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renal Flashcards

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1
Q

what virus causes Measles mumps and rubella

A

RNA. paromyoxvrus (measles morbilivirus)

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2
Q

most common viral hepatitis worldwide

route of spread for the viral heps

A

HEP A

A- FO
B+C - blood
D - always with B
E - Zoo+ FO

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3
Q

child with a high fever and spots on uvula, and as fever settles rash appears ? name and viral cause

A

roseola
HHV-6

NAGAYAMA spots

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4
Q

what marker is used to distinguish iron overload from haemochromatosis and other causes

A

transferrin saturations
high in haemochromatosis low in others

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5
Q

lacey rash on kids face - called and virus cause by ?

A

erythema infectiosum/slapped cheek/ fifths disease
parvovirus B19

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6
Q

what is diagnostic criteria of an AKI

A
  1. rise in createnine of 26 within 48 hrs
  2. an increase of 50% createnine in 7 days
  3. oligouria (<0.5ml/kg/hr) for > 6 hrs in adults
  4. 25% fall in eGRF in kids in 7 days
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7
Q

drugs that should be stopped in AKI

A

ACEI, ARB, NSAID, aminoglyc, diuretic
DIG, met lithium due to toxiciity

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8
Q

what is given in hyperkalaemia to stabalise cardiac memebrane

A

IV Calcium Gluconate

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9
Q

what size of gallstone can be left to pass psontaneously

A

<5mm

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10
Q

CKD that causes large not small kidneys

A

ADPKD
diabetic nephropathy
amyloidosis
HIV assoc nephropathy

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11
Q

most common casue of CKD

A

diabetic nephropathy

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12
Q

how does scarlet fever casue a rash

A

GAS releases erythrogenic toxin

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13
Q

what is management of different volvulus

A

sigmoid volvulus: rigid sigmoidoscopy with rectal tube insertion
caecal volvulus: management is usually operative. Right hemicolectomy is often needed

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14
Q

out of PSC and PBC which is both intra and extr hepatic

A

PSC is intra and extra

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15
Q

most common complications of measels (2)

A

otiis media - most common
pneumonia - most common cause of death

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16
Q

where is water reabsorbed from in the kidney

A

PCT, descending loh and CD

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17
Q

what does ADH do and where does it act

A

stimulates aquaporin in CD of kidney

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18
Q

in the PCT what is HCO3 resorption driven by

A

sodium

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19
Q

types of nephrotic syndrome

A
  1. minimal change
  2. membranous GN
  3. focal segmental glomerulonephritis
  4. amyloidosis
  5. diabetic nephropathy
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20
Q

types of nephritic syndrome

A
  1. rapidly progressing GN
  2. IgA nephrpathy
  3. Alport syndrome
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21
Q

triad of nephrotic syndrome

A
  1. proteinuria
  2. oedema
  3. hypoalbinaemia
    + hypercholoesterol
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22
Q

what cells does nephrotic syndrome affect

A

podocytes

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23
Q

how does nephrotic syndrome cause thrombosisi

A

loss of antithrombin III, protein C and S and associated increase in fibrinogen

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24
Q

what would be seen on renal biopsy in minimal change disease

A

occasional IgM in mesangium
podocyte foot effacement

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25
causes of minimal change disease
idiopathic drugs - NSAID hodgkins MONO
26
middle aged itchy woman and treatment
PBC - first-line: ursodeoxycholic acid slows disease progression and improves symptoms - pruritus: cholestyramine - fat-soluble vitamin supplementation
27
commonest casue of GN in adults
membranous GN
28
spikes on renal biopsy
membranous GN
29
treatment of membranous GN
ACE/ARB immunisupp
30
what is the clinical picture of nephritic picture
haematuria proteinuri <3g sterile pyuria HTN oligouria
31
what is deposited on the basemenet membraen i nmembranous GN
IgG and C3
32
IgA nephropathy associated conditions
alcoholic cirrhosis coeliac. dermatitis herpetiformis HSP
33
what anti body is tested for in post streptococcal GN
anti-streptolysin o
34
what complement protein is low in post strep Gn
C3
35
starry sky on renal biopsy
post strep Gn
36
what is seen on renal biopsy in alports syndrome
basket weave - splitting of lamina dense
37
if someone has renal failure and haemoptysis what shoud you think ?
GPA or goodpasteurs
38
what chromosome is HLA found on
chromosome 6
39
different types of renal graft rejection and timeframe
1. hyperacute rejection - mins to hrs 2. acute graft failure - <6mnths 3. chronic graft failure >6mnth
40
what is the pathogenesis of hyperacute graft failure
due to pre-existing antibodies eg ABO
41
tx of hyperacute graft rejection
remove transplant
42
pathogenesis of acute graft failure
mismatched HLA - t cell mediated
43
what would indicate acute graft failure
increased createnine pyuria and proteinuria
44
tx of acute graft rejection
steroids and immunosuppresion
45
how does acute interstital nephritis present and assoc features
HTN and AKI rash arthralgia, fever, eosinophilia
46
causes of acute interstitial nephritis
drugs, SLE, sarcoid
47
what would be seen in urinalysis in acute interstitia nephritis
sterile pyuria white cell casts
48
what causes acute tubular necrosis
ischaemia or nephrotoxins
49
features of acute tubular necrosis
features of an AKI - increase createnine, urea and potassium muddy brown casts
50
what is the most common casue of an AKI
Acute tubular necrosisi
51
what is the most common type of renal tubular acidosis and pathophysiology
TYPE 4 - reduction of aldosterone causes a decrease in PT ammonia excretion
52
what is pathophysiology of type 1 renal tubular acidosis
inability to excrete Hydrogen in DCT
53
what would the urine pH be in a Type 1 renal tubular acidosis
above 6
54
is type 1 renal tubualr acidosis hyper or hypokalaemia
hypokalaemia
55
type 4 renal tubular acidosis- hypo or hyperkalaemia and what is urinary pH
hyperkalaemia and pH is less than 6
56
what type of acidosis/alkalosis is seen in renal tubular acidosos and what is anion gap
hyperchloraeic metabolic acidosis with a normal anion gap
57
most common type of renal cell cancer
clear cell
58
classic triad of renal cancer
loin pain haematria abdo mass
59
what paraneoplastic syndrome can renal cancer give
EPO - polycythaemia ACTH PTHrP - hypercalcamia
60
what testicular pathology can renal cell cancer cause
varicolcele due to compression of pampiniform plexus
61
what is treatment of a renal cell cancer less htan 7 cm
partial nephrectomy
62
what is treatment if a patient has transitional cell cancer of the kidney
nephrouretectomy trasiional cell is bladder cancer
63
treatment of wilms tumour
nephrectomy and chemo eg vinaristine duxorubicin
64
what drugs can cause acute urinary retention
TCA's - amitriptyline Anticholinergics opioids NSAIDS disopyramide
65
what is acute urinary retnetion most commonly secondary to
benign prostatic hypertension
66
how to differetiaite between acute and chronic urinary retention
acute - painful chronic- painless
67
what examinations shoud be performed in acute urinary retention
PR, PV and neuro exam
68
what is diagnostic investigation in urinary retention
USS
69
what volume of fluid is indicative of urinary retention
>300cc
70
if USS ambiguous as to urinary retention hat should be done
cathertise and if over 15 mins <200cc not rentention if >400 then retention
71
what is post -op dieuresis
polyuric state after relief of obstruction due to loss of medullary conc radietn
72
what differentiates high pressure retention in comparison to low pressure retention
hydronephrosis
73
treatment of uncomplicated UTI (and durtion )
Nitro/ Trime for 3 days
74
when should you culture for an uncomplicated UTI
haematuria or >65
75
management of an asymptomatic UTI in preganant women
nitro for 7 days and test for cure
76
shoudl you culture for pregannat women with UTI
yes - nitro/amox
77
treatment for men with UTI
culture and 7 day prescription of nitro or trime
78
if a child present with recurretn UTIS what shoudl you expect
vesicoureteric reflux
79
what is a common complication of vesicoureteric reflux
scarring
80
what is a complication of renal scarring secondary to VUR in kids
hypertension - scar produces renin
81
commonest renal stones
calcium oxalate
82
key risk factors for calicum based renal stones
hypercalcaemia and dehydration
83
how are struvite renal stones made
bacteria hydrolse urea in urine to ammonia creating struvite
84
what infections predispose struvite renal stones
proteus and Ureaplasma urealyticum - alkali environment
85
ground glass renal stone
cystine
86
cystine renal stone are due to what
auto recessive conditiion
87
risk factors for urate renal stones
GOUT and ILeostomy - loss of bicarb
88
what drugs are assoc with renal stones
loop diureticsm - cause hypocalcaemia but hypercalcinuria steroids, and theophylline
89
what drug prevent renal stones
thiazides
90
management of renal stones
<5mm pass spontaneously
91
pain mangement of renal stones
IM diclofenac
92
causes of renal artery stenosis
atherosclerosis fbromuscular dysplasia
93
features of renal artery stenosis
HTn, CKD and flash PO
94
how and where to LOH diuretics work
work on the ascending loop of henle they block the NA-CL-K co trasnporter on apical side of membrane therefore osmosis does not occur and water does not follow Na into interstitium
95
how and where do thiazides work
the work on the DCT - block NACL co transporter - there fore water and salt remain in lumen
96
treatment of good pasteurs disease
steroids and cyclophosphamide
97
common neuro symptoms in ANCA vasculiits
mononeuritis multiplex
98
qhat type of collagen does Goodpasteurs target
type IV collagen
99
common causes of acute interstitial nephritis
PPI and Fluclox
100
why may Acute interstitial nephritis presetn with pain
due to capsular stretch from inflammation
101
most important post organ trasnplant infection
CMV
102
is TIBC low or high in anaemia of chronic disease
low/normal in chronic disease high in iron deficiency
103
what shoudl be doen for an INR between 5-8 with no bleedign
withhold 1-2 doses of warfarin adn reducce susequent doses
104
what iron studies are seen in haemochromatosis tranferrin, ferritin adn TIBC
high transferring, high ferritin and low TIBC

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