Browse topics
Nephrology
33 notes, 101 questions and 287 flashcards.
Tier 1 is core knowledge expected of every trainee. Tier 2 is deeper or less common.
Presentations
- Acute oligo-anuriaFree sampleExclude obstruction first, sort pre-renal, intrinsic and post-renal causes at the bedside, and know when falling urine output needs dialysis.Tier 1, approach to a presentation, 3 questions, 9 flashcards
- Fever in renal transplant recipientsUse time since transplant and prophylaxis to predict the infection, remember non-infective causes, and watch tacrolimus interactions.Tier 1, approach to a presentation, 3 questions, 8 flashcards
- OedemaSeparate local from generalised oedema, dipstick the urine early, and match diuretic strategy to the cause, including diuretic resistance in nephrotic syndrome.Tier 1, approach to a presentation, 3 questions, 9 flashcards
Key conditions
- Acute and chronic glomerulonephritisFree sampleRecognising nephritic syndrome, using complement to narrow the cause, and managing IgA nephropathy, post-streptococcal GN and lupus nephritis to current KDIGO guidance.Tier 1, condition, 3 questions, 9 flashcards
- Acute kidney injury and acute tubular necrosisKDIGO definition and staging, why ATN happens and how it recovers, the hospital causes that dominate the exam, and what to do after discharge.Tier 1, condition, 3 questions, 8 flashcards
- Chronic kidney diseaseDefining and staging CKD by eGFR and albuminuria, who to test in Australia, the four drugs that slow progression, complications to screen for, and when to refer.Tier 1, condition, 3 questions, 9 flashcards
- Diabetic kidney diseaseScreening with ACR and eGFR, when the kidney disease probably isn't diabetic, and the four drug pillars (RAS blockade, SGLT2 inhibitor, finerenone, GLP-1 receptor agonist) with their trials.Tier 1, condition, 3 questions, 9 flashcards
- Drug-related nephrotoxicityDrug causes of kidney injury sorted by mechanism (haemodynamic, tubular, interstitial, crystal, glomerular), the high-yield culprits, and how to prevent and recognise each.Tier 1, condition, 3 questions, 9 flashcards
- Hypertension in kidney diseaseRenal parenchymal and renovascular hypertension, BP targets and drug choice across CKD, dialysis and transplant, and the renal emergencies where the right antihypertensive matters (scleroderma renal crisis).Tier 1, condition, 3 questions, 9 flashcards
- Nephrotic syndromeCauses of nephrotic syndrome in adults, the serology that can replace a biopsy (anti-PLA2R), managing minimal change disease, FSGS and membranous nephropathy, and preventing clots, infection and other complications.Tier 1, condition, 3 questions, 9 flashcards
- Rapidly progressive glomerulonephritisA nephrology emergency. Same-day ANCA and anti-GBM, early steroids, and induction with rituximab or cyclophosphamide to the KDIGO 2024 ANCA guideline.Tier 1, condition, 3 questions, 9 flashcards
Electrolyte abnormalities
- HyperkalaemiaExcluding pseudohyperkalaemia, ECG changes, and the three-step treatment of stabilise, shift and remove.Tier 1, condition, 3 questions, 10 flashcards
- Hyponatraemia and hypernatraemiaSodium disorders are water disorders. Osmolality, urine osmolality and urine sodium sort the causes; symptoms and duration set the speed of treatment; correction limits prevent osmotic demyelination.Tier 1, condition, 3 questions, 9 flashcards
End-stage renal failure
- Delaying progression of chronic kidney diseaseWhat drives CKD progression, how to measure it, and the evidence behind each intervention, from RAS blockade and SGLT2 inhibitors to the treatments that failed (allopurinol, bicarbonate in older people, stopping ACE inhibitors in advanced CKD).Tier 1, condition, 3 questions, 9 flashcards
- Initiating chronic dialysisPreparing for kidney failure, the indications for starting dialysis, why timing follows symptoms rather than an eGFR number (IDEAL), and when conservative kidney management is the better choice.Tier 1, condition, 3 questions, 8 flashcards
- Modes of dialysis: haemodialysis and peritoneal dialysisHow haemodialysis, haemodiafiltration and peritoneal dialysis work, how adequacy is measured, choosing a modality, and the PD-specific problems the exam likes (peritonitis, transporter status, icodextrin).Tier 1, condition, 3 questions, 9 flashcards
Less common or complex conditions
- Renal artery stenosisAtherosclerotic renal artery stenosis and fibromuscular dysplasia, the clinical clues, duplex and CT angiography, why ASTRAL and CORAL ended routine stenting, and the few patients who still need revascularisation.Tier 2, condition, 3 questions, 8 flashcards
- Renal calculus disease and obstructive uropathyRenal colic and its imaging, the obstructed infected kidney, which ureteric stones pass and when to refer, metabolic work-up by stone type, prevention after NOSTONE, and non-stone obstruction such as retroperitoneal fibrosis.Tier 2, condition, 3 questions, 9 flashcards
- Renal manifestations of systemic and chronic diseaseWhich kidney lesion each systemic disease causes (glomerular, tubular, vascular or obstructive), the urine and serology pattern that points to it, the conditions examiners pair (myeloma, amyloid, sarcoid, HIV, hepatitis, cirrhosis, sickle cell), and when to biopsy.Tier 2, condition, 3 questions, 8 flashcards
- Tubulo-interstitial kidney disordersAcute and chronic tubulointerstitial nephritis beyond drugs (TINU, sarcoid, Sjögren, IgG4), the tubular syndromes that give it away (Fanconi, RTA, concentrating defects), papillary necrosis, analgesic and lithium nephropathy, and ADTKD.Tier 2, condition, 3 questions, 8 flashcards
Chronic renal failure
- Anaemia in chronic kidney diseaseWhy CKD causes anaemia, the work-up that excludes other causes, iron first by the KDIGO 2026 thresholds, when an ESA is started and the 115 g/L ceiling, and why transfusion is avoided in transplant candidates.Tier 2, condition, 3 questions, 8 flashcards
- CKD mineral and bone disorderWhat to measure and how often by CKD stage (KDIGO 2017), reading calcium, phosphate, PTH and ALP together, the high-turnover versus adynamic bone patterns, first-line phosphate and PTH management, tertiary hyperparathyroidism after transplant, and the fracture and denosumab traps.Tier 2, condition, 3 questions, 8 flashcards
- Complications of dialysisThe intradialytic emergencies (hypotension, disequilibrium, dialyser reactions, air embolism), vascular access problems from catheter bacteraemia to steal syndrome, and the long-term burden of cardiovascular disease, amyloid, acquired cystic disease and pruritus, with the ward traps around fistula arms and drug dosing.Tier 2, condition, 3 questions, 8 flashcards
Inherited and genetic renal disease
- Autosomal dominant polycystic kidney diseaseFree sampleDiagnosis by age-specific cyst counts, risk stratification with the Mayo imaging class, who gets tolvaptan (KDIGO 2025 versus the PBS), and the extrarenal problems the exam asks about, from liver cysts to intracranial aneurysms.Tier 1, condition, 4 questions, 10 flashcards
- Alport syndromeType IV collagen (COL4A3, COL4A4, COL4A5) disease from persistent haematuria to kidney failure, the inheritance patterns and their risks, deafness and anterior lenticonus, genetic testing before biopsy, when to start an ACE inhibitor, and anti-GBM disease after transplant. Includes what used to be called thin basement membrane nephropathy.Tier 2, condition, 3 questions, 8 flashcards
Investigations and procedures
- Laboratory tests in renal diseaseReading creatinine, eGFR, cystatin C and Cockcroft-Gault (including in older people), the urine dipstick and microscopy, haematuria and proteinuria (ACR versus PCR), electrolytes, FBC clues and the blood gas in kidney disease, with worked examples.Tier 1, medical sciences concept, 3 questions, 10 flashcards
- Renal biopsyWhen a kidney biopsy changes management and when serology can replace it, contraindications, preparing the patient (BP, antithrombotics, desmopressin), what light, immunofluorescence and electron microscopy each add, and the bleeding risks from the 2020 meta-analysis.Tier 2, medical sciences concept, 3 questions, 8 flashcards
- Renal imagingWhich renal test answers which question, reading a renal ultrasound step by step (size, echogenicity, hydronephrosis, cysts), CT KUB versus CT urogram, the Bosniak classes, nuclear scans (DTPA, MAG3, DMSA) and when catheter angiography is still needed.Tier 2, medical sciences concept, 3 questions, 8 flashcards
Specific issues
- CKD in palliative careWho benefits from conservative kidney management rather than dialysis, how to estimate prognosis and lead the conversation, symptom control drugs that are safe at eGFR under 15, and the care of patients stopping dialysis.Tier 2, medical sciences concept, 3 questions, 7 flashcards
- Vascular access for dialysisFistula, graft or catheter and how to choose under the KDOQI 2019 ESKD Life-Plan, when to refer for access surgery, vein preservation, pre-operative mapping, examining a fistula and judging maturity, catheter placement rules, and the problems that need same-day referral.Tier 2, medical sciences concept, 3 questions, 9 flashcards
Renal transplantation
- Assessment of transplant donors and candidates, and anticipating RRTWhen to start planning for kidney failure, how a transplant candidate is worked up and which findings stop or delay listing, how to read a living donor's GFR, albuminuria and BP against KDIGO thresholds, and the immunological results that decide compatibility.Tier 2, medical sciences concept, 3 questions, 9 flashcards
- Short and long-term renal transplant complicationsHow to work up a rising creatinine after kidney transplant step by step, delayed graft function, rejection on Banff biopsy and its treatment, BK nephropathy, diarrhoea and neutropenia on immunosuppression, and the long-term burden of cancer, cardiovascular disease, post-transplant diabetes and recurrent disease.Tier 2, medical sciences concept, 4 questions, 10 flashcards
- Transplant immunosuppression and drug interactionsThe standard kidney transplant regimen (induction, then tacrolimus, mycophenolate and prednisolone), how to read a tacrolimus trough step by step, the interactions that cause toxicity or rejection, and pregnancy and vaccine rules for recipients.Tier 2, medical sciences concept, 3 questions, 9 flashcards