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notion 2 > Renal > Flashcards

Renal Flashcards

1
Q

aki serum reatinien needs to increase by

A

25.4 or 50%

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2
Q

common causes of acute tubular necrosis

A

sepsis and severe dehydration

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3
Q

uo criteria for AKI

A

1 <0.5 for greater than 6 hours
2 <0.5 for greater than 12 hours
3 <0.3 for greater than 24 hours or anuria for 12 hours

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4
Q

what makes you consider myeloma

A

elderly AKI +bone pain + hypokalaemia + anaemia

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5
Q

investigations for myeloma

A

protein electrophoresis and BJB

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6
Q

what not to give for pre- renal treatment

A

dextrose- give crystalloid or colloid

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7
Q

all these drugs are what: aminoglycosides, acei, arbs, bisphosphonates, calcineurin inhibitors, diuretics, lithium, mesalazine, NSAIDs

A

nephrotoxic

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8
Q

if has no makers of kidney transplant then to be CKD needs to have eGFR of less than

A

60

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9
Q

what can be classes as accelerated CKD

A

persistent decrease in eGFR by 25% or more and change in CKD category in 12 months
or
persistent decrease in eGFR of 15 within 12 months

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10
Q

hypertension aim for CKD

A

140/90

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11
Q

hypertension aim for CKD with diabetes

A

130/80

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12
Q

what can be used for prevention of CKD

A

atorvastatin

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13
Q

ckd can cause

A

metabolic acidosis

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14
Q

what is main mineral that should be restricted in renal mineral and bone disorder

A

phosphate

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15
Q

what drugs can cause hyperkalaemia

A

aldosterone antagonists
ace I
arbs
nsaids
potassium supplements

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16
Q

treatment of hyperkalaemia

A

insulin and dextrose infusion and IV calcium gluconate

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17
Q

what is the most dangerous breakdown product in rhabdomyolysis

A

k

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18
Q

management for rhabdomylosis

A

Iv fluids

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19
Q

does amyloidosis and diabetic nephropahty can have nephritic or nephrotic

A

nephrotic

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20
Q

does SLE/HSP have nephrotic or nephritic

A

mixed

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21
Q

which syndrome causes acute renal failure

A

nephritic

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22
Q

cancer that often cause glomerulonephritis

A

lymphomas

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23
Q

damage to what cells results in vascultiits

A

endothelial

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24
Q

proliferative vs non proliferative referes to presence or absence of

A

mesangial cells

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25
Q

what syndrome is non proliferative

A

nephrotic

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26
Q

linear igG

A

goodpastures

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27
Q

minimal change has what syndrome

A

nephrotic

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28
Q

second line in minimal change

A
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29
Q

second line in minimal change

A

cyclophosphamide

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30
Q

focal segmental is what syndrome

A

nephrotic

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31
Q

2nd most common nephrotic syndrome in adults

A

membranous

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32
Q

anti PLA2r antibody

A

membranous

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33
Q

thickened basement membrane and spike on silver stain

A

membranous

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34
Q

rituximab is the treatment for

A

membranous nephropathy

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35
Q

what has mixed nephrotic and nephritic

A

membranoproliferative

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36
Q

hyeprcellular glomeruli with thick membranes - tram tracks

A

mebranoproliferativce

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37
Q

what is nephritic

A

IgA nephropathy

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38
Q

related to mesangial cells and mesangium

A

IgA

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39
Q

tretamtne for IgA

A

acei, arb

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40
Q

what is a treatable cause of acute renal failure

A

rapidly progressive glomerulonephritis

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41
Q

urine of rapidly progressive glomerulonephritis shows

A

active urinary sediment

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42
Q

what has a deficiency fo alpha galactosidase A

A

Anderson fabrys disease

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43
Q

fabryzme enzyme is the treatment for

A

Anderson fabrys disease

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44
Q

cutaneous manifestation of Anderson fabrys

A

angiokeratomas

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45
Q

what is a X linked mutation in COL4A5

A

alports syndrome

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46
Q

alports presents with what and hearing gloss

A

microscopic haematuria

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47
Q

ocular defect in alports

A

anterior lenticonus

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48
Q

what is the characteristic feature of aports on biopsy

A

variable thickness of the glomeuralr basement membrane

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49
Q

what is inflammatory but haas all radiological features of malignancy

A

xanthogranulomatous pyelonephritis

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50
Q

RCC is adenocarcinoma of the

A

renal cortex

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51
Q

what accounts for most sporadic renal cancers

A

VHL

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52
Q

what score is used to predict cancer vs cystic kidney disease

A

bosniak

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53
Q

most common RCC

A

clear cell
- cytoplasm rich in lipids

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54
Q

foamy cells

A

papilla RCC

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55
Q

what are large cell with defined borders. atypical nuclear resembling raisins
historically similar to oncoytomas

A

chromophone

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56
Q

what RCC is associated with young sickle cell patients

A

medullary cell

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57
Q

what RCC is the most aggressive

A

collecting duct

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58
Q

extra things that can be asscoited with RCC

A

polycythaemia (excess erythropoietin)
hypertension (excess renin)
hypercalcaemia

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59
Q

what is an onococyte

A

epithelial cell with an excess amount of mitochondria

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60
Q

what has a spoke wheel pattern

A

oncocytoma

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61
Q

what is mahogany brown with a central stellate scar

A

oncocytoma

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62
Q

20% of angiomyolipoma are associates with

A

tuberose sclerosis

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63
Q

us and ct of angiomylipoma

A

us - bright echo pattern
ct - fatty tumour of low density

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64
Q

what is a painless palpable abdominal mass in children

A

nephroblastoma

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65
Q

most common cause ph pyelonephritis

A

e.coli

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66
Q

there can be pain on bimanual palpation of the kidneys in

A

pyelonephritis

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67
Q

what should be given in pyelonephritis until cultures are available

A

amoxicillin and gentamicin

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68
Q

what can help confirm diagnosis of pyelonephritis

A

CT

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69
Q

how does drug induced interstitial nephritis present

A

usually about 15 days after starting the drug and usually has a fever and occasional a rash

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70
Q

bloods show what in drug induced interstitial nephritis

A

eosinophilia

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71
Q

common drugs to cause drug induced interstitial nephritis

A

ampicillin
rifampicin
thiazides
nsaids
allopurinol

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72
Q

analgesic nephropahty presentation

A

usually develop anaemia and many develop UTI

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73
Q

what is associated with hypercalcaemia and amyloid deposition

A

myeloma

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74
Q

hyperuricaemia can occur in leukaemia patients on

A

agressive chemo

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75
Q

most add mutations are on chromosome

A

16

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76
Q

common presentation of ADKD

A

reduced urine concentration ability
chronic pain
hypertension
haematuria

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77
Q

what extra renal manifestation in ADPKD can result in SOB,ankle swelling

A

hepatic cyst

78
Q

intra cranial aneurysm can be seen in

A

ADPKD

79
Q

if can’t distinguish between ADPKD and recessive in children what should you do

A

US - congenital hepatic fibrosis suggest recessive

80
Q

what is a new treatment to slow loss of kidney function in ADPKD

A

tolvpaton

81
Q

most common mutation is on what chromosome for autosomal recessive kidney disease

A

6

82
Q

abnormal gene in autosomal recessive kidney disease codes for what

A

fibrocystin

83
Q

in arkd what are the kidneys like

A

usually of normal size and still have smooth outside

84
Q

histologically in rececessice where are cysts seen as appearing from

A

collecting duct

85
Q

what are always palpable in recessive disease

A

kidneys- despite being of normal size

86
Q

renal tubules leading to fibrosis

A

medullary cystic kidney disease

87
Q

cystic dilation of the collecting tubules

A

medially sponge kidney

88
Q

investigation for medullary sponge kidney

A

exertion urography

89
Q

what cysts have attenuated lining

A

simple

90
Q

excessive production of immunoglobulins

A

myeloma

91
Q

serum light chains

A

myeloma

92
Q

management for myeloma

A

stop nephrotic and manage hypercalcarmai

93
Q

hepatomegaly/ splenomegaly may be seen in

A

amyloidosis

94
Q

renal wise amyloid presents as

A

nephrotic range proteinuria

95
Q

good pastures is what type of hypersensotovty reaction

A

2

96
Q

renal biopsy in good pastures shows

A

glomeurlonephitis

97
Q

management fo good pastures

A

plasmapheresis

98
Q

what small vessel vasculitis generally has no kidney innvolvemetn

A

eosinophilic gpa

99
Q

what is NOT a good marker for disease severity in small vessel vasculitis

A

antibody titre

100
Q

urinalysis shows active eerie (lots of blood and protein)

A

small vessel vasculitis

101
Q

what is most frequently observed abnormality in SLE

A

proteinuria

102
Q

what is defined as malignant hypertension

A

systolic> 180
diastolic >120

102
Q

what is defined as malignant hypertension

A

systolic> 180
diastolic >120

103
Q

how does malignant hypertension present

A

crushing chest pain
sign of raised ICP

104
Q

management of malignant hypertension

A

medical emergency - urgent hospital admission

105
Q

management for acute urinary retention

A

catheter

106
Q

bell clapper deformity is a rf for

A

torsion of tests

107
Q

what is a bellclapper deformity

A

insertion of tunica vaginalis is high

108
Q

most common cause for epidiymoorchitis if under 25 vs over 35

A

under - n. gonorrhoea
over- e.coli

109
Q

elevation of testes alleviates pain

A

epididymoorhcitis

110
Q

management for epididymoorchitis

A

analgesia and antibiotics

111
Q

2 types of priapism

A

ischaemic and non ischaemic

112
Q

ischaemic o2 and co2 in

A

low 02 and high co2
whereas non ischaemic has normal arterial blood flow

113
Q

manage ischaemic priapism

A

aspirate
if fails - alpha agonist

114
Q

gas in tissues

A

fourneieres gangrene

114
Q

gas in tissues

A

fourneieres gangrene

115
Q

infection caused by gas forming pathogens usually e.coliu

A

emphysematous pyelonephritis

116
Q

emphysematous pyelonephritis usually occurs in diabetics and presents as

A

fever, vomiting and flank pain

117
Q

pyuria (pus in pee) may be

A

perinephric abscess

118
Q

frank haemturia investigation

A

ct with contrast

119
Q

how are most renal blunt injuries managed

A

angiography/embolization

120
Q

what is commonly associate with pelvic fracture

A

bladder injury

121
Q

investigation if got bladder injury

A

catheter, ct Cystography

122
Q

fracture of pubic rami asscoaited with

A

urethral injury

123
Q

high riding prostate suggest

A

urethral injury

124
Q

investigations for urethral injury

A

retrograde urethrogram

125
Q

inflammation of the bladder

A

cystitis

126
Q

infolding of bladder mucosa into cyst

A

cystitis cystica

127
Q

staghorn calculusu

A

proteus

128
Q

uti associated with catheters

A

pseudomonas

129
Q

staphylococcus saphrophticus usually affects

A

women of child bearing age

130
Q

urine is the kidneys, ureters and bladder is normally

A

sterile

131
Q

there is a risk of what in complicated UTI

A

gram negative septicaemia

132
Q

when is dipstick not suitable for uTI

A

urine of elderly or urine from a catheter specimen

133
Q

complicated UTi or pyelonephritis in rpiamry care

A

co amoxiclav or co- trimoxazole

134
Q

complicated UTI or pyelonephritis in hospital

A

amoxicillin and gentamicin

135
Q

when is asymptotic bacteria required

A

pregnancy

136
Q

when do you only give antibiotics in catheterised patients for UTI

A

if there is fever/ symptoms as unnecessary antibiotics can result in the catheter becoming colonised with increasingly resistant organisms

137
Q

symptoms fo UTI and Lowe abdo pain and tender prostate on examination

A

prostatitis

138
Q

management for prostates

A

ciprofloaxicin

139
Q

what composition of stone form stag horn calculi

A

magnesium ammonium phosphate

140
Q

urinalysis of renal calculi shoes

A

non visible haematuria

141
Q

what stones are not visible on X-ray

A

uric acid and cystine

142
Q

initial investigation for diagnosing kidney stones

A

CT KUB

143
Q

initial investigation for diagnosing kidney stones in children and pregnant. woman

A

US KUB

144
Q

what is hydronephrosis

A

dilation of the renal pelvis and calyces

145
Q

what incontinence may be due to bladder overactivity (prblem with detrusor)

A

urge

146
Q

constant leakage of urine suggests

A

fistulous communication

147
Q

medications for urge incontinence

A

anticholinergic and b agonists

148
Q

what are associated with bladder cancer

A

schistosomiasis and aromatic amines (beta- napythyline)

149
Q

most common type of bladder cancer

A

transitional cell

150
Q

transitional cell cancer is often

A

papillary

151
Q

forms dome of bladder

A

urachal adenocarcinoma

152
Q

investigation for bladder cancer

A

CT -urogram or flexible cystoscopy

153
Q

Benign prostate hyperplasia affects what cells of the prostate

A

stromal and epithelial

154
Q

the prostate grows in response to what ( a breakdown products of testosterone)

A

dihydrotestosterone

155
Q

does BPH make prostate cancer more likely

A

no

156
Q

what is the most common early symptoms of BPH

A

frequency of urinating particularly at night

157
Q

IF suspect bah do what

A

dipstick to exclude infection

158
Q

management for bph

A

alpha blocker - tamsulosin
5 alpha reductase inhibitor - finasteride

159
Q

rf for prostate cancer

A

cadmium batteries

160
Q

rf for prostate cancer

A

cadmium batteries

161
Q

transitional zone is where BPH occurs and surrounds what

A

prostatic urethra

162
Q

central zone of prostate surrounds what

A

ejaculatory ducts

163
Q

most common site of metastasis of prostate cancer

A

boen

164
Q

PSA does what

A

liquifies semen and allows sperm to swim

165
Q

high grader prostate cancers won’t produce what

A

PSA

166
Q

prostate cancer typically arises from what lobe

A

posterior

167
Q

what determines prognosis of prostate cancer

A

Gleason score

168
Q

what is unusually about the bony metastasis of prostate cancer

A

will show osterosclerosis - most malignancies cause osteolysis

169
Q

what drugs inhibit testosterone slowing the progression of prostate cancer

A

LHRH agonists and anti androgens

170
Q

non seminatous (teratoma) testiicualr cancer occurs in what age

A

under 35

171
Q

seminamotous testicular cancer occur in what age

A

35-45

172
Q

seminoma occurs from where

A

seminiferous tubules

173
Q

what testicualr cancers are more aggressive and can metastasise

A

teratoma

174
Q

what cancer is usually associated with other cell types

A

teratoma

175
Q

yolk sac tumour produce what

A

alpha feto protein

176
Q

what carcinoma is positive for beta HCG and shows positive pregnancy test

A

choriocarcinoma

177
Q

what imaging to stage testiualr cancer

A

CT chest abdomen

178
Q

alpha fetoprotein is not raised in

A

seminomas

179
Q

beta hcg can be raised in seminomas and teratomas but more often in

A

teratomas

180
Q

in what do you offer sperm preservation

A

radical inguinal orchidectomy

181
Q

HPV 16 and 18 are associate with

A

penile cancer

182
Q

most penile cancer are

A

squamous

183
Q

investigation for penile cancers

A

biopsy

184
Q

fluid filled cyst that develops at the head of the epididymis

A

spermatocele

185
Q

varicocele is an enlargement fo the pampinifrom venous plexus in the

A

scrotum

186
Q

varicoceles most commonly affects what side

A

left

187
Q

left sided varicocele can also be a presenting feature of what

A

RCC

188
Q

treatment for varicocele

A

generally need no treatment

notion 2 (9 decks)

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