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Renal > Passmedicine > Flashcards

Passmedicine Flashcards

1
Q

If a patient develops gynaecomastia on spironolactone, what can you give them instead?

A

Eplerenone

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2
Q

Adverse effects of spironolactone?

A

Hyperkalaemia

Gynaecomastia

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3
Q

Acute management of renal colic

A

Diclofenac

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4
Q

Haematuria following URTI in a boy

A

Think IgA nephropathy

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5
Q

Investigation of urethral injury

A

Ascending urethrogram

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6
Q

Management of urethal injury

A

Suprapubic catheter

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7
Q

Treatment of cytomegalovirus

A

Ganciclovir

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8
Q

Most common and important viral infection in solid organ transplant recipients

A

Cytomegalovirus

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9
Q

HSP prognosis

A

Excellent prognosis. HSP is a self-limiting condition, especially in children without renal involvement.
Around 1/3rd of patients will have relapse

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10
Q

A patient who has had a fall or prolonged epileptic seizure and now has acute renal failure

A

Rhabdomyolysis

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11
Q

A 24-year-old man who has a sister with adult polycystic kidney disease asks his GP if he could be screened for the disease. What is the most appropriate screening test?

A

Ultrasound abdomen

-genetic testing is still not routinely recommended for screening family members

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12
Q

First line investigation for suspected testicular cancers

A

Ultrasound

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13
Q

A 22-year-old man is involved in a road traffic accident. He is found to have a pelvic fracture. While on the ward the nursing staff report that he is complaining of lower abdominal pain. On examination you find a distended tender bladder. What is the most likely diagnosis?

A

Urethral injury

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14
Q

What is the lowest Gleason score that is indicative of malignancy?

A

6

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15
Q

Main benefit of erythropoietin injections?

A

Improved exercise tolerance

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16
Q

Test used to confirm diabetes insipidus

A

water deprivation test

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17
Q

Tachycardia, fatigue, pallor and an aortic flow murmur.

A

Anaemia

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18
Q

A 44-year-old man notices a pea-sized lump on his right testicle. On examination a discrete soft mass can be felt posterior to the right testicle.

A

Epididymal cyst

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19
Q

A 31-year-old man presents as he and his partner have been having problems conceiving. On examination there is a diffuse lumpy swelling on the left side of his scrotum. This is not painful and the testicle, which can be felt separately, is normal.

A

Varicocele

20
Q

Why can varicoceles be annoying?

A

Can affect fertility

21
Q

A 75-year-old man presents with a swelling in his right scrotum. On examination a large, non-tender swelling is found in the scrotum. You cannot palpate above the swelling during the examination.

A

Inguinal hernia

22
Q

Investigating renal stones

A

US good first line

Non-contrast CT KUB is gold standard diagnostic

23
Q

What might cause a 1+ of blood on urinalysis?

A

UTI
Menstruation
Vigorous exercise (normally settles after around 3 days)
Sexual intercourse

Cancer (bladder, renal, prostate)
Stones
Benign prostatic hyperplasia
Prostatitis
Urethritis (e.g. Chlamydia)
Renal causes: IgA nephropathy, thin basement membrane disease
24
Q

What might cause red/orange urine?

A

Beetroot, rhubarb

Rifampicin, doxorubicin

25
Q

Drug that can cause nephrogenic diabetes insipidus?

A

Lithium

26
Q

Treatment of 2.3cm staghorn calculus

A

Percutaenous nephrolithotomy

27
Q

Treatment of calculi less than 2cm

A

Extra corpeal shock wave lithotripsy

28
Q

A 23-year-old male is admitted with left sided loin pain and fever. His investigations demonstrate a left sided ureteric calculi that measures 0.7cm in diameter and associated hydronephrosis.

A

Percutaneous nephrostomy

29
Q

Management of goodpastures syndrome?

A

Plasma exchange (plasma pharesis)
Steroids
Cyclophosphamide

30
Q

Treatment of minimal change disease?

A

Steroids
(24 hour urinary protein measurement would help confirm the diagnosis but you would not delay starting treatment prior to doing so)

31
Q

Most common type of renal stone?

A

Calcium oxalate

32
Q

Which ethnic group has an increased risk of prostate cancer

A

Afro-carribean

33
Q

Why can varicoceles be a sign of renal cell cancer?

A

Cancer can cause compression of the renal vein (between the abdominal aorta and the mesenteric vein) - called the nutcracker angle

34
Q

Why can you get polycythemia in renal cell cancer?

A

The tumour cells can also make EPO

35
Q

Why can you get clots in nephrotic syndrome?

A

Nephrotic syndrome is associated with a hypercoagulable state due to loss of antithrombin III via the kidneys

36
Q

Preferred method of access for haemodialysis

A

Arteriovenous fistula

37
Q

Investigating bladder injury

A

IVU or cystogram

38
Q

Investigation of perineal injury

A

Ascending urethrogram

39
Q

Which has a better prognosis, teratomas or seminomas?

A

Seminoma have better prognosis

40
Q

Most common type of renal cancer

A

Renal adenocarcinoma

41
Q

What is a grawitz tumour?

A

A renal adenocarcinoma

42
Q

If someone has chronic kidney disease and is on dialysis, what are they most likely to die from?

A

Ischaemic heart disease

43
Q

What is the most likely outcome following the diagnosis of minimal change nephropathy in a 10-year-old male?

A

Full recovery but with later recurrent episode

44
Q

“bland” sediment in urine

A

Pre-renal uraemia

45
Q

Brown granular casts

A

Acute tubular necrosis

Renal (3 decks)

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