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Year 4 Finals > Renal/Nephrology > Flashcards

Renal/Nephrology Flashcards

(109 cards)

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1
Q

How may nephrotoxicity due to contrast media by prevented?

A

IV fluid therapy with 0.9% sodium chloride for 12 hours pre and post procedure

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2
Q

In patients at risk of nephrotoxicity due to contrast media, which medication should be withheld for minimum of how long?

A

Metformin for minimum 48 hours

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3
Q

Metformin can increase the risk of which metabolic abnormality?

A

Lactic acidosis

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4
Q

What is the most common cause of AKI?

A

Acute tubular necrosis

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5
Q

Acute interstitial nephritis can be caused by what antibiotic?

A

Penicillin

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6
Q

Eosinophilia in the context of AKI suggests what?

A

Acute interstitial nephritis

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7
Q

Muddy brown casts in the urine are suggestive of what?

A

Acute tubular necrosis

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8
Q

Fill in the blank:
Creatinine kinase should be at least __ times upper limit to support a diagnosis of rhabdomyolysis

A

5

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9
Q

What levels of urinary sodium may we expect in pre renal AKI vs acute tubular necrosis?

A

Pre renal - low (kidneys hold on to sodium to preserve volume, still working/not source of problem)
Acute tubular necrosis - high

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10
Q

Good response to fluid challenge suggests the problem lies where in AKI?

A

Pre renal

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11
Q

Protein on urine dipstick suggests the problem lies where in AKI?

A

Intrinsic

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12
Q

Blood on urine dipstick suggests the problem lies where in AKI?

A

Post renal

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13
Q

What is the most common cause of inherited kidney disease?

A

Autosomal dominant polycystic kidney disease

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14
Q

What are the target Hb levels for patients with CKD?

A

10-12g/dL

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15
Q

Pruritus in CKD occurs secondary to build up of what?

A

Urea

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16
Q

What type of anaemia is observed in CKD?

A

Normochromic normocytic

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17
Q

What is the biggest risk factor for CKD induced anaemia?

A

Reduction in EPO

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18
Q

What test should be used to quantify proteinuria in CKD?

A

Albumin creatinine ratio

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19
Q

In CKD, we can expect high or low levels of:
1. Vitamin D
2. Calcium
3. Phosphate

A
  1. Low vitamin D
  2. Low calcium
  3. High phosphate
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20
Q

What type of hyperparathyroidism is observed in CKD?

A

Secondary

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21
Q

How should mineral bone disease in CKD be managed first line?

A

Reduce dietary phosphate

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22
Q

What drug may be used in steroid resistant minimal change disease?

A

Cyclophosphamide

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23
Q

Which type of glomerulonephritis may only be seen under electron microscopy?

A

Minimal change disease

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24
Q

At what ACR level should CKD patients be started on an ACE inhibitor?

A

Over 30mg/mmol

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25
What is the first line treatment for minimal change disease?
Prednisolone
26
How long after infection does haematuria develop in: 1. IgA nephropathy 2. Post strep glomerulonephritis
1. 1-2 days 2. 1-2 weeks
27
In hyperaldosteronism, high renin levels suggests the cause is primary or secondary?
Secondary
28
Sevelamer is what kind of drug?
Phosphate binder
29
What is the screening method for adult polycystic kidney disease?
Ultrasound
30
Fill in the blanks: CKD can be diagnosed with an eGFR below __, on 2 occasions __ months apart.
1. 60 2. 3
31
Which neurology complication are adult polycystic kidney disease patients at risk of?
Subarachnoid haemorrhage
32
HIV is most associated with which type of glomerulonephritis?
Focal segmented
33
Malignancy is most associated with which type of glomerulonephritis?
Membranous nephropathy
34
Local spread of bladder cancer is most commonly assessed using what?
Pelvic MRI
35
Painless macroscopic haematuria is suggestive of what?
Bladder cancer
36
What is the most common histological type of bladder cancer?
Transitional
37
What is the most common type of testicular cancer?
Germ cell
38
What is the biggest risk factor for testicular cancer?
Infertility
39
Germ cell testicular cancers may secrete what 3 markers?
AFP, hCG, LDH
40
What is the first line diagnostic investigation for testicular cancer?
Ultrasound
41
What is the first line investigation for prostate cancer?
Multi parametric MRI
42
What is the upper limit of PSA testing?
4ng/ml
43
What is the most common histological type of prostate cancer?
Adenocarcinoma
44
Which zone of the prostate is most commonly affected in prostate cancer?
Peripheral
45
Which grading system is used for prostate cancer?
Gleason
46
Which group of lymph nodes does prostate cancer spread to first?
Obturator
47
What is the standard treatment for localised prostate cancer?
Radical prostatectomy
48
Following a UTI, how long should we wait until carrying out a PSA test?
6 weeks after treatment finished
49
Why should LHRH analogues be co-prescribed with anti-androgens?
Due to risk of tumour flare
50
What is the typical age range testicular cancer may present in?
15-35 years old
51
Raised AFP excludes what type of testicular cancer?
Seminoma
52
Schistosomiasis increases the risk of what type of bladder cancer?
Squamous
53
What is the diagnostic method of choice in bladder cancer?
Cystoscopy with biopsy
54
What is the most common complication of radiotherapy administered for prostate cancer?
Proctitis
55
Fill in the blank: Patients aged ___ and above with ___ ___ should be referred on a 2 week wait for bladder cancer.
1. 60 2. Painless haematuria
56
Kimmelstein-Wilson nodules on histology are suggestive of what?
Diabetic nephropathy stage 4
57
How often should an ACR be carried out in diabetic nephropathy patients?
Annually
58
Which macronutrient should be restricted in diabetic nephropathy patients?
Protein
59
Diabetic nephropathy patients should aim for BP of?
Under 130/80
60
An ACR value of what warrants therapy with ACE inhibitors or an ARB?
3mg/mmol or more
61
What is the maintenance fluid value for adults?
25-30ml/kg/hour
62
What is the maintenance value for potassium, sodium and chloride?
1mmol/kg/day
63
What 2 blood findings does TURP syndrome present with?
Hyponatraemia and hyper ammonia
64
What class of BPH drugs cause a decrease in prostate volume?
5-alpha reductase inhibitors (Finasteride)
65
What class of BPH drug is indicated in patients with lower urinary tract symptoms?
Alpha 1 antagonists (Tamsulosin)
66
What is the most common kidney stone composition?
Calcium oxalate
67
Staghorn calculi are most commonly composed of what?
Struvite (magnesium, ammonia, phosphate)
68
Which type of renal stones are associated with chronic infection?
Struvite
69
Which colonic surgical procedure is associated with the development of uric acid stones?
Ileostomy
70
Which type of diuretic is associated with: 1. Increased risk of calcium renal stones 2. Decreased risk of calcium renal stones
1. Increased risk - loop diuretics 2. Decreased risk - thiazide diuretics
71
Which imaging modality should be used in suspected renal stones in pregnant women and children?
USS
72
How should a patient who is asymptomatic with a renal stones under 5mm be managed?
Watchful waiting
73
When should percutaneous nephrolithotomy be considered in renal stones?
If stones over 20mm
74
A renal stone of 5-10mm should be managed how?
Shockwave lithotripsy
75
Alpha blockers should be considered in what type of stones?
Uretic
76
Renal stones 10-20mm should be managed how?
Ureteroscopy
77
Cholestyramine and pyroxidine may be used in prevention of what type of stones?
Oxalate
78
What is the most useful initial diagnostic test in haemolytic uraemic syndrome?
Blood film
79
Hyaline casts in urine are associated with which class of drugs?
Loop diuretics
80
What is the maximum recommended infusion rate of potassium?
10mmol/hour
81
Autosomal dominant adult polycystic kidney disease is associated with what cardiac defect?
Mitral valve prolapse
82
What is the treatment of choice for nephrogenic diabetes insipidus?
Thiazide diuretics
83
What is the treatment of choice for cranial diabetes insipidus?
Desmopressin
84
How may contrast induced nephrotoxicity be prevented in patients with CKD?
IV fluid therapy with 0.9% sodium chloride, 1ml/kg/hour for 12 hours pre and post scan
85
What is the most common bacterial cause of haemolytic uraemic syndrome?
E.coli
86
In CKD, deficiency in what should be corrected before administering EPO stimulating agents for anaemia?
Iron
87
Low levels of what hormone may be seen in nephrotic syndrome?
Thyroxine
88
What is the most common histological subtype of renal cell carcinoma?
Clear cell
89
Varicocele is associated with what type of cancer?
Renal cell
90
Combination of cholestasis and renal cell carcinoma is known as what?
Stauffer syndrome
91
Partial nephrectomy can be carried out in renal cell cancers of what size?
Under 7cm
92
How many mmol of potassium are there per litre of Hartmann’s solution?
5
93
Infusion rate of potassium should not exceed what?
20mmol per hour
94
What is the standard fluid challenge value?
500mls of 0.9% sodium chloride
95
Administering large volumes of 0.9% sodium chloride increases risk of what acid/base disorder?
Hyperchloraemic metabolic acidosis
96
Prolonged diarrhoea is associated with what acid/base disturbance?
Hypokalaemic metabolic acidosis
97
Sensorineural hearing loss is associated with which genetic renal disorder?
Alports syndrome
98
Haemolytic uraemic syndrome is most commonly caused by which bacteria?
E.coli
99
What is the preferred method of access for haemodialysis?
Arteriovenous fistula
100
What is the investigation of choice for suspected diabetes insipidus?
Water deprivation test
101
What is the most common and important viral infection following renal transplant?
Cytomegalovirus
102
Which method of anticoagulation is recommended in nephrotic syndrome?
Low molecular weight heparin
103
Which electrolyte imbalance indicated kidney disease is chronic rather than acute?
Hypocalcaemia
104
Haemoptysis in the context of AKI suggests what?
Anti-GBM disease (Goodpasture’s)
105
What investigation is warranted in cases of AKI with unknown aetiology?
Renal USS
106
Nephrogenic diabetes insipidus can be caused by which antipsychotic medication?
Lithium
107
Nephrotic syndrome is associated with thrombosis due to deficiency of what?
Antithrombin III
108
What is the most common organism to infect a peritoneal dialysis site?
Staph epidermis
109
Congo red staining on renal biopsy can reveal what?
Amyloidosis

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