Nephrology Flashcards
what are the features of rhabdomyolysis?
patient with fall with AKI on admission
disproportionately raised creatinine
elevated CK
hypocalcaemia
hyperphosphotaemia
hyperkalaemia
metabolic acidosis
what are the features of polycystic kidney disease?
haematuria
loin pain
hypertension
recurrent UTIs
kidney stones
headaches - sign of ruptured berry aneurysm and SAH
what are the examination findings of polycystic kidney disease?
palpable kidneys/abdominal mass
hepatomegaly due to hepatic cysts
abdominal wall hernias
cardiac murmur
what are the extra-renal manifestations of polycystic kidney disease?
liver cysts - most common and can cause hepatomegaly
SAH due to ruptured berry aneurysm
cardiac murmurs
cysts in other organs
what are the features of renal artery stenosis?
hypertension
worsening renal function after ACEi
‘flash’ pulmonary oedema
CKD
how is renal artery stenosis investigated?
renal angiography (gold standard)
renal USS shows small kidneys
what are the causes of acute tubular necrosis?
ischaemia: shock, sepsis
nephrotoxins: aminoglycosides, myoglobin secondary to rhabdomyolysis, radiocontrast agents, lead
what are the features of acute tubular necrosis?
features of AKI: raised urea, creatinine, potassium
muddy brown casts in urine
what are the causes of acute interstitial nephritis?
drugs: penicillin, rifampicin, NSAIDs, allopurinol, furosemide
systemic disease: SLE, Sjögren’s, sarcoidosis
infection: staphylococcus
what are the features of acute interstitial nephritis?
fever, rash, arthralgia
eosinophilia
mild renal impairment
hypertension
sterile pyuria
white cell casts
what are the features of streptococcal glomerulonephritis?
occurs 1-2 weeks after an infection (usually S. pyogenes)
typically young children
headache, malaise
visible haematuria
proteinuria - can result in oedema
oliguria
what is Goodpasture’s syndrome?
anti-glomerular basement membrane antibodies against type IV collagen, small-vessel vasculitis
what are the features of Goodpasture’s syndrome?
haemoptysis
cough
shortness of breath
nausea and vomiting
lung crackles
rapidly progressive glomerulonephritis (proteinuria and haematuria) - typically results in rapid onset AKI
how is Goodpasture’s syndrome investigated?
renal biopsy (linear IgG staining on basement membrane) - gold standard
U&Es (high urea and creatinine)
anti-GBM antibodies
how is Goodpasture’s syndrome managed?
plasmapheresis
steroids
cyclophosphamide
