Kidney conditions.
What renal problem did chronic use of "Bex" powder cause which precipitated it's removal from sale in Australia in 1977?
BEX was a combination of Aspirin 420mg, Phenacetin 420mg and Caffeine 160mg---and was known as an APC powder. There were other popular brands like Vincents powders. Used and advertised widely to Australian housewives to treat pain and stress it was an over the counter formulation.
It caused analgesic nephropathy---specifically renal papillary necrosis.
Also caused upper urinary tract cancers which added to the case to remove it's sale.
If this information stressor you----"Have a cup of tea, a BEX and a lie down" and it will all be fine.
What sort of kidney problems can occur in patients who develop "Henoch Schonlein purpura"?
Henoch Schonlein purpura has been renamed IgA vasculitis. The IgA deposits in the small vessel walls of the kidney.
Renal involvement is seen in half of patients with Henoch Schonlein purpura.
Which of the following statements best describes nephrotic syndrome?
Those with nephrotic syndrome lose a lot of protein in their urine so may present with pitting oedema, hypertension or even frothy urine (because of the protein).
Most commonly seen in young children.
Which of these options is the most important association to know in a patient with polycystic kidneys?
All of these options occur in some patients with polycystic kidney disease. About 5% develop cerebral aneurysms, higher if someone else in their family has had one (about 15%).
One of these Australian celebrities did not die of renal cancer. Which one?
Barry Humphries died recently with complications after a hip fracture. He fell whilst reaching for a book
Which of the following conditions is unlikely to cause hydronephrosis?
An ascending urinary tract infection may cause pyelonephritis and even renal abscesses but is very unlikely to cause obstruction and hydronephrosis.
The 3 other options all can cause unilateral or bilateral obstruction of the ureters causing hydronephrosis on one or both sides.
A 23yr old lady presents with pyelonephritis that requires IV antibiotics. She does not have any allergies. What are the first line intravenous antibiotics to be given according to the Australian therapeutic guidelines?
Not surprisingly antibiotic regimes vary around the world. The ECI (Emergency Care Institiute) has a good summary of Australian guidelines.
Which of the following statements about Renal cell carcinomas is CORRECT?
Macroscopic haematuria, flank pain or a palpable mass are the most likely ways this cancer presents. Incidentally finding the mass on a CT is now becoming more common.
Stage 1 tumours have a 90% 5 year survival rate but a person with a Stage 4 tumour has only about a 5% 5 year survival.
Crystal nephropathy occurs when some drugs which are insoluble in human urine precipitate in the renal tubules. Which of the following substances does NOT cause this?
From an Emergency Physician's point of view overdose of Ethylene Glycol (anti freeze) is important to remember. It causes deposits of Calcium Oxalate crystals in multiple parts of the body, including the kidneys.
There are illegal rackets in India to buy kidneys from poor villages. In June 2016 one the presigious Apollo hospitals in New Delhi was caught. How much money did the donors get for a kidney?
Where demand outstrips demands and people are desperate a black economy is created.