Nephrology

Question 1

What is the most common cause of steroid resistant nephrotic syndrome?

Answer 1

Focal segmental glomerular sclerosis

Question 2

What is the most common cause of nephrotic syndrome in children?

Answer 2

Minimal change disease

Question 3

What is the treatment for Nephrotic Syndrome?

Answer 3

Prednisolone 60mg/kg for 4 weeks then 40mg/kg for 3/7 for 4 weeks

Second Line Treatment:
IV Methylprednisolone
Cyclophosphamide
Cyclosporin

Question 4

What is the commonest cause of HUS?

Answer 4

E.coli (subtype 0157:H7)

Question 5

What electrolyte changes does Primary Hyperaldosteronism cause?

Answer 5

Hypokalaemia, Hypernatraemia, metabolic alkalosis, hypertension and low renin levels

Question 6

Raised renin, aldosterone and normal blood pressure with low sodium, low potassium and chloride is which 2 conditions?

Answer 6

Bartter Syndrome - normal Mg
Gitelmann Syndrome - low Mg

Question 7

Bartter syndrome is associated with which antenatal problems?

Answer 7

Polyhydramnios
Preterm delivery

Question 8

Children in acute renal failure w/ oliguria should receive which replacement fluids?

Answer 8

0.9% NaCl 5% dextrose at 300ml/m2 per day + ongoing losses

Question 9

Painless abdominal mass +/- haematuria in 10-20% of cases?

Answer 9

Wilm’s tumour

Question 10

Asymptomatic microscopic haematuria and deafness?

Answer 10

Alport Syndrome

Question 11

Faltering growth, polyuria, polydipsia, faltering growth and hypophosphataemic rickets + corneal cystine deposits leading to photophobia/ blindness?

Answer 11

Cystinosis

Question 12

What is the commonest cause of Fanconi Syndrome in Children?

Answer 12

Cystinosis

Question 13

Staghorn calculi are made up of what?

Answer 13

Struvite

Question 14

What condition presents with a hyperchloraemic, hypokalaemia metabolic acidosis?

Answer 14

Fanconi syndrome (often caused by cystinosis)

Question 15

Which condition presents with a hypochloraemic, hypokalaemic, metabolic alkalosis with hypercalciuria?

Answer 15

Bartter syndrome

Question 16

Which part of the nephron is affected in Bartter Syndrome?

Answer 16

Ascending limb of the loop of Henle

Question 17

Which part of the nephron is affected in Gitelmann Syndrome?

Answer 17

Distal convoluted tubule

Question 18

Which type of stones are most present in BArtter Syndrome?

Answer 18

Kidney Stones

Question 19

Which type of stones are most common in Gitelmann Syndrome?

Answer 19

Gallstones

Question 20

What are the features of Liddle Syndrome?

Answer 20

Hypertension
Hypernatraemia
Hypokalaemia
Metabolic Alkalosis

Question 21

What is the triad that makes up Goodpastrue’s disease?

Answer 21

Glomerulonephritis (rapidly progressive or crescentic)
Pulmonary haemorrhage
Anti-glomerular basement membrane antibody formation

Question 22

What is the most common presenting symptom of Goodpastures disease?

Answer 22

Haemoptysis

Question 23

Causes of normal complement nephritis?

Answer 23

HSP
Goodpastures
IgA nephropathy
Polyarteritis Nodosa

Question 24

Causes of low complement nephritis?

Answer 24

SLE
Post-strep GN
Shunt Nephritis
Infective Endocarditis
Membranoproliferaive GN

Question 25

What are the atypical features of UTI?

Answer 25

Seriously ill Raised creatinine Non-e.coli organisms Abdominal or bladder mass Septicaemia Poor urine flow

Question 26

What are the NICE guidelines for imaging in UTI?

Answer 26

Infants < 6 months who present with a first UTI which responds to treatment should have an ultrasound within 6 weeks Children > 6 months who present with a first UTI which responds to treatment do not require imaging unless there are features suggestive of an atypical infection (see below) or recurrent infection

Question 27

What is Sheehan syndrome?

Answer 27

Postpartum pituitary necrosis

Question 28

What is the most common site of hypospadias?

Answer 28

Distal ventral aspect of penis

Question 29

Define cranial diabetes insipidus?

Answer 29

Decreased secretion of ADH (therefore desmopressin may have an effect)

Question 30

Define nephrogenic diabetes insipidus?

Answer 30

Resistance to ADH within the kidneys

Question 31

Polycystic kidney disease inheritance patterns?

Answer 31

ADPKD - most common type, older children ARPKD - rare, presents causing death in childhood

Question 32

IgG glomerular immune deposits?

Answer 32

HSP

Question 33

Renal tubular acidosis type 1 =

Answer 33

Impaired excretion of H+ ions

Question 34

Renal tubular acidosis type 2 =

Answer 34

Failure to reabsorb HCO3 ions in the proximal portion of the tubules

Question 35

What electrolyte disturbances are associated with distal (hydrogen) renal tubular acidosis?

Answer 35

Hypokalaemia Hypocalcaemia (therefore hypercalciuria)