Renal / urology

Question 1

which drug removes K+ from the body?

Answer 1

calcium polystyrene sulphonate

Question 2

how do you differentiate between cranial and nephrogenic DI?

Answer 2

Water deprivation test

Question 3

how does the water deprivation test work?

Answer 3

it allows us to localise the cause of the DI by depriving the patient of fluid for 8 hours and subsequently give a trial of desmopressin to see if the patient responds to it. If the patient responds to ADH, we can localise the pathology to the brain. If not, we will suspect the problem to be with the kidney

Question 4

Causes of nephrogenic DI

Answer 4

tubulo-interstitial disease: obstruction, sickle-cell, pyelonephritis
hypercalcaemia, hypokalaemia
lithium

Question 5

is urine osmolality is too high does that mean DI is confirmed?

Answer 5

no it rules it out as diabetes insipidus
presents with
urine osmolality is low, plasma osmolality is high

Question 6

2 episodes of frank haemturia

NICE guidelines? for screening

Answer 6

cystoscopy

query bladder cancer

Question 7

acute interstitial nephritis

Answer 7

triad of rash, fever and eosinophilia.

white cell casts

Question 8

bladder Cancer

Mx

Answer 8

intravesical chemo
t2- radical cystectomy
radical radiotherapy

Question 9

Metastatic prostate cancer disease - hormonal therapy

Answer 9

GnRH agonists: e.g. Goserelin (Zoladex)

GnRH antagonists such as degarelix

Question 10

bph mx

surgical?

Answer 10

5 alpha-reductase inhibitors e.g. finasteride
gynaecomastia, ED

alpha-1 antagonists e.g. tamsulosin, alfuzosin

TURP