renal Flashcards by zaynah yousaf

CKD diagnosis

egfr less than 60 on 2 occasions 3 months apart

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Which nephrotic syndrome is associated with malignancy

membranous nephropathy

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When do you send MSU

aged > 65 years
visible or non-visible haematuria

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What opioid is preferred in renal impairment

oxycodone: mild-moderate renal impairment
alfentanil, buprenorphine and fentanyl: severe

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Renal colic management

<5mm + no symptoms: watchful waiting
5-10mm: shockwave lithotripsy + alpha blocker (tamsulosin)
> 20mm: percutaneous nephrolithomy

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asthma, eosinophillia, impaired kidney function

churg-strauss (pANCA)

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How do you diferentiate CKD and AKI

CKD has small kidneys and hypocalcamia

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do you get raised or decreased haptoglobin in HUS

decreased

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most common organism in peritonitis secondary to peritoneal dialysis

staph epidermis

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Complications of RTA1

renal stones and nephrocalcinosis

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Complication of RTA2

osteomalacia

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pathophysiology of iga nephropathy

mesangial deposits of iga immune complexes

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enlarged kidneys on USS with CKD

autosomal dominant polycystic kidney disease
diabetic nephropathy (early stages)
amyloidosis
HIV-associated nephropathy

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pathophysiology of membranous nephropathy

IgG immune complex deposits in the basement membrane

God gives people cancer

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what kidney issue is HIV associated with

nephrotic syndrome
focal segmental glomerulosclerosis

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nephrotic syndrome criteria

proteinuria >3g/24 hours
hypoalbuminiea <25g/24 hours
peripheral oedema
hypercholesteremia

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cause of renal artery stenosis

young: fibromuscular dysplasia
Old: atheroscleoris

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what is seen on MR angiography with RAS

string of beads appearance

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pathophysiology of post-stre glomeurulonephritis

immune complex (IgG, IgM and C3) deposition in the glomeruli.

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most common and important viral infection in solid organ transplant recipients

CMV

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why do you get High serum urea:creatinine ratio is seen in pre-renal AKI

urea is passively reabosrbed with sodium

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maximum recommended rate of potassium infusion via a peripheral line

is 10 mmol/hour, whereas rates above 20 mmol/hour require cardiac monitoring

How does myoglobin cause AKI

tubular cell necrosis

nephrotic syndrome causes

focal segmental glomerulosclerosis
minimal change disease
membranous nephropathy
Membranoproliferative Glomerulonephritis
amyloidosis

Secondary
- diabetic nephropathy
- HIV/hepatitis
- SLE

why do you get increased risk of thrombus in kidney disease

loss of antithrombin III

Lights criteria for exudative

1. pleural fluid protein/serum fluid protein ratio > 0.5 2. pleural fluid LDH/serum fluid LDH ratio > 0.6

SAAG

>11g/L is portal hypertension

Choice of drug in PE with low renal function

heparin

Stag-horn calculi

struvite

Drugs that cause AIN

- penicillin - NSAIDs - Rifampicin - Allopurinol - Furosemide

ATN causes

- Aminoglycosides - Rhabdo - Ischamia (shock/sepsis )

drugs to avoid in renal failure

antibiotics: tetracycline, nitrofurantoin NSAIDs lithium metformin

budd chiari syndrome investigation

doppler USS

liver transplant criteria following PO

Arterial pH < 7.3, 24 hours after ingestion or all of the following: prothrombin time > 100 seconds creatinine > 300 µmol/l grade III or IV encephalopathy

Choice of treatment for CKD bone disease

alfacalcidol (does not need to be activated in the kidneys)

potential complication of nephrotic syndrome

renal vein thrombosis - loss of antithrombin III creats hypercoaguable state

urine sodium > 40 mmol/L

ATN

urea > creatinine

dehydration

sudden onset abdominal pain, ascites, and tender hepatomegaly

budd-chiari syndrome

most common affected site in crohns

ileum

associated with sewage workers/rat urine

Leptospirosis

causes of transient haematuria

urinary tract infection menstruation vigorous exercise (this normally settles after around 3 days) sexual intercourse

Where do the diuretics work

Aldosterone antagonists: DCT Loop: ascending look (Na, Cl, K channels) PCT: carbonic anhydase

goodpastures symptoms

pulmonary haemorrhage rapidly progressive glomerulonephritis this typically results in a rapid onset acute kidney injury nephritis → proteinuria + haematuria IgG deposits in basement membrane

which nephrotic syndrome is associated with HIV

FSGS

toxic megacolon imagining

abdo x-ray

most likely cause of death with CKD on haemodialysis

IHD

isolated rise in bilirubin

gilbert

complication of ERCP

Pancreatitis Perforation Infection (eg acute cholangitis) Bleeding Aspiration pneumonia Cytology reveals malignant cells

what is required before a large volume paracentesis

albumin replacment

complication of TIPS

Inadequate metabolism of nitrogenous waste products by the liver Blood bypasses liver

first line treatment of nephortic syndrome unknown aetiology

LMWH

pulmonary oedema not responding to diuretics (AKI)

haemodialysis

ACE inhibitors and CKD

A potassium above 6mmol/L should prompt cessation of ACE inhibitors in a patient with CKD (once other agents that promote hyperkalemia have been stopped)