Renal

Question 1

First line Mx for pyelonephritis

Answer 1

Cefalexin or co-amoxiclav for 7-10 days

Question 2

First line mx for UTI

Answer 2

Trimethoprim or Nitrofurantoin

Question 3

What increases the risk of AKI with contrast agents?

Answer 3

Being aged 75 or over

Question 4

What medication can increase serum creatinine and why?

Answer 4

Trimethoprim competitively inhibits the mechanism for tubular secretion of creatinine through the base-secreting pathway, leading to an increase in serum creatinine.

Question 5

What would you give a patient with pyelonephritis who also has a penicilin allergy?

Answer 5

Ciprofloxacin as cefalexin is structurally similar to penicilin

Question 6

What abx do you give to female with UTI coming to term?

Answer 6

Cefalexin

Question 7

What does long term use of nitrofurantoin lead to?

Answer 7

Restrictive lung disease

Question 8

When should you avoid the use of nitrofuratoin in UTI?

Answer 8

If GFR is <45
Use Trimethoprim

Question 9

If asymptomatic women comes in with urine dipstick showing neutrophils and nitrites, what to do?

Answer 9

Prescribe Cefalexin as asymptomatic bacteriuria is possible during pregnancy

Question 10

What is a side effect of SGLT-2 inhibitor, Empagliflozin, in diabetic nephropathy?

Answer 10

Vaginal candidiasis

Question 11

Management in diabetic nephropathy

Answer 11

if ACR is >3 then ACEi
if ACR is >30 then SGLT-2 inhibitor

Question 12

What is the criteria for CKD?

Answer 12

GFR lower than 60 for 3 months
OR kidney damage markers like albuminuria

Question 13

What are absolute indications for dialysis?

Answer 13

Absolute indications for dialysis include refractory hyperkalaemia, severe intractable metabolic acidosis, intractable fluid overload and pulmonary oedema, presence of uraemic complications such as pericarditis, encephalopathy and seizures

Question 14

What would indicate acute rather than chronic kidney disease in a diabetic patient?

Answer 14

Hyperkalemia is more of a AKI issue and if seen in chronic kidney injury it is most likely acute on chronic kidney disease

Question 15

What is the most common for reason for mortality in chronic kidney disease secondary to diabetes?

Answer 15

Cardiovascular disease

Question 16

How should you treat anaemia in CKD patients?

Answer 16

Treat with iron supplementations, if needed, first before the EPO

Question 17

What drug can cause excessive hair growth?

Answer 17

Ciclosporin

Question 18

What causes avascular necrosis after transplant surgery and what symptoms can this cause?

Answer 18

Long term steroid use to prevent organ rejection

Question 19

What symptoms point to nephritic syndrome?

Answer 19

Blood in urine, raised BP and recent infection like cold
could be like IgA nephropathy

Question 20

How do kidneys look like once they progressive to end stage renal failure?

Answer 20

Shrunken on ultrasound

Question 21

eGFR and creatinine clearance equations

Answer 21

eGFR = CAGE (creatinine, age, gender, ethnicity)
Creatinine clearance = replace ethnicity with weight

Question 22

What type of cancer is most prevalent in renal transplant patients?

Answer 22

Skin cancer

Question 23

At what Hb should a patient be transfused

Answer 23

Less than 70

Question 24

Whats the most likely cause of haemolytic uraemic syndrome in children?

Answer 24

E.coli that secrete shiga toxin

Question 25

Patient with hiv comes in with hypoalbuminemia oedema and significant proteinuria, what is it associated with?(Nephrotic syndrome)

Answer 25

Focal segmental glomerulosclerosis

Question 26

Patient with acute nephritic syndrome with oedema, haematuria and hypertension is the most frequent presentation of what?

Answer 26

Post streptococcal glomerulonephritis

Question 27

What is haemolytic uraemic syndrome symptoms and what is it usually secondary to?

Answer 27

characterised by triad of AKI, microangiopathic haemolytic anaemia and thrombocytopenia secondary to Shiga toxin producing Escherichia coli