Renal disease

Published on 05/05/2015 by admin

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Last modified 05/05/2015

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11 Renal disease

Questions

How do you calculate the plasma creatinine clearance value at the bedside, by body weight?

Can you tell me whether administering low doses of dopamine to increase renal blood flow is today considered obsolete?

Why does haemoglobinuria cause anuria?

I am confused over the use of a ‘high-protein diet’ in the management of nephrotic syndrome. You say it confers no advantage, but the Oxford Handbook of Clinical Medicine advocates its use and Davidson’s Principles and Practice of Medicine says it is even dangerous as it could lead to renal damage. Which one should I choose, assuming I see the question in an MCQ?

Is albumin infusion contraindicated in nephrotic syndrome? If not, then what are the indications?

Listed under the drug causes of nephrotic syndrome, it has been stated that high doses of captopril can induce an immune-complex-mediated membranous glomerulonephritis. If a patient with nephrotic syndrome has hypertension, is it detrimental to give captopril as a treatment for his hypertension? Could this exacerbate the patient’s nephrotic syndrome?

Please explain the pathophysiology of ascites in the nephrotic syndrome?

Does the nephritic syndrome cause hyperkalaemia? I don’t seem to be able to find a definitive answer in the textbooks that I have consulted.

You say that the investigation of first choice for urinary tract infections (UTIs) in males or children, or recurrent UTIs in females, is intravenous urography (IVU); in Oxford Handbook of Clinical Medicine it is ultrasound (US). Which is best?

1. Other than amoxicillin, what other orally administered drug is recommended for the treatment of a urinary tract infection (UTI) caused by enterococcus?

2. What is the recommended dosage for antibiotics in the prophylactic treatment of recurrent UTI in pregnancy? Is amoxicillin clavulanic acid safe to use during pregnancy?

What is the advantage of intermittent self-catheterization over an indwelling catheter? How is bladder training done while on an indwelling catheter?

Kindly tell me about the role of pulse wave velocity (PWV) in early diagnosis of arteriosclerosis. How is it useful in cardiac, diabetic and renal medicine?

You say that no convincing evidence was found that chronic hyperuricaemia causes nephropathy and nor can it be corrected by allopurinol. However, some patients we see have high serum uric acid and creatinine, which both come down with allopurinol. Please comment.

Can aspirin cause analgesic nephropathy? If yes, then how could we justify its use in primary prevention of coronary artery disease (CAD), even in high-risk patients? I have read that regular use of analgesics for 3 years could cause analgesic nephropathy.

What is the probability that a patient on a moderate daily dose of non-steroidal anti-inflammatory drugs (NSAIDs; ibuprofen 800mg once daily for tension headache) will develop analgesic nephropathy?

Do daily doses of paracetamol with the dosage range of 1g/day cause analgesic nephropathy. If so, after what length of time?

Allopurinol is used for the treatment of uric acid stones; it is also one of the aetiologies of renal calculi. Could you please explain its actual effect.

Why should we avoid angiotensin-converting enzyme (ACE) inhibitors as hypertensive therapy in the presence of renal artery stenoses? How can they lead to acute renal failure? What else can we prescribe for this patient to regulate the hypertension?

Is the use of angiotensin-converting enzyme (ACE) inhibitors contraindicated in cases of unilateral renal artery stenosis?

1. How effective is renal duplex in detecting renal artery stenosis?

2. Is magnetic resonance angiography superior to renal duplex in detecting renal artery stenosis?

How accurate is ultrasonography in detecting renal calculi?

Please explain the most effective way to manage a case of intrauterine fetal unilateral hydronephrosis in the 32nd week of pregnancy.

In renal failure, why does oedema first occur in the periorbital area and nowhere else?

How does sodium valproate decrease serum urea concentration and GI bleed increases it? Renal disease

1. What clinical information can be obtained by checking the blood urea nitrogen (BUN) level that cannot be obtained by checking the blood urea and serum creatinine alone?

2. What is the signifying difference between blood urea and BUN?

1. Does uraemia cause dysentery with blood and mucus mixed with the stools?

2. Is it correct to use the term ‘uraemic dysentery’?

3. Does uraemia cause finger clubbing?

What are the causes of a low serum creatinine?

Why does oliguria occur in the early stages of acute tubular necrosis (ATN)?

Is renal impairment induced by lithium therapy in bipolar affective disorders irreversible? How often does it occur?

Can you please explain why a patient with chronic renal failure (CRF) might present with either oliguria or polyuria?

What are uraemic frost conditions?

What is the role of terlipressin or novapressin in the management of hepatorenal syndrome?

What is the rationale of angiotensin-converting enzyme (ACE) inhibitors in chronic renal disease?

What procedure is recommended for post renal transplant if this is the second graft?

Do the cysts in autosomal-dominant polycystic kidney disease (PCKD) undergo malignant transformation and in what percentage?

In a 69-year-old patient with a 2-cm hard prostatic nodule on digital rectal examination, what is the more appropriate way to make a definitive diagnosis of prostate cancer: prostate biopsy or serum prostate-specific antigen (PSA)?

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