Renal

Question 1

How is alports syndrome inherited?

Answer 1

X linked dominant

Question 2

Why might patients with alport’s syndrome have a failing renal transplant?

Answer 2

Anti GBM antibodies

Question 3

What does the renal biopsy of alports show

Answer 3

Splitting on the lamina densa resulting in a bsket weave appearance (only seen on electron microscopy)

Question 4

What collagen is defective in alports syndrome?

Answer 4

Type 4

Question 5

What are the common drug causes of acute interstitial nephritis?

Answer 5

Penicillin 
Rifampicin 
NSAIDs 
Allopurinol 
Furosemide

Question 6

Features of acute interstitial nephritis?

Answer 6

Fever, rash, arthralgia, eosinophilia, mild renal impairment

Sterile pyuria with white cell casts.

Question 7

What is the best medication for lupus nephritis (maintenence treatment)

Answer 7

Mycophenolate

Question 8

What are the classes of lupus nephritis?

Answer 8

1: Normal
2: Mesangial glomerulonephritis
3. focal segmental proliferative glomerulonephritis
4.Diffuse proliferative glomerulonephritis
5. Diffuse membranous glomerulonephritis
C6. Sclerosisng glomerulonephritis

Question 9

What renal disease has the highest rate of recurrence after transplant?

Answer 9

Membranoproliferative glomerulonephritis (particular type 2)

Question 10

Treatment for dialysis disequilibrium syndrome

Answer 10

Hypertonic saline

Question 11

What renal disease does heroin cause?

Answer 11

Focal segmental glomerulosclerosis

Question 12

What renal disease does hepatitis B cause?

Answer 12

Membranous nephropathy

Question 13

What renal disease does hepatitis C cause?

Answer 13

Membranoproliferative glomerulonephritis or membranous nephropathy

Question 14

When does acute graft failure occur?

Answer 14

Less than 6 months

Question 15

What causes acute graft failure of a kidney transplant?

Answer 15

Mismatched HLA

Question 16

Why is there an increased risk of clots in nephrotic syndrome?

Answer 16

Loss of antithrombin 3 and plaminogen in the urine.

Question 17

high plasma osmolality and low urine osmolality

Answer 17

Diabetes insipidus

Question 18

Treatment of diabetes insipidus?

Answer 18

Cranial - desmopresson

Nephrogenic -thiazides

Question 19

Treatment of central diabetes insipidus?

Answer 19

Desmopressin

Question 20

Podocyte fusion

Answer 20

Minimal change disease

Question 21

Management of minimal change disease

Answer 21

Steroids

Cyclophosphamide is the next step if steroid resistant

Question 22

Prognosis of minimal change disease?

Answer 22

1/3rd have one episode
1/3rd have infrequent relapse
1/3rd have frequent relapses which stop before adulthood

Question 23

Criteria for diagnosis of AKI?

Answer 23

Rise in creatanine of 26 or more in 48 hours OR 50% rise in creatanine over 7 days OR fall in urine output to less than 0.5ml.kg/hour for more than 6 hours OR 25% fall in eGFR in children in 7 days,

Question 24

Causes of membranous glomerulonephritis?

Answer 24

idiopathic (anti phospholipase A2 antibodies)
Infections (hepB, malaria, syphillis)
Malignancy
Drugs (gold, penicllamine, gold, NSAIDS)
Autoimmune disease (SLE, thyroiditis, rheumatoid

Question 25

Treatment of membranous glomerulonephritis

Answer 25

ACE inhibitor or ARB | Immunosupression only used in severe or progressive disease (steroids + cyclophosphamine)

Question 26

Prognosis of membranous glomerulonephritis

Answer 26

1/3rd - spontaneous remission 1/3rd - remain prpteinuric 1/3rd - develop end stage renal failure

Question 27

Most common renal disease in SLE?

Answer 27

Diffuse proliferative glomerulonephritis (most common and most severe)

Question 28

Wire loop appearance on renal biopsy

Answer 28

Diffuse proliferative glomerulonephritis

Question 29

Causes of membranoproliferative gomerulonephritis type 1

Answer 29

Cryoglobulinaemia, hepatitis C

Question 30

What is fanconi syndrome?

Answer 30

A general reabsorptive disorder of renal tubular transort in the proximal convoluted tubule that causes tyoe 2 renal tubular acidosis

Question 31

Causes of focal segmental glomerulosclerosis ?

Answer 31

``` Idiopathic HIV Heroin Alports syndrome Sickle cell ```

Question 32

Causes of rapidly progressive glomerulonephritis?

Answer 32

Goodpastures Wegeners granulomatosis SLE, microscopic polyarteritis

Question 33

Treatment for peritoneal dialysis peritonitis?

Answer 33

Intraperitoneal vancomycin and ceftazidime

Question 34

Treatment of cystinuria?

Answer 34

1. Hydration 2. Potassium citrate 3. D penicillamine

Question 35

Reduction of calcium renal stones?

Answer 35

Bendroflumathiazide

Question 36

Reduction of uric acid stones?

Answer 36

Allopurinol