

tx membranous glomerulonephritis

25
What is acute interstitial nephritis
Inflammation of extra-glomerular tissue
26
How would acute interstitial nephritis present
Characteristic triad is rash, fever and eosinophilia (uncommon)
27
Tx acute interstitial nephritis
Discontinue drugs and add fluids treating underlying cause steroids
28
What can cause acute interstitial nephritis
PPIs are a common cause Antibiotics NSAIDs Infections Autoimmune conditions NOT STEROIDS they are safe
29
Features of haemolytic uraemic syndrome
Children under 5 Triad; thrombocytopenia, normocytic anaemia, AKI Caused by enterohaemorrhagic E.coli from undercooked meat or petting farms Diarrhoea
30
Mx haemolytic uraemic syndrome
IV Fluids
31
Features of wegener granulomatosis
cANCA positive Renal failure Nasopharyngeal involvement - SADDLE NOSE DEFORMITY Haemoptysis Palpable purpura 65-74 y/o
32
Features of churg strauss syndrome
pANCA positive Severe asthma Blood eosinophilia Sinusitis Purpura 38-54 y/o
33
Tx of wegener granulomatosis and churg strauss syndrome
Steroids
34
Features of alport syndrome
X linked dominant Nephritis Hearing loss Eye problems
35
In good pastures syndrome what are antibodies made against
Type IV collagen
36
Complications of nephrotic syndromes to watch out for
Venous thromboembolism Infection Hyperlipidaemia
37
With a patient with minimal change disease what would you see on light microscopy
Normal glomerular architecture
38
With a patient with minimal change disease what would you see on electron microscopy
Effacement of podocyte foot processes
39
what is henoch-schonlein purpura
IgA mediated small vessel vasculitis HSP usually seen in children following an infection
40
features of henoch-schonlein purpura
palpable purpuric rats with localised oedema over buttocks and extensor surfaces of arms and legs
41
for post-strep glomerulonephritis what would you see on a biopsy sample
IgG, IgM and C3 immune complex deposition endothelial proliferation with neutrophils subepithelial "hump" appearance on electron microscopy
42
for post-strep glomerulonephritis what would you see on immunofluorescence
a granular or "starry sky" appearance
43
stage 1 AKI
increase in creatinine to 1.5-1.9x baseline increase in creatinine by >=26.5 mmol/l reduction in urine output to <0.5 ml/kg/hour for >= 6 hours
44
stage 2 AKI
increase in creatinine 2.0 to 2.9x the baseline reduction in urine output to <0.5 ml/kg/hour for >= 12 hours
45
stage 3 AKI
increase in creatinine to >= 3x baseline increase in creatinine to >=353.6mmol/l reduction in urine output to <0.3ml/kg/hours for >= 24 hours pt requires renal replacement therapy
46
indications for dialysis
persistent hyperkalaemia uraemia fluid overload
47
features of Pyelonephritis
UTI sx and The patient may be vomiting, febrile, and complain of loin pain. Clinical examination will reveal pyrexia and renal angle tenderness.
48
mx of pyelonephritis
The patient should be admitted to hospital for intravenous antibiotics (broad-spectrum cephalosporin/a quinolone/gentamicin)
49
whats a common complication of peritoneal dialysis
peritoneal dialysis peritonitis typically caused by staph epidermidis presents with abdominal pain, fever and a cloudy dialysis bag
50
A 56-year-old man with nephrotic syndrome presents to his GP complaining of swelling around the eyes and swelling of the scrotum and the legs. What is the most likely cause of this?
hypoalbuminaemia
51
what is rapidly progressive glomerulonephritis
a spectrum of conditions associated with severe glomerular injury characterised by a nephritic picture associated with a rapid and progressive loss of renal function patients are often significantly oliguric can be broadly grouped into 3 categories

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