Renal

Question 1

What medication is key in the management of Proteinuria in CKD?

Answer 1

Ace Inhibitors

Question 2

When should patients with Proteinuria secondary to CKD be given an ACE Inhibitor? If they have:
1. Co-existing Diabetes
2. Co-existing Hypertension
3. When else?

Answer 2

1. In patients with co-existing diabetes ACE offered if ACR is over 3mg/mmol.
2. If ACR over 30mg/mmol
3. To all patients if ACR over 70mg/mmol.

Question 3

Which NSAID can be continued at cardioprotective dose in AKI?

Answer 3

Aspirin

Question 4

What are the investigations of choice in Multiple Myeloma?

Answer 4

• Bloods
• Protein Electrophoresis
• Bone marrow aspiration
• Imaging (Whole-Body MRI or X-ray)

Question 5

What would the bloods look like from a patient with Multiple Myeloma?

Answer 5

• FBC showing Anaemia
• Peripheral Blood film: Rouleaux Formation.
• Urea and Electrolytes: Renal Failure
• Bone profile: Hypercalcaemia.

Question 6

What would protein electrophoresis show from a patient with Multiple Myeloma?

Answer 6

Raised concentrations of Monoclonal IgA/IgG proteins present in the serum.

(in the urine these are called Bence Jones proteins)

Question 7

What complication is a common issue with Increasing the levels of Sodium Too quickly?

Answer 7

Central pontine myelinolysis

Question 8

What complication would occur as a result of large volumes of Sodium Chloride being transfused into a patient?

Answer 8

Hyperchloraemic Metabolic Acidosis

• This can occur when there is resuscitation using sodium chloride 0.9% in the acute setting most commonly.

Question 9

What imaging modality is used to look for renal stones?

Answer 9

NON-CONTRAST CT of Abdo and Pelvis

Question 10

In which scenario would a >60 year old man be suspected as having bladder cancer and sent with a 2ww for suspected cancer pathway?

Answer 10

if they had unexplained non-visible haematuria and either dysuria or a raised white cell count on a blood test they should be referred.