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MRCPCH Part 2 > Nephrology > Flashcards

Nephrology Flashcards

1
Q

Imaging for atypical UTI in an unwell baby

A

Acute ultrasound before discharge

OP MCUG and DMSA

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2
Q

Type of renal stone in Proteus infection

A

Struvite or triple stones

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3
Q

Type of renal stone in CF patient

A

Calcium

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4
Q

Type of renal stone in Lesch-Nyhan syndrome

A

Uric acid

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5
Q

Type of renal stone in Crohns disease

A

Calcium oxalate

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6
Q

Causes of metabolic alkalosis with volume contraction (normal or low BP)

A 
Diuretics
Vomiting/laxatives
Bartter syndrome
Cystic fibrosis
Postnephrotic syndrome diuresis
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7
Q

Causes of metabolic alkalosis with volume expansion (high BP)

A 
Primary hyperaldosteronism
Renal artery stenosis
Pseudohyperaldosteronism
Renin producing tumour
Adrenal carcinoma
Liquorice
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8
Q

What happens in renal osteodystrohpy?

A 
Decreased renal excretion of phosphate
Reciprocal hypocalcaemia
Osteomalacia
Secondary hyperparathyroidism
Then causes bone resorption and osteoporosis
Decreased 1,25-dihydroxycholecalciferol
High ALP
Acidosis as kidneys can't excrete H+
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9
Q

Grade I vesico-ureteric reflux

A

Into the ureter only on micturition

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10
Q

Grade II vesico-ureteric reflux

A

Into the ureter, pelvis and calyces without dilatation on micturition

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11
Q

Grade III vesico-ureteric reflux

A

Into the pelvis and calyces, but with mild dilatation

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12
Q

Grade IV vesico-ureteric reflux

A

Moderate dilatation of the ureter, renal pelvis and obliteration of the sharp angle of fornices on micturition

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13
Q

Grade V vesico-ureteric reflux

A

Gross dilatation and tortuosity with no papillary impression viable in calyces

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14
Q

Treatment for hypertensive emergencies

A

IV labetalol
Sodium nitroprusside
Sublingual nifedipine

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15
Q

Difference in urinalysis between Fanconi’s syndrome and nephrocalcinosis?

A

In nephrocalcinosis, the urine is not acidified

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16
Q

Presentation of Gitelman syndrome

A 
Hypokalaemia
Metabolic alkalosis
Hypomagnesaemia
Hypocalciuria
Normal blood pressure
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17
Q

Presentation of Liddle syndrome

A 
Hypokalaemia
Metabolic alkalosis
Hypertension
Hypernatraemia
Low to normal aldosterone levels
18
Q

Best investigation for pyelonephritis

A

DMSA

19
Q

Best investigation for obstructive renal disease

A

Diuretic scintigraphy

20
Q

Best investigation for horseshoe kidney

A

Intravenous urography

21
Q

Treatment for Bartter’s syndrome

A

Sodium supplements
Potassium supplements
Indometacin 2mg/kg/day

22
Q

Presentation of acute glomerulonephritis

A 
Sudden onset haematuria
Proteinuria
Renal impairment
Hypertension
Oedema
23
Q

Features of distal renal tubular acidosis?

A

Hyperchloraemia
Hypokalaemia
Metabolic acidosis
Renal stones

24
Q

Suspect if there is localised posterolateral scrotal tenderness and the scrotum is red and swollen

A

Epididymo-orchitis

25
Q

Best investigation for obstruction

A

MAG3 scan

26
Q

Best investigation for renal scarring

A

DMSA

27
Q

Treatment for oxalosis

A

Liver and kidney transplantation

28
Q

Causes of low complement nephritis

A 
Post infectious glomerulonephritis
SLE
Cryoglobulinaemia
Shunt nephritis
Membranoproliferative glomerulonephritis
Infective endocarditis
29
Q

Causes of normal complement nephritis

A 
HSP
Goodpastures
PAN
Wegener's
IgA nephropathy
30
Q

Biochemical features of Fanconi syndrome

A

Proximal RTA

Impaired reabsorption of glucose, bicarb, phosphate, potassium, sodium, and water

31
Q

Clinical features of Fanconi syndrome

A 
Failure to thrive
Vomiting
Polyuria
Polydipsia
Hypokalaemia
Hypophosphataemic rickets
32
Q

Causes of Fanconi syndrome

A 
Cystinosis
Lowe syndrome
Wilson disease
Tyrosinaemia
Galactosaemia
Hereditary fructose intolerance
Toxicity to heavy metal e.g. lead
33
Q

Likely diagnoses if nephrotic syndrome not responding to prednisolone?

A

Focal segmental glomerular sclerosis

Mesangio-capillary glomerulonephritis

34
Q

Side effects of ciclosporin

A 
Renal toxicity
Hepatotoxicity
Hypertrichosis
Tremor
Gingival hypertrophy
Hypertension
35
Q

What is cystinuria?

A

Disorder of intestinal absorption and renal tubular reabsorption of the dibasic amino acids ornithine, arginine, lysin and cystine

36
Q

Complications of cystinuria?

A

Haematuria
Obstructive uropathy
Chronic renal failure

37
Q

Type of renal stones with chemotherapy/TLS

A

Uric acid stones

38
Q

Type of renal stones with renal tubular acidosis

A

Calcium stones

39
Q

What constitutes relapse of nephrotic syndrome?

A

3+ protein or more on dipstick for 3 or more days

40
Q

Features of nephronophthisis

A 
Progressive symmetrical destruction of tubules and glomeruli
Polyuria + polydipsia
Isosthenuria
Chronic renal failure
NO hypertension or proteinuria
41
Q

Features of cystinosis

A 
Polyuria + polydipsia
Growth retardation
Hypophosphataemic rickets
Fair hair and skin
Cystine in cornea causes photophobia, retinitis pigmentosa and blindness
42
Q

Features of Alports

A

Microscopic or gross haematuria
Symptoms of chronic renal failure
X-linked
Develop CRF by 2nd or 3rd decade

MRCPCH Part 2 (24 decks)

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