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BDS2 BAMS Urology/Nephrology (Renal) > 1. Renal Medicine > Flashcards

1. Renal Medicine Flashcards

1
Q

Where does filtration occur

A

Glomerus

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2
Q

What is filtration dependent upon

A

Glomerular pressure

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3
Q

What does the juxta-glomerular apparatus contain

A

RAAS

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4
Q

Function of prostaglandins

A

Control glomerular functions

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5
Q

Definition of polyuria

A

Excess urine

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6
Q

Definition of dysuria

A

Pain when passing urine

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7
Q

Definition of haematuria

A

Blood in urine

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8
Q

Definition of proteinuria

A

Protein in urine

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9
Q

Definition of uraemia

A

Excess urea in blood

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10
Q

Renal function is measured by (3)

A

Serum urea
Serum creatinine
24hr urine collection (creatinine clearance)

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11
Q

Renal failure involves (4)

A

Loss of renal excretory function
Loss of water and electrolyte balance
Loss of acid base balance
Loss of renal endocrine function (EPO, calcium metabolism, renin secretion)

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12
Q

Renal failure can be (2)

A

Acute (usually reversible)

Chronic

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13
Q

Features of acute renal failure

A

Rapid loss of renal function, usually over hours/days

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14
Q

Features of chronic renal failure

A

Gradual loss of renal function, usually over many years

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15
Q

Causes of renal failure (3)

A

Pre-renal
Renal
Post-renal

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16
Q

Definition of pre-renal failure and examples (3)

A

Hypo-perfusion of kidney
Shock
Renal artery disease
Aorta disease

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17
Q

Examples of renal failure (4)

A

Chronic disease
Drug damage
Trauma
Rhabdolysis

18
Q

Definition of rhabdolysis

A

Breakdown of skeletal muscle

19
Q

Examples of post-renal failure

A

Renal outflow obstruction

20
Q

Acute renal failure involves (5)

A 
Rapid loss of renal function
Anuric initially with volume overload
Gradual progression to polyuria
Development of hyperkalaemia
Development of uraemia and acidosis
21
Q

Creatinine level in acute renal failure

A

> 200umol/l

22
Q

Symptoms of acute renal failure (5)

A 
Ankle oedema (ambulatory) or sacral oedema (sedentary)
Pulmonary oedema
Breathlessness
Raised JVP
Weight gain
23
Q

Effects of acidosis (3)

A

Low bicarbonate
Increased respiratory excretion of CO2
Raised respiratory rate

24
Q

Main cause of acute renal failure

A

Pre-renal cause

25
Q

Specific cause and example of acute renal failure (2)

A

Trauma/drug-induced

Crush injury –> muscle breakdown –> uraemia –> kidneys blocked –> acute failure

26
Q

Types of chronic renal failure (2)

A

Primary

Secondary

27
Q

Causes of primary renal failure (2)

A

Glomerulonephritis

Polycystic kidney disease

28
Q

Causes of secondary renal failure (6)

A 
Diabetes (30%)
HTN (20%)
Drug therapy
Vasculitis
Renal artery disease
Aorta disease
29
Q

Presentation of glomerulonephritis (4)

A

Haematuria
Proteinuria
In an otherwise healthy individual
Gradual progression to HTN and chronic renal failure

30
Q

Complications of glomerulonephritis

A

Nephrotic syndrome

31
Q

Nephrotic syndrome involves (4)

A

Excessive loss of protein in urine (leads to hypoalbuminaemia)
Loss of plasma oncotic pressure
Tissue swelling (oedema)
Hypercoagulable state (loss of clotting factors)

32
Q

Why should NSAIDs be avoided in renal failure (2)

A

Inhibit glomerular blood flow

Causes interstitial nephritis

33
Q

Nephrotoxic drugs include

A

Cyclosporin

34
Q

Renal vascular disease involves (2)

A

Reduced blood flow to kidney (atheroma, HTN)

Microangiopathy

35
Q

Immune-mediated renal damage can be (3)

A

Multiple myeloma (plasma cell tumour/tubular nephritis)
Goodpasture’s syndrome
Vasculitis (lupus)

36
Q

Polycystic kidney disease causes (2)

A 
Gene mutation (PKD 1, 2, 3)
Multiple cysts in renal parenchyma (enlarged kidney, progressive destruction, gradual renal failure)
37
Q

When does end stage renal disease (ESRD) occur (2)

A

When eGFR <15ml/min

Creatinine is 800-1000umol/l

38
Q

Chronic renal failure management involves (5)

A 
Reduce rate of decline (control underlying cause)
Correct fluid balance
Correct deficiencies 
Remove outflow obstruction
Treat infection
39
Q

Signs of chronic renal failure (3)

A

Anaemia
HTN
Renal bone disease (low Ca, high PO4, hyperparathyroidism, osteomalacia)

40
Q

Symptoms of chronic renal failure (6)

A 
Insidious (may be few)
Polyuria
Nocturia 
Tired
Weak
Nausea
41
Q

Renal malignancies include (2)

A

Renal cell carcinoma (HTN, polycythaemia)

Transitional cell carcinoma (haematuria, asymptomatic)

42
Q

Secondary oral effects of anaemia include (2)

A

Oral ulceration

Dysaesthesia

BDS2 BAMS Urology/Nephrology (Renal) (3 decks)

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