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Renal and Endocrine Disorders Flashcards

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  1. A 58-year-old man with type 2 diabetes has an eGFR of 45 mL/min and a urine albumin-to-creatinine ratio of 80 mg/mmol. Which medication class provides the strongest renoprotection in addition to glycaemic control?

    Answer: SGLT2 inhibitor

    SGLT2 inhibitors slow progression of diabetic kidney disease and reduce albuminuria independent of glucose lowering.

  2. A 30-year-old woman presents with hypertension, hypokalaemia and metabolic alkalosis with suppressed renin and elevated aldosterone. What is the most likely diagnosis?

    Answer: Primary hyperaldosteronism

    Suppressed renin with raised aldosterone causing hypertension and hypokalaemia is classic for primary hyperaldosteronism (Conn syndrome).

  3. A patient with chronic kidney disease stage 4 develops fatigue and a haemoglobin of 88 g/L with normal iron stores. What is the primary cause of this anaemia?

    Answer: Reduced erythropoietin production

    Failing kidneys produce insufficient erythropoietin, causing a normocytic normochromic anaemia.

  4. A 24-year-old presents with polyuria and polydipsia. After water deprivation the urine remains dilute, and it concentrates following desmopressin. What is the diagnosis?

    Answer: Central diabetes insipidus

    A response to desmopressin indicates ADH deficiency, confirming central diabetes insipidus.

  5. A 65-year-old man on a thiazide diuretic presents confused with a serum sodium of 118 mmol/L and is clinically euvolaemic. What is the most appropriate initial management of asymptomatic chronic hyponatraemia?

    Answer: Fluid restriction and stop the offending drug

    Chronic mild hyponatraemia is managed with fluid restriction and removing the cause to avoid osmotic demyelination from overly rapid correction.

  6. A 45-year-old woman has weight gain, cold intolerance, constipation and a raised TSH with low free T4. What is the diagnosis?

    Answer: Primary hypothyroidism

    A high TSH with low free T4 indicates primary thyroid gland failure.

  7. A patient presents with acute kidney injury, a urine output of 5 mL/hr, and a fractional excretion of sodium below 1%. What does this finding suggest?

    Answer: Pre-renal cause

    A FENa below 1% indicates intact tubular sodium avidity typical of a pre-renal (hypovolaemic) cause.