Renal Medicine and Pharmacology Flashcards
(154 cards)
1
Q
Lower abdominal pain +bloody diarrhoea + purpuric rash + nephritis Diagnosis
A
Henoch–Schönlein purpura
2
Q
Rheumatoid Arthritis + On Penicillamine + Swollen Legs
A
Penicillamine-induced membranous nephropathy
3
Q
Confirmatory investigations for HSP
A
Skin biopsy (a leucoclastic vasculitis with IgA deposition)
Renal biopsy (mesangial IgA deposition)
4
Q
Formula for plasma osmolality
A
2 ([Na] + [K]) + [Urea] + [Glucose]
5
Q
Acute Tubular Necrosis Lab findings
A
Increased Urinary Sodium >40
Decreased Urine Osmolalilty <450
6
Q
IOC for detecting Obstructive Pylonephritis or Uropathy
A
Non Contrast CT
7
Q
Triad of Alport Syndrome
A
Nephritis (Hematuria) + SNHL + Vision Loss (Lens Dislocation)
8
Q
Management of GoodPasteurs Syndrome with Hyperkalemia and High Creatinine
A
Plasma Exchange
9
Q
Erythropoietin Induced Seizure
A
Seen within 90 days of starting and Rarely cause seizure
10
Q
Patient with retroperitoneal sarcoma presents with decreased GFR
A
Retroperitoneal Fibrosis causing obstructive uropathy
11
Q
CKD patient who Never needed Dialysis has anemia now with ferritin <100
A
1st Line: Oral Iron
2nd Line: IV Iron
3rd line: Weekly S/c Erythropoietin
12
Q
Indication for monthly Erythropoietin
A
Ferritin between 200-500
13
Q
Granulomatosis with Polyangiitis Management
A
Steroids + Cyclophosphamide
14
Q
Causes of Retroperitoneal Fibrosis
A
- Malignancy
- Sarcoidosis
- Surgery
- Mycobacterium Infection
- Treponemal Infection
15
Q
Primary Hyperaldosteronism (Conn’s Disease) Lab Findings
A
- Decreased Renin
- Increased Aldosterone
16
Q
Secondary Hyperaldosteronism
A
- Increased Renin
- Increased Aldosterone
17
Q
Mutation in Liddle Syndrome
A
Epithelial sodium channel ENaC Mutation Gain of Function in Collecting Duct
18
Q
Mutation in Barter Syndrome
A
Na-K-2Cl Channel Mutation in Loop of Henly
19
Q
Mutation in Gitelmann Syndrome
A
Na-Cl Symporter mutation in DCT
20
Q
Management of CKD in Scleroderma Crisis
A
ACE inhibitors
21
Q
Flash Pulmonary Edema + Young + Hypertension
A
Fibromuscular Dysplasia
22
Q
Screening USG Criteria for ADPKD
A
- Family history of ICA
- Previous Rupture of ICA
- High Risk Profession
- Patient Anxiety
23
Q
Medication Causing Retroperitoneal Fibrosis
A
Bisoprolol - Beta Blocker
24
Q
Initial Management of Pyelonephritis
A
Oral Cefalexin
25
RTA Associated with Wilson Disease
RTA Type 2
26
Common Cause of Papillary Necrosis
Analgesic Nephropathy
27
West Africa + HSM + Occasional Fever + Pedal Edema
Malaria - Urine Protein Estimation
28
Laboratory Findings of Acute Tubular Necrosis
Urine Osmolality <450 and Increased Urine Sodium
29
Diagnosis of Diabetic Kidney Disease
- GFR <60 persistently
- A:C Ratio >3 for atleast 3 months
30
Sterile Pyuria + Fever + Travel to Asia
Urine culture for Mycobacterium
31
Anemia + Hypercalcemia + Cast Nephropathy + Weight loss
Multiple Myeloma
32
Mainstay Treatment of Multiple Myeloma
Hematopoitic Stem Cell Transplantation
33
Hyponatremia + Lipaemic blood sample + Normal Plasma Osmolality
Nephrotic Syndrome
34
Nephrotic range proteinuria
>3.4 gram in 24 hours
35
Characteristic feature of Xanthogranulomatous pyelonephritis on Kidney biopsy
Lipid Laiden Macrophages, Lymphocytes and PMN Cells
36
Management of Xanthogranulomatous pyelonephritis
Nephrectomy
37
Sarcoidosis Renal Biopsy findings
Granulomatous Tubulo-interstitial nephritis
38
Proteinuria + Hypertension + Microscopic Hematuria
Focal Segmental Glomerulosclerosis
39
Proteinuria + Normotensive
Membranous Nephropathy
40
Hematuria + Decreased Complement levels + Sore throat previously
PSGN
41
Microscopic Hematuria + >60 year old
Rule out Cancer - Urology Referral
42
Bladder cancer type seen with Schistosomiasis
Squamous Cell Cancer of bladder
43
Bladder cancer type seen with smoking and factory workers
Transitional Cell Cancer of bladder
44
On HIV treatment now started on Co-Trimoxazole Has blood and protein in urine
Diagnosis: Crystal Nephropathy
Cause: Atazanavir Use
Management: Normal Saline
45
Recurrent UTI and WBC cast in Urine with creatinine increasing
Reflux Nephropathy
46
"string of beads" appearance in renal arteries seen in
Fibromuscular dysplasia (FMD)
47
fibromuscular dysplasia (FMD) management
Renal Angioplasty
48
Management for Liddle Syndrome
Potassium Sparing Diuretic - Amiloride
49
Cystinuria patient with persistent renal stones
Pencillamine
50
Indication for emergency stone removal surgery in renal stones
- Infection (Complicated UTI or Pyelonephritis)
- B/L Obstruction
- AKI
51
Indication for elective stone removal surgery in renal stones
- Stone >10 mm
- Persistent HUN
- Recurrent UTI
52
CKD patient guidelines for Hb Level According to European Renal Associated
100-120 (110)
53
K/C/O Nephrotic Syndrome with vague flank pain and rising Creatinine
Renal Vein Thrombosis
54
Causes of Renal Vein Thrombosis
- Nephrotic Syndrome
- Lupus nephritis
55
Nephrogenic Systemic Fibrosis
- Rapid development of thick skin and soft tissue change
- Risk for people on long term dialysis
56
Anti Arrythmic associated with elevated ciclosporine levels
Diltiazem - CYP3A4 inhibitor
57
Post Kidney transplant patient on ciclosporine with recent use of antibiotic has elevated creatinine
Acute Ciclosporine Toxicity
58
Increased Oxalate in Urine
Primary Oxaluria - Most common is Type 1
59
Renal stone associated with Crohns and Short Bowel Syndrome
Oxalate Stones
60
Type 1 RTA associated disease
Sjögren syndrome
Rheumatoid arthritis (RA)
Systemic Lupus Erythematosus (SLE)
61
Type 2 RTA associated disease
Multiple Myeloma
Acetazolamide
Cystinosis
Wilsons Disease
62
Complication of Long term use of conventional dialysis membrane
Beta 2 microglobulin Amyloidosis
63
Indication for Urgent Hemodialysis
- Refractory Severe metabolic acidosis
- Refractory Severe Hyperkalemia
- Uraemic encephalopathy
- Uraemic pericarditis
64
Acute Tubular Necrosis
Urinary Sodium Excretion is Increased
65
Known case of CKD underwent MRI Scan now has telangiectasia and small white patches
Nephrogenic Systemic Fibrosis
66
Screening for ADPKD which age to start from
20 years
67
CKD on EPO treatment with anemia and normal WBC and platelet along with 0 reticulocytes
Pure red cell aplasia
68
Nephrotic range proteinuria in a patient with FSGS and IV drug abuse
HIV
69
Findings for Acute Tubular Necrosis (ATN)
- Muddy brown casts
- Urine sodium is high > 30
- Urine osmolality is low < 350
70
Findings of Acute Tubulointerstitial Nephritis
- Eosinophiluria
- White blood cell casts
71
Post Kidney transplant patient with small rise in creatitine
USG doppler of Kidney to look for graft dysfunction
72
Renal pathology to occur commonly after renal transplantation
Membranoproliferative glomerulonephritis >30%
73
Management of Kidney involvement in Granulomatosis with Polyangitis
High dose IV Methylprednisolone and Cyclophosphamide
74
Amyloidosis Confirmatory investigation
Subcutaneous Fat biopsy
75
Membranous glomerulonephritis IF Study
Thick GBM Deposit of IgG and C3
76
Hemolytic Uremic Syndrome Management
Supportive - Dialysis, IV fluids and blood transfusion
77
Rhabdomyolysis with AKI and Sepsis management
Sodium Bicarbonate
78
ADPKD most common side effects
- Hypertension -M/C
- Berry Aneurysm 20-25%
79
Characteristic Feature of Renal Artery Stenosis
Flash Pulmonary Edema
80
Kidney disease with ACE contraindication
Renal Artery Stenosis
81
Mild proteinuria in an obese + black patient + hypertension
Focal Segmental Glomerulosclerosis
82
Normal PaO2 in the presence of Cyanosis and decreased saturation
Methemoglobinemia
83
Iron tablet overdose intial management
IV desferrioxamine
84
Drugs causing decreased clearance of theophylline
- Allopurinol
- Cimetidine
- Ciprofloxacin
- Erythromycin
85
Methanol Poisoning Clinical Features
- High Anion Gap Metabolic Acidosis
- Optic Atrophy
- Homeless
86
Ipilimumab MOA
Cytotoxic T-lymphocyte associated protein 4 (CTLA-4) Inhibitor
87
Vemurafenib MOA
B- RAF inhibitor
88
Cobimetinib MOA
Mitogen-activated protein kinase MEK 1 inhibitor
89
Ulcerative Colitis patient with Acute Pancreatitis cause
Oral Mesalazine
90
Elevated Zinc Proptoporphyrin
Lead Poisoning
91
Management of Lead poisoning
Calcium EDTA
92
Management of Neuroleptic Malignant Syndrome
Bromocriptine
93
Streptomycin Side Effect
Vestibular Damage
94
Initial Management in Paraquat Poisoning
Confirm absorption via urine test
95
ECG shows Prolonged QT interval and flattened T waves
Lithium Toxicity
96
Anticonvulsant causing decreased peripheral vision and color vision
Vigabatrin
97
Ciclosporin Levels elevated by which anti hypertensives
Verapamil
98
Complication of Amyl Nitrate
Causes Methemoglobinemia
99
Medication causing Myasthenia Gravis
Pennicillamine
100
Phenytoin Toxicity Clinical Features
Broad Based Gait
Nystagmus
Dysdiadokokinesia
101
Benzodiazapine (Phenobarbital) overdose management
Flumazenil
Sodium Bicarbonate
102
Drugs causing chronic urticaria
- Aspirin
- NSAID
103
Most common method of finding EPO abuse in sports
Urine examination first few weeks following injection
104
Managment of Monomorphic VT caused by Digoxin Toxicity
Phenytoin 250 mg
105
Management of Cyanide Poisoning
Hydroxycobalamine
Dicobalt Edetate
106
Calclium Channel Blocker Overdose Management
IV Calcium Chloride
107
Most common Complication of Sodium Nitroprusside
Cyanide Toxicity
108
Local Injection Lignocaine toxicity management
Lipid Emulsion
109
Aspirin Toxicity initial management
Treat Hypokalemia Aggressively
110
Management of Neuroleptic Malignant syndrome
S/C Bromocriptine
111
Poor Prognosis causes in Ecstacy overdose
Temperature >42
Rhabdomyolisis
Liver failure
Kidney failure
112
Management of OP Poisoning
- Pralidoxime
- Atropine
113
Anti Hypertensive safest with Lithium
Amlodipine
114
Anti epileptic medication overdose patient with seziure drug of choice
IV Lorazepam
115
First line management of pregnant women with nausea and vomiting
Promethazine
116
Rheumatoid Arthritis management safer in Pregnancy
Azathioprine
Hydroxychloroquine
117
Medications on chronic use increasing risk of paracetamol overdose
Phenytoin
Carbamazepine
Phenobarbital
118
Causative drug for a patient with pancytopenia for patient already on azathioprine
Allopurinol (Increases 6 MP)
119
Angioplasty with Upper GI bleed management
- Stop Fondaparinux
- Continue Aspirin + Clopidogrel
120
Immense Hot Pain in one limb during swimming
Stingray poison
Management - Atropine for Bradycardia and Immersion of limb in cold water
121
Upward rolling of eyes and torticollis after giving medication
Oculogenic Crisis
122
Management of Oculogenic Crisis
trihexyphenidyl or procyclidine
123
Anti Depressant of Choice for patient on anticoagulant or anti-platelet (aspirin)
Mirtazapine
124
Drug causing progressive weakness of muscles with tingling sensation and increased CPK
Colchicine
125
Anti depressant causing Upper GI bleeding
Citalopram
126
Best measure of drug absorption
Bio Availability
127
Anti Cancer Agent Associated with pulmonary fibrosis
Bleomycin
128
Hypertension patient with lip swelling causative agent
Ramipril
129
OTC drug which decreases digoxin absorption
Sodium Algenate
130
Drug commonly causing hypertrichosis
Ciclosporine
131
Mangement of Methotrexate induced bone marrow suppression
Calcium Folinate
132
What is Dothiepin
Tricyclic Antidepressant
133
Safest antiepileptic in pregnancy
Lamotrigine
134
Initial test to confirm testosterone abuse
Urinary Testosterone /epitestosterone ratio
135
Management of UTI in G6PD deficiency
Co-Amoxiclav
136
Multiple dose activated charcol used for which drug overdose
Carbamazepine
137
Thalidomide taken by male recently in relationship
Contraception for both as can be seen in semen
138
Antipsychotic causing agranulocytosis
Clozapine
139
Antibiotic causing obstructive jaundice
Co-Amoxiclav
140
Electrolyte Imbalance caused by Furosemide
Hyponatremia
Hypokalemia
Hypochloremia
141
Electrolyte Imbalance caused by Citalopram
Hyponatremia - SIADH
142
Side Effect of Doxycycline to Infant if given to breastfeeding mother
Teeth Staining
143
Anti Arrythmic with Vomiting, Vertigo, Tinnitus, Headache and Blurred vision as side effect
Quinine
144
Anti Arrythmic with tunnel vision and dizziness as side effect
Lignocaine
145
Anti Arrythmic with yellow vision and vomting as side effect
Digoxin
146
Drug Body packers management
Asymptomatic - Laxatives
Symptomatic - Surgery Referral
147
Management of Benzodiazepine withdrawal seizure
IV Diazepam
148
Lifestyle intervention to improve parkinsons patient
Diet - Dietary proteins can reduce absorption of levodopa
149
Confused patient who took something which tasted like seaweed
Gamma-Hydroxybutyrate Overdose
150
Guidelines on stopping trastuzumab
When Ejection Fraction 10% decrease after starting
or baseline <50%
151
Indications for giving anti-venom (White PECS)
- WBC Count > 20,000
- Persistent hypotension
- ECG changes
- Clotting problems
- Severe edema
152
Autoimmune conditions in pregnancy drugs to use
Sulfasalazine (More safe in RA)
Azathioprine
Hydroxychloroquine (for SLE)
153
Drugs causing gynecomastia
Ketoconazole
Digoxin
Finasteride
154
