13. Signs And Symptoms Flashcards
Name 3 general common causes of kidney disease.
Infection/sepsis.
Hypovolaemia.
Nephrotoxins.
Inflammatory conditions.
What 2 initial investigations will be abnormal in a patient presenting with CKD?
Abnormal blood result.
Abnormal urine dipstick.
Give 3 presenting symptoms of a patient with CKD.
No symptoms. Fatigue/malaise. Loss of appetite/weight. Acute illness/recent infection. Ankle swelling. Haematuria/nocturia.
Give 4 presenting symptoms of a patient with AKI.
Preceding illness/infection. Inter-current illness. History of volume depletion. Fatigue/malaise. Ankle swelling/SOB. Nausea and vomiting. Pain (suprapubic/loin/joints). Change in urine. Dysuria. Fever.
Give two questions about past medical history that you should ask young patients presenting with renal problems.
Enuresis in childhood.
Problems in pregnancy.
Name 2 conditions you should ask about in past medical history when you suspect a patient has a renal problem.
Diabetes mellitus.
Hypertension.
Ischaemic heart disease.
Cerebrovascular disease.
Name 3 conditions you should ask about when taking a patients family history, if you suspect they have a renal problem.
Kidney disease - inherited or CKD. Diabetes mellitus. Hypertension. Ischaemic heart disease. Cerebrovascular disease. Auto-immune disease. UTIs.
What needs to be particularly thorough in a patient with kidney disease when taking a history/examining?
Systems review.
What 2 vital examinations should always be done in a patient with suspected renal disease?
Blood pressure.
Urine dipstick.
What is uraemia?
Raised level of urea and other nitrogenous waste compounds in the blood. Can cause a change to skin tone.
Name 2 things that can cause inaccuracies on dipsticks.
Extreme exercise - causes proteinuria and haematuria.
Mestruation - proteinuria and haematuria.
Indwelling catheters - leukocytes, nitrites, haematuria.
When is it best to do a dipstick in terms of proteinuria and why?
Early origin as removes orthostatic and exercise effect.
What does the level of proteinuria depend on?
Concentration of urine.
Name 2 non-glomerular causes of proteinuria.
UTI. Inflammation. Kidney tubule damage (CKD, AKI). Bence Jones Protein. Myoglobin and haemoglobin.
Name 2 glomerular causes of proteinuria.
Glomerulonephritis.
Amyloidosis.
Physiological - fever and exercise.
What does a dipstick detect to indicate haematuria? So what can give false positives?
Detects haemoglobin.
But myoglobin and intravascular haemolysis give false positives.
Name 2 causes of haematuria.
Renal - pyelonephritis , glomerulonephritis, renal calculi etc.
Ureteric - stones, carcinoma.
Bladder - cystitis, trauma, stone, carcinoma.
Urethra - benign prostatic hypertrophy, trauma, stone, carcinoma of prostate.
Name 2 things that can give positive leukocytes on a urine dipstick.
Infection. Glomerulonephritis. Interstitial nephritis. Cystitis. Neoplasms. Stones.
What can give a false positive reading of leukocytes on a urine dipstick?
Contamination with vaginal secretions.
Name 2 things you might look for on a urine microscopy.
Infection (culture).
Crystals - gout and pseudogout.
Casts.
Red cell casts.
