Renal

Question 1

Renal failure definition

Answer 1

Creatinine >50% above the baseline

Question 2

Symptoms due to ureamia in renal failure

Answer 2

Lethargy 
Confusion 
Convulsions 
Nausea and Vom 
Itching

Question 3

Life threatening conditions caused by ureamia

Answer 3

Pericarditis and encephalopathy

Question 4

Poor regulation of salt and water in renal failure leads to

Answer 4

oedema, hypertension and breathlessness

Question 5

Cardiac symptoms of renal failure

Answer 5

Pericarditis, fluid overload, arrhythmias

Question 6

GI symptoms of renal failure

Answer 6

nausea, vomiting, anorexia

Question 7

CNS symptoms of renal failure

Answer 7

fatigue, weakness, confusion, seziures, coma

Question 8

Investigations in renal failure

Answer 8

FBC 
Urine 
ECG 
Imaging  - USS 
Biopsy

Question 9

How to distinguish prerenal and renal causes

Answer 9

Pre-renal reduced perfusion - urine concentrated

Renal - salt and water loss due to problems with kidney

Question 10

Pre renal causes of acute renal failure

Answer 10

Cardiogenic shock 
Septic shock 
Fluid loss - haemorrhage / dehydration 
Renal artery stenosis 
Nephrotoxic drugs

Question 11

Renal causes of acute renal failure

Answer 11

Glomerular disease 
Acute tubular necrosis 
Ischaemia 
Vascuilitis 
Pyelonephritis

Question 12

Postrenal causes of acute renal failure

Answer 12

Urinary tract obstruction

Rena vein thrombosis

Question 13

ABG result in acute renal failure

Answer 13

Metabolic acidosis (with / without resp compensations)

Question 14

ECG changes in acute renal failure

Answer 14

Peaked T waves, wide QRS, reduced P waves

Question 15

CXR result in acute renal failure

Answer 15

overload in pulmonary oedema

Question 16

Acute treatment of acute renal failure

Answer 16

ABC - TREAT SEPSIS 
Treat PO and hyperkalaemia 
Monitor - BP, pulse, CVP and urinary output 
Monitor fluids 
U&Es 
Stop nephrotoxic drugs 
Nutrition

Question 17

C ommonest extra-renal manifestation of ADPKD are?

Answer 17

Liver cysts are the commonest extra-renal manifestation of ADPKD

Question 18

Blood tests in glomerulonephritis

Answer 18

FBC
UandEs
Blood film
ABG

Question 19

Non blood investigations on glomerulonephritis

Answer 19

Urine - dip, protein and creatinine levels
Renal US
Renal biopsy

Question 20

Treatment of glomerulonephritis

Answer 20

Treat the cause - immunosuppression
Blood pressure monitoring
Fluid control
consider renal transplan

Question 21

Triad of nephrotic syndrome

Answer 21

Oedema
Hypoalbuminaemia
Proteinuria

Question 22

Causes of acute nephritic syndrome

Answer 22

Post strep
IgA
SLE
Haemolytic uraemic syndrome

Question 23

Causes of nephrotic syndrome

Answer 23

SLE
Myeloma
DM
Glomerulonephritis

Question 24

Blood test in nephrotic syndrome

Answer 24

Renal profile 
Albumin 
Clotting 
Cholestrol 
Glucose

Question 25

Urine tests in nephrotic syndrome

Answer 25

Protein and creatinine | Benz-Jones

Question 26

None bedside tests in nephrotic syndrome

Answer 26

Renal US | Biopsy

Question 27

Complications of nephrotic syndrome

Answer 27

Hypercoagulability Hypercholesterolaemia Infection

Question 28

Triad of HUS

Answer 28

Haemolysis Thrombocytopenia Acute renal failure

Question 29

Common cause of HUS

Answer 29

Post infection - renal failure

Question 30

Symptoms of chronic renal failure

Answer 30

``` NandV Puritis Oedema Fatige SOB Bone pain ```

Question 31

Blood results in chronic renal failure ``` FBC Ca2+ and Phosphate ABG K+ Haematemics ```

Answer 31

``` Chronic normocytic anaemia Low, high metabolic acidosis high low ferritin ```

Question 32

Treatment of chronic renal failure

Answer 32

``` Low protein diet Fluid control Symptom control Treat anaemia Correct calcium ``` Dialysis CrCl <20mL/min

Question 33

Commonest cause of glomerulonephritis

Answer 33

IgA nephropathy

Question 34

Why does nephrotic syndrome lead to a hypercoagulable state?

Answer 34

Nephrotic syndrome is associated with a hypercoagulable state due to loss of antithrombin III via the kidneys

Question 35

Cause of chronic kidney disease ``` H I D D E N ```

Answer 35

``` HTN (recurrent) Infections Diabetes Drugs Exotica - SLE / vasculitis Nephritis ```

Question 36

Indications for dialysis

Answer 36

Low creatinine clearance <20 / 15 depending on guidelines Symptomatic uraemia despite treatment Fluid overload Bone disease Hyperkalaemia

Question 37

what causes the thrill you can feel in an AV fistula

Answer 37

Arterial blood from the radial artery

Question 38

which artery and vein are usually used in an AV fistula

Answer 38

radial artery and cephalic vein

Question 39

Complications of AV fistula?

Answer 39

Thrombosis Infection Stenosis Bleeding

Question 40

Cycle of pathology in CKD

Answer 40

Irreversible loss of nephrons (HTN/ DM etc) Blood flow shifts to the healthy nephrons Hyperfiltration Eventual sclerosis Loss of nephron... Leads to clinical manifesations - low eGFR - low urine production - waste retention

Question 41

Why is calcium low in CKD

Answer 41

Unable to produce calcitriol | so Ca2+ no reabs

Question 42

What does this low calcium in CKD lead to?

Answer 42

secondary hyperparathyroidism

Question 43

Metabolic results of CKD

Answer 43

``` Water and Na2+ retention K+ retention Metabolic acidosis - can't secrete H+ and reabs HCO3- Hypocalcaemia Uraemia ```