Renal Flashcards Preview

Year 5 Notes > Renal > Flashcards

Flashcards in Renal Deck (36):
1

Nephritic syndrome: Symptoms

Haematuria ⬇️UO Facial swelling/edema Milder proteinuria Mild HTN

2

Nephritic syndrome: Causes

Group A strep Bacterial (MRSA, pneumonia, IE) Viral (measles, mumps, hep) Toxo, malaria Good pasture, wegeners, SLE, HSP

3

Nephrotic vs Nephritic syndrome

Main difference is haematuria --> nephritic Proteinuria is milder in nephritic Albumin and lipid changes and nephrosis

4

Nephrotic syndrome: Symptoms/features

Proteinuria >3.5g/day Serum album

5

Nephrotic syndrome: Management

Low salt high protein Diuretics, ACE inhibitors Steroids Immunosuppressants if steroids don't work

6

IgA nephropathy (Bergers disease): Symptoms

Gross haematuria +URTI/gastroenteritis

7

IgA nephropathy: Ix

Renal biopsy is gold standard Measure protein excretion, if too high ?myeloma Urine microscopy Renal function

8

Good pastures: Presentation

Massive pulmonary haemorrhage + acute glomerulnephritis

9

Investigation for renal colic

Non-contrast CT

10

Haemolytic Uraemic Syndrome: Typical/features

Acute renal failure+microangiopathic haemolytic anaemia + thrombocytopenia Usually post dysentery (typically E. coli) , if not cicoosporin, tumor, preg Needs FBC, U+E, stool culture Supportive management only

11

Alports syndrome

Haematuria + progressive CKD + sensorineural hearing loss + ocular abnormalities X links dominant HTN and supportive tx

12

Autosomal recessive poly cystic kidney disease

Rare Chr6 Pre/perinatal Bilateral masses, generally fibrosis

13

Renal cancer: Endocrine complications

Erythropoietin- polycythaemia Parathyroid - high Ca

14

PKD: Symptoms

Frequency Loin pain HTN Bilateral kidney enlargement UTI/pyelonephritis Gross haematuria following trauma Stones

15

PKD: Extra renal manifestations

Liver cysts Pancreatic cysts Aneurysms: cardiac, berry Cardiac eg mitral valve prolapse

16

PKD: Ix and target BP

USS is definitive scan Higher number of cysts needed for diagnosis as you get older due to naturally occurring cysts

17

Muddy brown casts on microscopy

Acute tubular necrosis

18

Post-streptococcal glomerulonephritis: Signs and symptoms

Post strep - sore throat, impetigo Haematuria, Oliguria, edema, HTN (ie Nephritic syndrome) + general malaise

19

Most common viral infection in organ transplant

CMV

20

Renal artery stenosis: Signs

HTN resistant to tx Worsening renal function in response to ACE Flash pulmonary edema Carotid/femoral bruit

21

Renal Artery Stenosis: Ix

USS - smaller kidney Doppler - poor blood flow CT/MRI Renal angio - gold standard but invasive

22

Renal tubular acidosis: Metabolic effect

Hyperchloraemic acidosis with normal anion gap

23

Diabetic nephropathy stages

1) GFR elevated 2) glomerular hyperfiltration 3) microalbuminaemia 4) nephropathy

24

Myeloma kidney

Antibodies and light chains accumulate and block tubules Causes acute tubular necrosis Tx - fluids and dialysis

25

AKI: Risk factors

Diabetes Sepsis CKD Heart failure PVD Drugs Dehydration

26

AKI: Pre renal causes

Renal hypoperfusion e,g from hypovolaemia, hypotension, sepsis, RAS

27

AKI: Intrinsic causes

Acute tubular necrosis Autoimmune e.g SLE, HSP Drugs Vasculitis

28

AKI: Post renal

Urinary tract obstruction

29

AKI: Management/Investigations

ABCDEU

ABG - degree of acidosis, K+

Bloods - FBC, U+Es, cultures

Catheter to assess fluid balance

Dietary protein restriction and Drug r/v

Electrolytes and ECG - hyperkalaemia

Ultrasound - obstruction, renal size

 

30

AKI: Referral criterial

Hyperkalaemia and oligoanuric/unresponsive to Tx Urea>40 or Uraemic Glomerulonephritis Systemic disease

31

AKI: Dialysis criteria

Persistent hyperkalaemia Refractory pulmonary edema Severe acidosis Drug OD Uraemic complications

32

eGFR >90%

Stage 1 CKD - eGFR fine but other abnormalities

33

eGFR 60-89

Stage 2 CKD: mild

34

eGFR 30-59

Stage 3 CKD: moderate

35

eGFR 15-29

Stage 4 CKD: severe

36

eGFR <15

Stage 5: end stage