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RENAL FINALS > Passmedicine Knowledge > Flashcards

Passmedicine Knowledge Flashcards

(73 cards)

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1
Q

Definition and Management of Severe Hyperkalaemia

A 
>6.5 or <6.5 with ECG changes
IV calcium gluconates
Insulin/Dextrose Infusion
Stop Exacerbating drugs
Treat underlying cause
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2
Q

Blood Gas Pattern of Salicylate Poisoning

A

Raised Anion Gap Metabolic Acidosis4

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3
Q

Mx of cranial and nephrogenic DI

A

Cranial: Desmopressin

Nephrogenic: Diuretics/Low salt + protein diet

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4
Q

How is anaemia treated in CKD

A

Oral Iron

Then Erythropoetin

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5
Q

Side effects of erythropoetin

A

Hypertension
Flu like symptoms
Encephalopathy
Pure red cell aplasia

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6
Q

Stages of AKI

A

Stage 1:

1.5-1.9x baseline creatinine
Creatinine rise of 26.5 in 48 hours or >50% in 7 days
<0.5ml/kg/hr urine for 6 hours

Stage 2:

2-2.9x baseline creatinine
<0.5mls/kg/hr for 12 hrs

Stage 3
>3x baseline
Creatinine at 353.6
<0.3mls/kg/hr for >24 hrs

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7
Q

Most common viral pathogen in solid organ transplants and its management

A

Cytomegalovirus

Ganicociclovir

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8
Q

CKD staging

A

1: >90 with signs of kidney damage on other tests
2: 60-90 with signs of kidney damage on other tests
3a: 45-59
3b: 30-44
4: 15-29
5: <15

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9
Q

Maintenance fluids requirements

A

25-30mls/kg/day water
1mmol/kg/day potassium
50-100g/day of glucose

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10
Q

Maintenance Fluids in a child

A

100mls/kg first 10kg
50mls/kg second 10 kg
20mls/kg after that

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11
Q

What is renal cell TCC associated with

A

Exposure to dyes etc
Smoking
Rubber manufacturing
Cyclophosphamide

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12
Q

Which renal stones are opaque

A

Calcium phosphate
Calcium oxalate
Triple Phosphate
Mixed calcium oxalate/phosphate

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13
Q

Which renal stones are radio lucent

A

Xanthine

Urate

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14
Q

Which renal stones are semi opaque “ground glass” appearance

A

Cystine

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15
Q

Where do the majority of varicoceles occurs

A

left side

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16
Q

mx of renal stones

A

<5mm: Expectant
<2cm or not passed within 48 hours: Lithotripsy
<2cm pregnant: Ureteroscopy
Complex or staghorn: Percutaneous nephrolithotomy

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17
Q

Symptoms of TURP syndrome

A

Hypoatraemia and agitation after resection of the prostate

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18
Q

Ix and Mx of testicular cancer

A

US first line

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19
Q

Adult with hydrocele management

A

Referral as this is a RF for cancer

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20
Q

When should PSA testing not be done

A

6 weeks afer biopsy
4 weeks after proven UTI
1 week after rectal exam
48 hrs after exercise or ejaculation

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21
Q

Epididymo orchitis causes

A

<35 or v sexually active: Chlamydia

>35 or low sexual risk: E.Coli

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22
Q

Bladder Cancer Mx

A

Superficial lesions: TURBT
High recurrence risk: Intravesical Chemo
T2 or more: Radical cystectomy

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23
Q

How long does an AV fistula take to become ready for use

A

6-8 weeks

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24
Q

Features of acute interstitial nephritis

A

Sterile pyuria

White cell casts

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25
Peristent pyuria?
Renal TB
26
1st line ix for prostate cancer
MRI
27
Nephritic Syndrome Definition
Haematuria Oliguria Proteinuria <3g/24hrs Fluid Retention
28
Nephrotic Syndrome Definition
peripheral oedema Proteinuria >3g/24 hours Serum Albumin <25g/L Hypercholesterolaemia
29
Most common cause of peritonitis secondary to peritoneal dialysis
Staph Epidermidis
30
Salicyate poisoning blood gas pattern
Raised anion gap metabolic acidosis
31
Triad in HUS
AKI Microangiopathic Haemolytic Anaemia Thrombocytopenia
32
What is a normal anion gap
6-16
33
Nephrotic Syndrome in HIV and IVDU
Focal Segmental Glomerulosclerosis
34
Definition of high pressure and low pressure chronic urinary retention
High Pressure: W/ assoc hydronephrosis or renal impairment | Low Pressure: W/ no renal impairment or hydronephrosis
35
Most common cause of death on haemodialysis
Ischaemic heart disease.
36
Risk factors for testicular cancer
Cryptorchitis Infertility Mumps orchitis Klinefelters.
37
Follow up for Vasectomy
sperm count at 16 and 20 weeks. Use barrier methods until azoospermia is confirmed.
38
What are staghorn calculi made of and what is the most common organism
Struvite, proteus mirabalis
39
Normal fluid challenge and fluid challenge in heart failure
500 mls Normal saline STAT HF: 250 mls normal saline STAT
40
Risk of radiotherapy for prostate cancer
Bladder colon and rectal cancer.
41
Side effects of erythropoetin
Flu like symptoms Rash Bone aches
42
Aetiology and Management of hyperacute graft rejection
Preexisting HLA or AB antigens, in minutes/hours | Removal of graft
43
Aetiology and Management of Acute graft rejection
Mismatched HLA, <6 months | Steroids and Immunosuppressants
44
mx of renal cell carcinomoa
<7cm partial nephrectomy >7cm total nephrectomy Interferon A and IL2 used to shrink lesions and for mets.
45
Renal cell carcinoma does not become symptomatic until what stage
Stage 4
46
Most common type of renal stone
Calcium oxalate
47
When should ACEI's be started in diabetic nephropathy and what is the target BP
Urinary ACR >3 | <130/80
48
What kind of cancer is varicoceles associated with
RCC
49
What is important when prescribing a goserelin analogue for prostate cancer
Anti androgen treatment (Cyproterone) to prevent tumour flare.
50
What type of testicular cancer has raised AFP and HCG
Teratomas.
51
Indication for haemodialysis in AKI
Hyperkalaemia Pulmonary Oedema Acidosis Uraemia with no response to medical treatment.
52
Best Ix for hydronephrosis
US
53
Normal Post Void Volumes in <65 and >65
``` <65 = 50mls >65 = 100mls ```
54
Management of hydroceles
Infants: Surgical removal if nor resolution within 1 yr Adults: Conservative but investigate for testicular cancer.
55
How does lithium cause nephrogenic DI How do genetics cause nephrogenic DI
Desensitisation of Kindey response to ADH. Common: Defect in Desmopresin receptors, Less common: Defect in aquaporin 2 receptors.
56
Suspected bladder cancer but cystoscopy was normal?
Renal tract US
57
RF for SCC of the bladder
Schistosomiasis | Smoking
58
AKI after starting an ACE? | Common finding?
Fibromuscular dysplasia | String of beads appearance
59
Pelvic fracture and displaced prostate?
Membranous urethral rupture
60
Pelvic fracture, no passing urine and lower abdo peritonism
Bladder rupture
61
What is the most common US finding on CKD patients and what are the exceptions?
Bilaterally shrunk kidneys Exceptions (Enlarged kidneys): - ADPKD - Diabetic Nephropathy - Amyloidosis - HIV associated nephropathy.
62
When should CKD patients be referred from primary care
EGFR <30 or drop by 15 in one year.
63
Prostatitis Mx
Quinolone (ciprofloxacin) for 14 days.
64
Most common form of prostate cancer
Adenocarcinoma
65
Normal urinary findings in acute graft failure
Rise in creatinine Pyuria Proteinuria
66
Mx of prostate cancer What does hormonal therapy involve
T1/2: Radical prostatectomy or Radiotherapy. Conservative if patient is palliative T3/4: Hormonal therapy or radical prostatectomy or radiotherapy Hormonal Therapy: GNRH analogues Non Steroidal Anti Androgens (Bicalutamide) Cyproterone acetate (Androgen receptor blocker)
67
Side effect of radical prostatectomy
ED
68
What kind of testicular cancer has a better prognosis
Seminomas
69
Acute prostatitis in a young man requires what additional Ix
STI screening
70
Haematuria post Catheterisation
Normal
71
Hyaline Casts?
Furosemide
72
Extrarenal Manifestations in ADPKD
Hepatomegaly/Cysts (most common) | Berry aneurysms leading to SAH
73
Findings on Renal Biopsy in minimal change disease
Podocyte fusion and effacement of foot processes on electron microscopy

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