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
Correct Answer(s)
A. Proteinurea
B. Hypoalbuminaemia
E. Oedema
F. Hyperlipidaemia
H. Pro thrombotic state
J. Can cause progressive renal disease
L. IgG nephropathy as a possible cause
N. Diabetes as a possible cause
O. Lupus as a possible cause
P. NSAIDs as a possible cause
R. C3 depositionExplanation
Nephrotic syndrome is characterized by a group of symptoms including proteinuria (presence of excess protein in the urine), hypoalbuminemia (low levels of albumin in the blood), edema (swelling due to fluid retention), hyperlipidemia (high levels of lipids in the blood), prothrombotic state (increased risk of blood clots), can cause progressive renal disease, IgG nephropathy, diabetes, lupus, NSAIDs, and C3 deposition. These are all associated with the pathophysiology and clinical presentation of nephrotic syndrome.Rate this question:
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- 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
Correct Answer(s)
A. Proteinurea
B. Hypoalbuminaemia
E. Oedema
G. Haematuria
J. Can cause progressive renal disease
K. Low urine volume
M. IgA nephropathy as a possible cause
O. Lupus as a possible cause
Q. Hypertension
R. C3 depositionExplanation
Nephritic syndrome is characterized by inflammation of the glomeruli in the kidneys. This leads to leakage of protein in the urine (proteinurea), low levels of albumin in the blood (hypoalbuminaemia), and accumulation of fluid in the body (oedema). Haematuria, the presence of blood in the urine, is also associated with nephritic syndrome. It can cause progressive renal disease, leading to kidney damage. Other possible causes of nephritic syndrome include IgA nephropathy, lupus, and hypertension. C3 deposition, a marker of complement activation, is also associated with nephritic syndrome.Rate this question:
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- 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
Correct Answer(s)
A. RBC Casts always indicate renal disease
B. RBC Casts indicate, most commonly, glomerulonephritis
C. White Cell Casts can be seen in acute pyelonephritis
E. Some casts may be normal
G. Coarsely granulated casts indicate glomerular/tubular disease
I. Coarsely granulated casts are associated with pathological proteinureraExplanation
RBC Casts always indicate renal disease and RBC Casts indicate, most commonly, glomerulonephritis because the presence of red blood cell casts in urine microscopy is a strong indication of renal disease. Glomerulonephritis is the most common cause of RBC casts. White Cell Casts can be seen in acute pyelonephritis, which is an infection of the kidneys. Some casts may be normal, as not all casts are pathological. Coarsely granulated casts indicate glomerular/tubular disease and are associated with pathological proteinuria.Rate this question:
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- 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
Correct Answer(s)
A. Oliguria is common
C. Biochemically, increased plasma urea
D. Biochemically, increased creatinine
J. More common in elderly
K. AKI is most commonly Pre-RenalExplanation
In Acute Kidney Injury (AKI), oliguria, which is a decreased urine output, is a common symptom. Biochemically, there is an increase in plasma urea and creatinine levels, indicating impaired kidney function. AKI is more common in the elderly population. Additionally, AKI is most commonly caused by pre-renal factors, such as decreased blood flow to the kidneys, rather than intrinsic or post-renal causes.Rate this question:
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- 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
Correct Answer(s)
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
I. Can be an ADR of ACE InhibitorsExplanation
Pre Renal AKI is a type of acute kidney injury that is caused by decreased blood flow to the kidneys, leading to impaired kidney function. It can be a secondary effect of peritonitis, sepsis, anaphylaxis, heart failure, and adverse drug reactions such as NSAIDs and ACE inhibitors. This condition is not irreversible, as it can be resolved by addressing the underlying cause and restoring proper blood flow to the kidneys.Rate this question:
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- 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
Correct Answer(s)
A. Haematuria indicates Glomerular damage
B. Proteinurea indicates Glomerular damage
C. RBC Casts indicate Glomerular damage
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
L. Tubulo-interstitium injury is usually normal on urinalysis
O. Tubulo-interstitium injury can be caused by ischaemia
Q. Radiocontrast is a major cause of tubulo-interstitium 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 nephritisExplanation
Haematuria, proteinuria, and RBC casts are all indicators of glomerular damage. P-ANCA is present in Microscopic Polyangitis. Anti-glomerular basement membrane antibody disease and Goodpastures are synonymous. Glomerular AKI is associated with edema and hypertension. Tubulo-interstitium injury is usually normal on urinalysis. It can be caused by ischemia. Radiocontrast and rhabdomyolysis are major causes of tubulo-interstitium damage. Diuretics and NSAIDs can produce acute allergic interstitial nephritis.Rate this question:
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- 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
Correct Answer(s)
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 injuryExplanation
The possible causes of AKI include pre-renal acute kidney injury due to dehydration and hypotension, bladder outflow obstruction due to an enlarged prostate, acute interstitial nephritis due to the use of NSAIs like ibuprofen, acute interstitial nephritis due to the use of PPIs like lansoprazole, and multi-system disorders causing intrinsic renal injury. These conditions can all lead to impaired kidney function and the development of AKI.Rate this question:
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- 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
Correct Answer
B. UltrasoundExplanation
Ultrasound is the most useful method of imaging the kidneys for AKI. Ultrasound uses sound waves to create images of the kidneys and can provide valuable information about the size, shape, and structure of the kidneys. It is a non-invasive procedure that does not involve the use of radiation or contrast agents, making it safe and suitable for patients with renal impairment. Ultrasound can also help identify any abnormalities or blockages in the urinary tract that may be contributing to the AKI. Overall, ultrasound is a reliable and widely available imaging modality for evaluating kidney function in cases of AKI.Rate this question:
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- 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
Correct Answer(s)
A. Urinalysis - dipstick for blood and protein
F. Urine microscopyExplanation
Urinalysis - dipstick for blood and protein and urine microscopy are the most useful tests to clarify the cause of AKI. The dipstick for blood and protein can help identify any abnormalities in the urine, such as the presence of blood or protein, which can indicate underlying kidney damage. Urine microscopy involves examining a urine sample under a microscope to look for the presence of red and white blood cells, casts, crystals, or bacteria, which can further help in determining the cause of AKI. These tests provide valuable information about the kidney function and can aid in diagnosing the underlying condition causing AKI.Rate this question:
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- 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
Correct Answer(s)
A. Pulmonary oedema
B. Hospital-acquired pneumonia
E. Pulmonary haemorrhageExplanation
The more likely causes of shortness of breath in a young patient who has been hospitalized with AKI associated with dyspnoea are pulmonary oedema, hospital-acquired pneumonia, and pulmonary haemorrhage. Pulmonary oedema refers to the accumulation of fluid in the lungs, which can cause difficulty in breathing. Hospital-acquired pneumonia is a lung infection that develops during a hospital stay and can lead to respiratory symptoms. Pulmonary haemorrhage refers to bleeding in the lungs, which can also result in shortness of breath.Rate this question:
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- 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
Correct Answer(s)
C. It is a marker of microscopic vasculitis
D. It is associated with Wegener's Granulomatosis
E. It suggests intrinsic renal diseaseExplanation
Positive C ANCA (antineutrophil cytoplasmic antibody) is a marker of microscopic vasculitis, specifically associated with Wegener's Granulomatosis. It suggests the presence of intrinsic renal disease.Rate this question:
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- 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
Correct Answer(s)
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 haemorrhageExplanation
Microscopic vasculitis can present with various symptoms, including episcleritis (inflammation of the outermost layer of the sclera), skin rashes, joint pains, nosebleeds, gastrointestinal bleeds, acute kidney injury (AKI), chronic kidney disease (CKD), pulmonary hemorrhage, mononeuritis multiplex (inflammation of multiple nerves), and seizures due to intracerebral hemorrhage. These symptoms can occur due to inflammation and damage to the blood vessels in different organs and tissues of the body.Rate this question:
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- 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
Correct Answer
E. Crescents indicate severe glomerular injuryExplanation
Crescents on renal biopsy indicate severe glomerular injury. This means that there is significant damage to the glomeruli, which are the filtering units of the kidneys. The presence of crescents suggests that there is inflammation and disruption of the glomerular structure, leading to impaired kidney function. These crescents can be seen in various conditions, including autoimmune diseases like ANCA positive vasculitis and Pulmonary-Renal syndrome. However, they are not specific to these conditions and can also be seen in other forms of glomerular injury. Therefore, the presence of crescents on renal biopsy is an important finding that indicates severe damage to the kidneys.Rate this question:
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- 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
Correct Answer(s)
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 functionExplanation
Patients with Rapidly Progressive Glomerulonephritis (RPGN) can rapidly become unwell with multi-system symptoms, such as kidney failure, lung involvement, and other organ dysfunction. Additionally, all c ANCA positive patients are at risk of developing pulmonary involvement. Rapid aggressive immunosuppression is necessary in order to salvage damaged nephrons and restore useful renal function. Therefore, speed is crucial in dealing with RPGN to prevent further complications and improve patient outcomes.Rate this question:
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- 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
Correct Answer(s)
A. Steroids
B. Cortimoxazole
C. Cyclophosphamide
D. MMF
E. Plasmapheresis
F. RituximabExplanation
The options listed are all potential treatments for microscopic vasculitis. Steroids are commonly used to reduce inflammation and suppress the immune system. Cortimoxazole is an antibiotic that can be used to treat infections associated with vasculitis. Cyclophosphamide is a chemotherapy drug that can suppress the immune system and reduce inflammation. MMF, or mycophenolate mofetil, is an immunosuppressive medication that can be used to treat vasculitis. Plasmapheresis is a procedure where the liquid part of the blood, called plasma, is separated from the blood cells. This can help remove harmful antibodies and other substances from the blood. Rituximab is a medication that targets certain cells of the immune system and can be used to treat vasculitis.Rate this question:
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Mar 20, 2023Quiz Edited by
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Nov 27, 2011Quiz Created by
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