MICRO
KIDNEY.pptx

31 a patient presents with acute renal failure with

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A PATIENT PRESENTS WITH ACUTE RENAL FAILURE WITH NORMAL ULTRASOUND ABDOMEN REPORT. NEXT MOST USEFUL INVESTIGATION IS - (AIIMS JUNE 99) A) INTRAVENOUS PYELOGRAPHY B) DTPA SCAN C) RETROGRADE PYELOGRAPHY D) X-RAY ABDOMEN AND CT SCAN. ANS. IS ‘B’ I.E., DTPA SCAN [REF: HARRISON 18'H/EP. 2049] “NOW THE MOST CONVENIENT METHOD OF ESTIMATION RENAL FUNCTION IS BY ISOTOPE RENOGRAPHY” - NAMMALWAR/85. REMEMBER: RENOGRAM, MAG3 OR DTPA IS PRIMARILY USED TO STUDY THE FUNCTIONING OF KIDNEYS. STATIC RENAL SCAN, DMSA SCAN IS PRIMARILY USED TO LOOK AT THE STRUCTURE, OF KIDNEYS. 32
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CYSTATIN C LEVELS ARE USED IN UROLOGY FOR – A) DETECTING UTI (NBE BASED AI 13 PATTERN ) B) ESTIMATING GFR C) ESTIMATING DIFFERENCE BETWEEN CRF AND ARF D) SCREENING OF RENA CA 33
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GFR ESTIMATIONS DETERMINED BY CREATININE BASED EQUATIONS ARE NOT PRECISE , SO OTHER SUBSTANCES SUCH AS “CYSTATIN C” ARE BEING EXPLORED TO ESTIMATE GFR. CYSTATIN C, A NON GLYCOSYLATED 13 KDA PROTEIN HAS THE POTENTIAL TO IMPROVE ESTIMATES OF GFR BECAUSE IT IS THOUGHT TO BE LESS INFLUENCED BY MUSCLE MASS OR DIET. CYSTATIN C MAY BE USED AS AN ALTERNATIVE TO CREATININE AND CREATININE CLEARANCE TO SCREEN FOR AND MONITOR KIDNEY DYSFUNCTION. 34
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IT MAY BE ESPECIALLY USEFUL IN THOSE CASES WHERE CREATININE MEASUREMENT IS NOT APPROPRIATE FOR INSTANCE IN THOSE WHO HAVE LIVER CIRRHOSIS VERY OBESE OR MALNOURISHED HAVE REDUCED MUSCLE MASS. 35
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IN ADDITION TO KIDNEY DYSFUNCTION IT HAS BEEN ASSOCIATED WITH AN INCREASED RISK OF CARDIOVASCULAR DISEASE AND HEART FAILURE IN OLDER ADULTS. CYSTATIN C IS GAINING ACCEPTANCE AS STUDIES CONFIRM AND DEFINE ITS USEFULNESS, ESPECIALLY AS AN EARLY SENSITIVE MARKER FOR CHRONIC KIDNEY DISEASE. 36
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CYSTATIN C LEVELS ARE USED IN UROLOGY FOR - A) DETECTING UTI (NBE BASED AI 13 PATTERN ) B) ESTIMATING GFR C) ESTIMATING DIFFERENCE BETWEEN CRF AND ARF D) SCREENING OF RENA CA ANS. IS ‘B’ I.E., ESTIMATING GFR [REF: HARRISON 18‘VE P. 2304] 37
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WATER DEPRIVATION TEST IS USED TO ASSESS – A) GLOMERULAR FUNCTION (NBE/DNB PATTERN ) B) PROXIMAL TUBULAR FUNCTION C) DISTAL TUBULAR FUNCTION D) RENAL PLASMA FLOW 38
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WATER DEPRIVATION TEST IS USED TO ASSESS – A) GLOMERULAR FUNCTION (NBE/DNB PATTERN ) B) PROXIMAL TUBULAR FUNCTION C) DISTAL TUBULAR FUNCTION D) RENAL PLASMA FLOW ANS. IS ‘C’ I.E., DISTAL TUBULAR FUNCTION [REF: ESSENTIALS OF NEPHROLOGY 2ND/E P. 33] . WATER DEPRIVATION TEST IS USED TO ASSESS DISTAL TUBULAR FUNCTION. 40
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MAJOR CAUSES, CLINICAL FEATURES, AND DIAGNOSTIC STUDIES FOR ACUTE KIDNEY INJURY 41
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DRUGS CAUSING ATN- (PGI NOV 09) A) CALCINEURIN INHIBITOR B) AMPHOTERICIN B C) RIFAMPICIN D) AMINOGLYCOSIDES 45
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DRUGS CAUSING ACUTE TUBULAR NECROSIS:- AMINOGLYCOSIDESE • AMPHOTERICIN B • CEPHALORIDINE COLISTIN CYCLOSPORINE (CALCINEURIN INHIBITOR) 46
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DRUGS CAUSING ATN- (PGI NOV 09) A) CALCINEURIN INHIBITOR B) AMPHOTERICIN B C) RIFAMPICIN D) AMINOGLYCOSIDES ANS. IS ‘A’ I.E., CALCINEURIN INHIBITOR; ‘B’ I.E., AMPHOTERICIN B;
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