Case - Renal Disease
CASE - renal disease + Knowledge
- 1.KNOWLEDGE - Which of the following are associated with NEPHROTIC SYNDROME..
- A.
Proteinurea
- B.
Hypoalbuminaemia
- C.
Hyperalbuminaemia
- D.
Normal urine protein
- E.
Oedema
- F.
Hyperlipidaemia
- G.
Haematuria
- H.
Pro thrombotic state
- I.
Hypocoagulative state
- J.
Can cause progressive renal disease
- K.
Low urine volume
- L.
IgG nephropathy as a possible cause
- M.
IgA nephropathy as a possible cause
- N.
Diabetes as a possible cause
- O.
Lupus as a possible cause
- P.
NSAIDs as a possible cause
- Q.
Hypertension
- R.
C3 deposition
- 2.KNOWLEDGE - Which of the following are associated with NEPHRITIC SYNDROME..
- A.
Proteinurea
- B.
Hypoalbuminaemia
- C.
Hyperalbuminaemia
- D.
Normal urine protein
- E.
Oedema
- F.
Hyperlipidaemia
- G.
Haematuria
- H.
Pro thrombotic state
- I.
Hypocoagulative state
- J.
Can cause progressive renal disease
- K.
Low urine volume
- L.
IgG nephropathy as a possible cause
- M.
IgA nephropathy as a possible cause
- N.
Diabetes as a possible cause
- O.
Lupus as a possible cause
- P.
NSAIDs as a possible cause
- Q.
Hypertension
- R.
C3 deposition
- 3.KNOWLEDGE - regarding the presence of casts on urine microscopy...
- A.
RBC Casts always indicate renal disease
- B.
RBC Casts indicate, most commonly, glomerulonephritis
- C.
White Cell Casts can be seen in acute pyelonephritis
- D.
White Cell Casts can be seen in glomerulonephritis
- E.
Some casts may be normal
- F.
Finely granulated casts indicate glomerular/tubular disease
- G.
Coarsely granulated casts indicate glomerular/tubular disease
- H.
Finely granulated casts are associated with pathological proteinurea
- I.
Coarsely granulated casts are associated with pathological proteinurera
- 4.KNOWLEDGE - in Acute Kidney Injury, (AKI)...
- A.
Oliguria is common
- B.
Polyuria is common
- C.
Biochemically, increased plasma urea
- D.
Biochemically, increased creatinine
- E.
Biochemically, decreased plasma urea
- F.
Biocehcmically, decreased creatinine
- G.
Associated with anaemia
- H.
Associated with hypocalcemia
- I.
Associated with increased phosphate
- J.
More common in elderly
- K.
AKI is most commonly Pre-Renal
- L.
AKI is most commonly Intrinsic AKI
- M.
AKI is most commonly Post Renal
- 5.KNOWLEDGE - Pre Renal AKI...
- A.
Is due to increased renal perfusion
- B.
Is irreversible
- C.
Can be a secondary effect of peritonitis
- D.
Can be an effect of sepsis
- E.
Can be an effect of anaphylaxis
- F.
Can be an effect of heart failure
- G.
Can be an ADR of NSAIDs
- H.
Can be an ADR of diuretics
- I.
Can be an ADR of ACE Inhibitors
- 6.KNOWLEDGE - in Intrinsic AKI...
- A.
Haematuria indicates Glomerular damage
- B.
Proteinurea indicates Glomerular damage
- C.
RBC Casts indicate Glomerular damage
- D.
Goodpastures can cause Tubulo-interstitium injury
- E.
P-ANCA is present in Wegener's granulomatosis
- F.
P-ANCA is present in Microscopic Polyangitis
- G.
Anti-glomerular basement membrane antibody disease and Goodpastures are synonymous
- H.
Glomerular AKI is associated with oedema and hypertension
- I.
Tubulo-interstitium injury is part of Pulmonary-Renal disease
- J.
Tubulo-interstitium injury is often autoimmune
- K.
Tubulo-interstitium injury is associated with haematuria
- L.
Tubulo-interstitium injury is usually normal on urinalysis
- M.
Tubulo-interstitium injury is associated with proteinurea
- N.
Urinalysis is commonly normal in Glomerular damage
- O.
Tubulo-interstitium injury can be caused by ischaemia
- P.
Radiocontrast is a major cause of glomerular damage
- Q.
Radiocontrast is a major cause of tubulo-interstitium damage
- R.
Rabdomyolysis is a major cause of glomerular damage
- S.
Rabdomyolysis is a major cause of tubulo-interstitium damage
- T.
Diuretics can produce an acute allergic interstital nephritis
- U.
NSAIDS can produce an acute allergic interstitial nephritis
- 7.Whata re the possible causes of AKI?
- A.
Pre-renal acute kidney secondary to dehydration and hypotension
- B.
Bladder outflow obstruction secondary to enlarged prostate
- C.
Acute interstitial nephritis secondary to NSAI ibuprofen
- D.
Acute interstitial nephritis secondary to PPI lansoprazole
- E.
Multi-system disorder causing intrinsic renal injury
- 8.Which is the ONE most useful method of imaging the kidneys for AKI?
- A.
Plain X-Ray (KUB)
- B.
Ultrasound
- C.
Intravenous Urogram
- D.
Non-Contrast CT KUB
- E.
MR Angiogram
- 9.What tests would help you to clarify the of his AKI - which TWO are the most useful?
- A.
Urinalysis - dipstick for blood and protein
- B.
Urinalysis - dipstick for pH and nitrites
- C.
Urinary sodium
- D.
Urinary creatinine
- E.
Urine culture
- F.
Urine microscopy
- 10.(Case) In AKI associated with dyspnoeia, what are the more likely causes of shortness of breath ina young patient who has been hospitalised?
- A.
Pulmonary oedema
- B.
Hospital-acquired pneumonia
- C.
Aspiration pneumonia
- D.
Pulmonary embolism
- E.
Pulmonary haemorrhage
- 11.What does Positive C ANCA mean? Give ALL possible answers
- A.
It confirms a recent infection
- B.
It confirms irreversible renal failure
- C.
It is a marker of microscopic vasculitis
- D.
It is associated with Wegener's Granulomatosis
- E.
It suggests intrinsic renal disease
- 12.How may microscopic vasculitis present? Give ALL possible answers
- A.
Episcleritis
- B.
Skin rashes
- C.
Joint pains
- D.
Nosebleeds
- E.
GI Bleeds
- F.
AKI
- G.
CKD
- H.
Pulmonary haemorrhage
- I.
Mononeuritis Multiplex
- J.
Seizures due to intracerebral haemorrhage
- 13.What is the significance of Crescents on renal biopsy? Give ALL correct answers
- A.
Crescents indicate UTI
- B.
Crescents indicate irreversible renal damage
- C.
Crescents are diagnostic of Pulmonary-Renal syndrome
- D.
Crescents are diagnostic of ANCA positive vasculitis
- E.
Crescents indicate severe glomerular injury
- 14.Why is there a need for speed in dealing with Rapidly Progressive Glomerulonephritis (RPGN)? Give ALL correct options
- A.
In fact, there is no particular urgency once the diagnosis is made
- B.
Patients can rapidly become unwell with multi-system symptoms
- C.
All c ANCA positive patients are at risk of developing pulmonary involvement
- D.
Rapid aggressive immunosuppression may salvage damaged nephrons and restore useful renal function
- E.
It is essential to prepare for urgent dialysis
- 15.What are the options for treatment for microscopic vasculitis? Give ALL correct answers
- A.
Steroids
- B.
Cortimoxazole
- C.
Cyclophosphamide
- D.
MMF
- E.
Plasmapheresis
- F.
Rituximab
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