đź©ş MedAtlax

Search

SearchSearch

NEPHROLOGY CS-OSPE

Sep 26, 20243 min read

Case 1

A 50-year-old patient has chronic renal failure with end-stage renal disease (ESRD). Now started on dialysis. After 2 dialysis sessions, he developed confusion and mental status changes.

  1. What is the name of this CNS complication which he has developed?Z

    • Dialysis Disequilibrium syndrome

  2. Mention 1 more complication of hemodialysis?

    • Hypotension
    • Infection/Thrombosis of the fistula

  3. Mention 2 complications of peritoneal dialysis?

    • Hyperglycemia and Peritonitis

  4. Mention 2 Absolute indications for dialysis?

    • Uremic encephalopathy
    • Uremic pericarditis

  5. Once a fistula is made, after how much time is it ready to be used?

    • After few months

  6. At what GFR should you start dialysis in a renal failure patient, if he also has diabetes mellitus?

    • When GFR reaches below 15

Case 2

A 20 year old male has a history of “recurrent” urinary tract infection. His urine looks turbid as shown below, and urine analysis shows UTI.

  1. Name 3 features in a Urine analysis report that indicate infection?

    • +nitrites, +leukocyte esterase, WBC more than 8-10/high power field

  2. Name 2 bacteria which commonly cause UTI?

    • E.coli and klebsiella

  3. Which is the drug of first choice to treat this patient’s UTI?Z

    • Bactrim, Ciprofloxacin

  4. For how many days will you treat this patient?

    • 7 days for man in this case - 3 days for woman 7 if preg

  5. Name any 1 investigation which you will do in this patient as a work up for recurrent UTI?

    • Urine culture

  6. Urine culture should be done in recurrent UTI

Case 3

  1. If it comes to 20y/o man, what is the cause? Z Secondary HTN
  2. Name 2 etiologies of condition: Z Atherosclerosis, Fibromuscular dysplasia
  3. Pathology in the image: Renal Artery Stenosis
  4. Treatment option: Angioplasty + or - stent

Case 4Z

A patient with chronic renal failure. His blood tests show the following results:

  • Hb: 9g/dl.
  • Creatinine: 4 mg/dl
  • K (potassium): 6 meq/L
  • Serum Calcium: low
  • ABG: pH 7.28/ pCO2 28mmHg/ HCO3 18mEq/L

  1. Name the 2 most common causes of chronic renal failure worldwide?
    HTN and DM

  2. Name any 2 treatments which can be used for hyperkalemia? Z Insulin/glucose, K binding resins (Kay-exalate), calcium - gluconate

  3. What is the cause of low serum calcium in chronic renal failure?
    Inactivation of vit D - low vit D

  4. What acid base abnormality is seen in chronic renal failure?
    Metabolic acidosis

  5. Name 2 treatments used to treat anemia of chronic renal failure?
    Iron (Fe) and erythropoietin

  6. Give 2 indications for dialysis in renal failure?

    • **Uremic pericarditis
    • uremic encephalitis
    • Hyperkalemia
    • Pericarditis?

  7. Name any 2 complications of CRF Uremia, HTN, Osteoprosis

  8. How you’re going to treat his hyperkalemia?

    • Calcium gluconate
    • Oral chelating agent
    • Dialysis

Case 6Z

A 20 year old man known case of sickle cell disease developed nocturia and swollen ankles.

The following blood results were obtained:

  • Plasma urea 8.0 mmol/l

  • Sodium 145 mmol/l

  • Potassium 4.0 mmol/l

  • Bicarbonate 22 mmol/l

  • Phosphate 0.9 mmol/l

  • Serum Albumin 21 g/l

  • 24 hour urinary protein 10 g

  • Early morning urine osmolality 310 mOsm/kg

  1. Name 2 laboratory abnormalities? a. low serum albumin (hypoalbuminemia) b. urine protein is high (hyperprotienuria)

  2. What is the clinical diagnosis? a. nephrotic syndrome

M.N. (spike pattern)

Peri-Orbital Edema in Nephrotic

Graph View

Backlinks