Renal

Question 1

Name some examples of nephrotoxic drugs

Answer 1

• ACE inhibitors,
• NSAIDs,
• Diuretics,
• Lithium
• Digoxin,
• Aminoglycosides,
• Metformin,
• Iodinated contrast media,
• Opioids

Question 2

What are some causes of glomerulonephritis

Answer 2

Infections (streptococcus A, endocarditis, HIV)
Systemic inflammatory disease,
Drugs (NSAIDs, anabolic steroids)

Question 3

What are the signs and symptoms of glomerulonephritis

Answer 3

• Haematuria,
• Proteinuria,
• Oedema,
• Hypertension,
• Joint pain,
• Rash,
• Fever,
• Weigh loss

Question 4

What are some investigations and managements for glomerulonephritis

Answer 4

• Urinalysis,
• Urine microscopy,
• U+Es, FBC, CRP, ESR,
• Metabolic and lipid profile,
• Renal tract ultrasound,
• Renal Biopsy which is a definitive diagnosis
  Management - antibiotics, ACEi, Corticosteroids, diuretics, immunosuppressants, plasmapheresis.

Question 5

What are some causes of proteinuria

Answer 5

Diabetes, amyloidosis, UTI, pre-eclampsia

Question 6

What are some vascular diseases which can impact the kidneys

Answer 6

• Hypertension,
• Vasculitis,
• Thrombotic thrombocytopenia purpura,
• Haemolytic uraemic syndrome

Question 7

Describe features of nephritic syndrome

Answer 7

• Likely to present with haematuria, non-nephrotic range proteinuria and hypertension.
• Causes include post-infectious, vascular and systemic lupus erythematosus

Question 8

Describe features of nephrotic syndrome

Answer 8

• Marked proteinuria, oedema, hypalbuminaemia (due to damaged glomerulus which causes massive loss of proteins in the urine), hyperlipidaemia (liver compensation for low albumin) and lipiduria.
  Management - high dose steroids

Question 9

What are symptoms of UTIs

Answer 9

• Urinary frequency,
• Dysuria,
• Urgency,
• Foul-smelling urine,
• Suprapubic pain

Question 10

What are the UTI investigations?

Answer 10

• Urinalysis (leukocytes and nitrites)

- In children, men and pregnant women a mid-stream urine sample is needed for microbiology

Question 11

What is the first line treatment for UTIs?

Answer 11

Nitrofurantoin or trimethoprim

Question 12

What are the symptoms and treatment of pyelonephritis

Answer 12

Symptoms - patients will be febrile, vomiting and have flank pain.
Treatment - IV broad spectrum antibiotics (ciprofloxacin or co-amoxiclav)

Question 13

What is pure nephrotic syndrome?

Answer 13

Minimal change disease

Question 14

What is nephrotic syndrome with hematuria

Answer 14

Membranous glomerulonephritis

Question 15

What is nephritic syndrome with nephrotic range proteinuria

Answer 15

Membrano-proliferative glomerulonephritis

Question 16

What are the causes of a pure nephritic syndrome?

Answer 16

• Post streptococcal glomerulonephritis, infective endocarditis, goodpasture’s disease and vasculitis