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2 522
π *IMPORTANT 475* π
*The Complications of Renal Replacement Therapy*
It can be remembered in 3 headings
1) Complications Of Hemodialysis
2) Complications Of Peritoneal Dialysis
3) Complications Of Renal Transplantation
paceUrMRCP.
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*π IMPORTANT 474π*
*Causes Of Tenderness Over The Graft*
Graft Rejection
Graft Infection
paceUrMRCP.
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*π IMPORTANT 473π*
*Few Indications for Nephrectomy in ADPKD*
Peristent Pain
Recurrent Pyelonephritis
Rescurrent Stone formation
To Obtain Extra Rooom for Renal Transplantation If Massively Enlarged.
paceUrMRCP.
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*π IMPORTANT 472π*
*Few Complications Of ADPKD*
ESRD
Rupture of Berry`s aneurysm = SAH = Neurological deficit
Recurrent urinary infections & Recurrent abdominal pain
2ry polycythemia = Hyper-Coagulable State
HTN
MVP (Mitral Valve Prolapse)
Recurrent Kideny Stones (Uric Acid/Oxalate)
paceUrMRCP.
2 522
*π IMPORTANT 471π*
*Few Complications Of Nephrotic Syndrome*
Renal vein thrombosis (protein C & S deficiency)= Sudden loin pain and hematuria, AKI.
Atheroma & IHD
Malnutrition
Recurrent Infections (Loss of Immunoglobulins in urine)
DVT (Hypercoagulable state)
paceUrMRCP.
2 522
*π IMPORTANT 470π*
*Few Indications for Surgery of crohn,s disease*
Persistent Symptoms Despite High Dose Steroids
Toxic Megacolon
Strictures
Intractable Fistula
Perforation Or Cancer
paceUrMRCP.
2 522
*π IMPORTANT 466π*
*Complications Of Thalassemia*
Complications Of The Disease
Skeletal deformities
Severe Anemia
Heart failure
Gall stones
paceUrMRCP.
2 522
*π IMPORTANT 465π*
*Causes of Tender Hepatomegaly*
Acute Viral hepatitis
Budd-Chiari syndrome
Congestive cardiac failure
Malignancy
Tricuspid regurgitation (pulsatile)
paceUrMRCP.
2 522
*π IMPORTANT 464π*
*Tip for History taking
When the scenario involves a patient with a known disease that presents with uncontrolled symptoms, noncompliance with currently prescribed medications can be a common differential that you have to explore in detail during the consultation.
paceUrMRCP.
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π IMPORTANT 462π
Ultrasound diagnostic criteria in people with positive family history of ADPKD
β’ < 30 years old: at least two unilateral or bilateral cysts (consider rescanning after 30 years old if criteria not met)
β’ 30β60 years old: two cysts in each kidney
β’ > 60 years old: more than four cysts in each kidney.
paceUrMRCP.
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*π IMPORTANT 463π*
Always mention to avoid contact sports in a case of APKD.
paceUrMRCP.
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*π IMPORTANT 461π*
*possible differentials for bilateral palpable kidneys*
Bilateral hydronephrosis
Amyloidosis
Renal cell carcinoma
Bilateral kidney cysts
Tuberous sclerosis
Von Hippel Lindau.
paceUrMRCP.
2 522
Heartiest congratulations
To
Dr Sarah Babiker.
For passing MRCP 2 WRITTEN.
She has been a keen member of our WhatsApp group for MRCP 2 Preparation. We wish her the best for her future.
2 522
*π IMPORTANT 451π*
*Features of enlarged Spleen*
Cannot get above mass
Moves downwards & medially with inspiration
Splenic Notch
Percussion note Dull
Not Ballotable
paceUrMRCP.
2 522
*π IMPORTANT 450π*
*Common scars in abdomen*
(Stretch the abdomen skin if the patient is obese to see the scars)
Lt. Subcostal = Splenectomy= Cr.H.A (Chronic Hemolytic Anaemia)
Rt.Subcostal = Cholecystectomy = Cr.H.A
Laparoscopy = Cholecystectomy = Chr.H.A, Crohn`s disease
Ascites Tapping scars
Peritoneal Dialysis
Rt. Illiac Fossa Scar = Renal Transplant /Appendectomy
Mid Line Scar/Multiple Scars =Crohns
Mercedes Benz Scar = Liver Transplantation
paceUrMRCP.
2 522
*π IMPORTANT 449π*
Always remember to feel for Dupuyterin`s Contracture or its scar in a case of CLD.
paceUrMRCP.
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*π IMPORTANT 448π*
*Hepatomegaly β causes:*
Cirrhosis
Congestive cardiac failure
Cancer (liver, metastatic, haematological)
Infection (hepatitis, hydatid cyst, amoebic pyogenic abscess )
Infiltration (sarcoidosis, amyloidosis, storage diseases)
Alcoholic hepatitis
paceUrMRCP.
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*π IMPORTANT 447π*
*Causes of CLD:*
Metabolic causes, e.g. Wilsonβs, haemochromatosis, Ξ±-1 antitrypsin deficiency
Alcohol
Nonalcoholic fatty liver disease
Drugs, e.g. phenytoin, isoniazide, methotrexate
Infections, e.g. bacterial (Staphylococcus aureus)/parasitic (amoebiasis,hydatid disease)
Viral hepatitis, e.g. hepatitis B and C
Autoimmune causes, e.g. autoimmune hepatitis, primary biliary cirrhosis, primary sclerosing cholangitis
paceUrMRCP.
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*π IMPORTANT 446π*
*Causes of decompensation of CLD*
β’ Electrolyte imbalances
β’ Bleeding
β’ Infection
β’ Drugs and alcohol
β’ Constipation.
paceUrMRCP.
2 522
Heartiest congratulations
To
Dr Tanzeel Rehman.
For passing MRCP 2 WRITTEN.
He has been a keen member of our WhatsApp group for MRCP 2 Preparation. We wish him the best for his future.
