Renal

Question 1

Polycystic kidneys screening for aneurysm

Answer 1

Screen for SAH in first degree relatives of those with SAH and PKD

Question 2

Acute kidney rejection

Answer 2

Fever, graft pain
Increase in creatinine

Cell mediated cytotoxic T cells

Question 3

UTI Management

Answer 3

Uncomplicated women - nitro/tri

Pregnant woman - amoxicillin.
Avoid nitro at term
Avoid tri in first trimester

Men - 2 week quinolone

Question 4

Alports syndrome

Answer 4

X- linked dominant 
A-5 chain of type IV collagen 
Haematuria proteinuria. renal failure 
Systemic - sensorineural deafness. Ocular defects 
Thickened gbm with splitting

Question 5

Loop diueretic action

Answer 5

Inhibit na/k/2cl co transporter in thick ascending limb loop of Henley

Can cause:
- hyponatraemia, hypokalaemia, ototoxcity. Hypocalcaemia

Question 6

Thiazide diuretics site of action

Answer 6

Inhibit nacl transport in DCT

can cause hypokalaemia
Glucose intolerance
Hyperlipidaemia
Increase uric levels

Question 7

What determines the egfr?

Answer 7

CAGE 
C creatinine
A age 
G gender 
E ethnicity

Question 8

Complications of AKI

Answer 8

Hyperkalaemia
Pulmonary oedema
Acidosis
Reduced conscious level

Question 9

Indications for dialysis

Answer 9

Progressive decline in renal function - CKD stage 5

Question 10

Steal syndrome

Answer 10

Distal tissue ischaemia, AV fistula

Question 11

Haematuria

Answer 11

Renal calculi
UTI
Renal cancer
Bladder cancer
Coagulopathy
Trauma - post TURP/catheter/cystoscopy
Schistomosiasis
Prostatic problems

Question 12

Analgesic to avoid in renal disease

Answer 12

Pethidine

Question 13

Urgent referral criteria

Answer 13

> 45 + visible haematuria

>60 + unexplained non visible haematuria

Question 14

Bergers disease

Answer 14

=IgA nephropathy

Question 15

Anti-GBM disease

Answer 15

=Goodpastures
autoantibodies to type IV collagen

–> haemoptysis and haematuria

Question 16

Management of AKI

Answer 16

Stop nephrotoxics
Re-check U&Es
Urine dip/MSU
Fluid balance
USS
Referral to renal/ICU
CXR/ECG

Question 17

Indications for acute dialysis in AKI

Answer 17

• refractory pulmonary oedema
• persistent hyperkalaemia
• pH

Question 18

Post-streptococcal GN

Answer 18

low complement levels
Proteinuria + macrohaematuria –> coca cola urine

Recent URTI

Question 19

Stages of CKD

Answer 19

1 >90
2 60-89
3 A 45-59
3 B 30-44
4 15-29
5

Question 20

Nephrotic syndrome triad

Answer 20

Proteinuria >3g/24hour

Hypoalbuminanemia

Question 21

most common cause of nephrotic syndrome

Answer 21

Minimal change glomerulonephritis

Question 22

PKD genetic defects

Answer 22

Type 1 85% chromosome 18

type 2 15% chromosome 4

Question 23

Bladder cancer in schistosomiasis

Answer 23

Squamous cell carcinoma

Question 24

Suspected renal cancer referral guidelines

Answer 24

Over 45 and macroscopic haematuria

Over 69 and non visible haematuria AND dysuria, or raised WCC

Question 25

Wilms tumour

Answer 25

Nephroblastoma Most common abdominal malignancy in children Abdo mass and haematuria

Question 26

Causes of prostatitis

Answer 26

S.faecalis E.coli Also chlamydia Levofloxacin/doxycycline

Question 27

Bladder cancer in schistosomiasis

Answer 27

Squamous cell carcinoma

Question 28

Suspected renal cancer referral guidelines

Answer 28

Over 45 and macroscopic haematuria | Over 69 and non visible haematuria AND dysuria, or raised WCC

Question 29

Wilms tumour

Answer 29

Nephroblastoma Most common abdominal malignancy in children Abdo mass and haematuria

Question 30

Causes of prostatitis

Answer 30

S.faecalis E.coli Also chlamydia Levofloxacin/doxycycline

Question 31

Robson staging of renal carcinoma

Answer 31

I confined to kidney II perinephric fat involved (not gardas fascia) III renal vein involved IV local or distant organs spread

Question 32

Inheritance of PKD

Answer 32

AD - 1/1000 Genes involved - chromosome 16 (PKD1) and 4 (PKD2) AR - 1/40,000 - chromosome 6

Question 33

Wegeners granulomatosis

Answer 33

Necrotising granulomatosis inflammation, Vasculitis - small/medium C-ANCA positive

Question 34

Investigations for rhabdomyolysis

Answer 34

CK >1000 Positive urinary myoglobin

Question 35

Treatment of nephrotic syndrome

Answer 35

``` Oedema - diuretics and salt restriction Steroids / cyclophosphamide Ace inhibitor Anti coagulation Statin ```

Question 36

What is bence Jones protein seen in?

Answer 36

Myeloma