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MRCP 2 > Renal > Flashcards

Renal Flashcards

(53 cards)

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1
Q

What stones are formed in the presence of increased urinary ammonia and alkaline urine (>7.2)

A

Struvite

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2
Q

Most common cause of a renal stone

A

Calcium Oxalate

Hypercalciuria is a major risk factor

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3
Q

Electron microscopy:

The basement membrane is thickened with subepithelial electron dense deposits.

This creates a ‘spike and dome’ appearance

A

Membranous glomerulonephritis

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4
Q

Management of Membranous glomerulonephritis

A

ACE inhibitor or an angiotensin II receptor blocker

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5
Q

Causes of anaemia in renal failure

A

Reduced erythropoietin levels

Reduced absorption of iron

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6
Q

Diabetes insipidus

A

Either a decreased secretion of antidiuretic hormone from the pituitary (cranial DI)

or

an insensitivity to antidiuretic hormone (nephrogenic DI).

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7
Q

Patients with type one diabetes nearing end stage renal failure should be considered for ?

A

Joint pancreas and renal transplants.

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8
Q

Membranous glomerulonephritis

A

Commonest type of glomerulonephritis in adults.

It usually presents with nephrotic syndrome or proteinuria.

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9
Q

Anti-glomerular basement membrane (GBM) disease

Goodpasture’s Syndrome

A

Small-vessel vasculitis

Pulmonary haemorrhage

Rapidly progressive glomerulonephritis.

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10
Q

Renal Biopsy in Anti GBM disease

A

Linear IgG deposits along the basement membrane

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11
Q

Management in Anti GBM disease

A

Plasma exchange (plasmapheresis)

Steroids

Cyclophosphamide

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12
Q

Haemolytic uraemic syndrome

A

Acute kidney injury

Microangiopathic haemolytic anaemia (MAHA)

Thrombocytopenia

Classically Shiga toxin-producing Escherichia coli (STEC) 0157:H7

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13
Q

Nephrotic syndrome (Triad)

A

Heavy proteinuria >3 g/day

Low serum albumin <25 g/L

Oedema

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14
Q

Alport’s syndrome

A

X-linked dominant pattern

Defect in the gene which codes for type IV collagen resulting in an abnormal glomerular-basement membrane (GBM)

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15
Q

Electron microscopy

Longitudinal splitting of the lamina densa of the glomerular basement membrane, resulting in a ‘basket-weave’ appearance

A

Alport’s Syndrome

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16
Q

Management:

Nephrogenic diabetes insipidus

A

Thiazides

Low salt/protein diet

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17
Q

Management:

Cranial diabetes insipidus

A

Desmopressin

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18
Q

Histology:

Mesangial hypercellularity, positive immunofluorescence for IgA & C3

A

IgA Nephropathy

Berger’s Disease

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19
Q

Fanconi syndrome

A

Generalised reabsorptive disorder of renal tubular transport in the PCT

Type 2 (proximal) renal tubular acidosis

Polyuria

Aminoaciduria
Glycosuria
Phosphaturia
Osteomalacia

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20
Q

Most common Drug causes of Acute Interstitial Nephritis

A

Penicillin
Rifampicin
NSAIDs
Allopurinol
Furosemide

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21
Q

Anion gap

A

(Na+ + K+) - (Cl- + HCO-3)

Metabolic acidosis is commonly classified according to the anion gap

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22
Q

Causes of Normal anion gap
(hyperchloraemic metabolic acidosis)

Study These Flashcards
A

Gastrointestinal bicarbonate loss:

Renal tubular acidosis

Drugs: e.g. acetazolamide

Ammonium chloride injection

Addison’s disease

23
Q

Causes of Raised anion gap

Study These Flashcards
A

Lactate

Ketones:

Urate: renal failure

Acid poisoning: salicylates, methanol

24
Q

Causes of Unilateral Hydronephrosis

Study These Flashcards
A

PACT:

Pelvic-ureteric obstruction (congenital or acquired)

Aberrant renal vessels

Calculi

Tumours of renal pelvis

25
Causes of Bilateral Hydronephrosis
SUPER: Stenosis of the urethra Urethral valve Prostatic enlargement Extensive bladder tumour Retro-peritoneal fibrosis
26
Churg-Strauss syndrome
Late-onset asthma Vasculitis Eosinophilia
27
Nephrotic syndrome: complications
Increased risk of thromboembolism related to loss of antithrombin III and plasminogen in the urine Hyperlipidaemia - increasing risk of acute coronary syndrome, stroke. Chronic kidney disease Increased risk of infection due to urinary immunoglobulin loss Hypocalcaemia (vitamin D and binding protein lost in urine)
28
Renal biopsy: Effacement of foot processes on electron microscopy
Focal segmental glomerulosclerosis (FSGS) + Minimal Change disease
29
Time taken for an arteriovenous fistula to develop
6 to 8 weeks.
30
Focal or diffuse lupus nephritis - treatment
Glucocorticoids with either mycophenolate or cyclophosphamide is the initial treatment of choice
31
What is is homologous to TSH in structure and therefore can lead to hyperthyroidism
hCG
32
Chlorthalidone - MOA
Thiazide Diuretic
33
IgA nephropathy management no proteinuria, normal GFR
Observe
34
IgA nephropathy management Proteinuria
ACE inhibitor
35
IgA nephropathy management Significant fall in GFR/not responding to ACE inhibitor
Corticosteroid
36
For patients with chronic kidney disease, investigations for anaemia should be considered if ?
Haemoglobin falls below 110g/L OR They develop symptoms suggestive of anaemia
37
Management of Focal segmental glomerulosclerosis
Steroids +/- immunosuppressants
38
Indications for urgent dialysis
1. K > 6.5 even after appropriate medical management 2. Symptomatic uraemia 3. Pulmonary oedema resistant to full medical management 4. Metabolic acidosis pH <7.1 5. To remove certain toxins from body e.g. lithium
39
Absolute contraindications to renal biopsy
Hydronephrosis Polycystic kidneys Urinary tract obstruction, Uncontrolled hypertension Significant renal malignancy Significant bleeding disorders.
40
Hepatitis B infection - what kidney pathology
Membranous glomerulonephritis
41
Management: Nephrogenic diabetes insipidus
Thiazides Low salt/protein diet
42
Treatment of central diabetes insipidus
Desmopressin
43
Peritoneal dialysis peritonitis - treatment
Intraperitoneal vancomycin + ceftazidime
44
Rapidly progressive glomerulonephritis - causes
Goodpasture's syndrome Wegener's granulomatosis Others: SLE, microscopic polyarteritis
45
PKD-1 gene - located on chromosome
16
46
Preferred follow-on agent in lupus nephritis
Mycophenolate
47
? has been shown to reduce the rate of CKD progression in ADPKD
Tolvaptan
48
Treatment of Dialysis disequilibrium syndrome
Mannitol or hypertonic saline
49
? is the treatment of choice for HIV-associated nephropathy
Antiretroviral therapy
50
? staining is diagnostic of amyloidosis
Congo red
51
Target BP in CKD: With diabetes or had urinary ACR >70 mg/mmol
130/80mmHg
52
Target BP in CKD: Monitored at home (without DM): Monitored at clinic (without DM):
135/85mmHg 140/90mmHg
53
IgA nephropathy management No proteinuria, normal GFR: ? Proteinuria: ? Signifcant fall in GFR/not responding to ACE inhibitor: ?
No proteinuria, normal GFR: observe Proteinuria: ACE inhibitor Signifcant fall in GFR/not responding to ACE inhibitor: corticosteroid

MRCP 2 (13 decks)

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