Nephrology Flashcards
(55 cards)
child with : acute renal failure microangiopathic haemolytic anaemia thrombocytopenia bloody diarrhea
HUS haemolytic uraemic syndrome
The organism causing HUS
E.coli
urine osmolality high, urine sodium low
What is the type of renal failure?
pre-renal
Kidneys act to concentrate urine and retain sodium
urine osmolality low, urine sodium high
What is the type of renal failure?
renal. Most common = acute tubular necrosis
Kidneys can no longer concentrate urine or retain sodium
What is the appropriate type of diuretic to help prevent reaccumulation of ascites?
spironolactone
tachycardia, fatigue, pallor and an aortic flow murmur. in chronic kidney disease
what is the cause?
Anaemia is extremely common in chronic kidney disease. It is often caused by iron deficiency or erythropoietin deficiency
severe sudden-onset headache associated with vomiting and neck stiffness + history of recurrent migraine, chronic kidney disease (CKD) stage 4, autosomal-dominant polycystic kidney disease and early-onset hypertension.
ADPKD is associated with berry aneurysms (rupture can cause SAH)
When to change ACEI in treating HTN + CKD
As these drugs tend to reduce filtration pressure a small fall in glomerular filtration pressure (GFR) and rise in creatinine can be expected.
NICE suggest that a decrease in eGFR of up to 25% or a rise in creatinine of up to 30% is acceptable,
Which type of glomerulonephritis is most characteristically associated with streptococcal infection in children?
Diffuse proliferative glomerulonephritis, causes:
1-post-streptococcal
2-SLE
Which factors is most likely to explain unexpectedly low eGFR result?
The eGFR is often inaccurate in people with extremes of muscle mass. Body builders often have an inappropriately low eGFR.
how to calculate anion gap
([Na+] + [K+]) - ([Cl] + [HCO3])
f fever, arthralgia and lethargy + haemoptysis and dyspnoea + acute kidney injury think of ……….
Goodpasture syndrome or Granulomatosis with polyangiitis (GPA)
investigation suggestive of Goodpasture syndrome
A positive anti-glomerular basement membrane (GBM) antibody
investigation suggestive ofGranulomatosis with polyangiitis (GPA)
+ve ANCA (anti-neutrophil cytoplasmic antibody)
What is the most likely outcome following the diagnosis of minimal change nephropathy in a 10-year-old male?
Full recovery but with later recurrent episode
side-effect of erythropoietin
1-accelerated hypertension potentially leading to encephalopathy and seizures (blood pressure increases in 25% of patients)
2-bone aches
3-flu-like symptoms
4-skin rashes, urticaria
5-pure red cell aplasia* (due to antibodies against erythropoietin)
6-raised PCV increases risk of thrombosis (e.g. Fistula)
7-iron deficiency 2nd to increased erythropoiesis
8- Enchephalopathy
ttt of Severe hypokalaemia (<2.5mmol/l)
Transfer to high care area with cardiac monitoring, 3 x 1litre bags of 0.9% saline with 40mmol KCL per bag over 24 hours.
Nephrotic syndrome in children / young adults. the most likely cause is …………
minimal change glomerulonephritis
diagnosis of minimal change glomerulonephritis is made. What is the most appropriate treatment?
majority of cases (80%) are steroid responsive
cyclophosphamide is the next step for steroid resistant cases.
A renal biopsy is only indicated if response to steroids is poor
what findings would be expected on renal biopsy in GPA or Goodpasture $?
Crescentic glomerulonephritis =
Rapidly progressive glomerulonephritis
CKD on haemodialysis - most likely cause of death is
Cardiovascular events account for 50% of the mortality in patients receiving dialysis.
The most common and important viral infection in solid organ transplant recipients is………..
Cytomegalovirus
Ganciclovir is the treatment of choice in such patients.
the screening test for adult polycystic kidney disease is…………
Ultrasound
Genetic testing is still not routinely recommended for screening family members
to diagnose stages 1 & 2 ……….+………
decreased eGFR + abnormal kidney function
