4 Clinical Cases Flashcards
An 8 year old girl who is generally fit and well presents with discomfort passing urine. What questions should we be considering?
For info: Types of duplex ureters
Jenna, an 8 year old girl who is otherwise well- presents with this history:
What might be the likely diagnosis?
Duplex left kidney with ectopic ureter and ureterocele
A patient is diagnosed with duplex left kidney with ectopic ureter and uterocele. What management options are there?
- Reimplant ureter into better option (but ureter not functioning well anyway so not best option)
- Remove duplex kidney and ureter (heminephroureterectomy)
You are presented with the following patient and you suspect type 2 diabetes. What other signs/symptoms should you ask about?
(Finger prick glucose reads 18mmol/L)
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This patient has suspected type 2 diabetes. You have taken a full history. What tests should now be done?
- HbA1C (Glycated hemoglobin is a form of hemoglobin that is chemically linked to a sugar)
- Glucose tolerance test
- U&Es
- eGFR
- Urine dip
- Albumin:creatinine in urine (raised in CKD)
Name a systemic condition that CKD is often associated with.
Hypertension, diabetes, obesity
A 19 year old man comes into A&E following an accident at work causing the injury in the image:
How is Dillon’s CVS system responding the the fall in blood pressure?
What is inculded in the major haemorrhage protocol?
How might nephrogenic diabetes insipidus present? (In a baby)
Baby- normal birth BUT after few days- symptoms eg:
How should nephrogenic diabetes insipidus be managed? (acutely and long term)
Differentiate between central diabetes insipidus and nephrogenic diabetes insipidus (causes).
What is Bartter’s syndrome?
Group of autosomal recessive disorders with impaired salt reabsorption in the thick ascending loop of Henle with pronounced salt wasting, hypokalaemic metabolic alkalosis, and hypercalciuria
ACTS ON SAME RECEPTORS AS FUROSEMIDE
What are the clinical consequences of Bartter’s syndrome?
With this underlying condition- electorlytes imbalances eg due to diarrhoea and vomiting can cause serious issues- may need to be admitted to hospital and given fluids to restore balance
Give some of the symptoms/complications caused by systemic lupus erythematosus.
A patient known to have SLE comes into A&E with worsening rash, mouth ulcers and joint pains. A renal biposy is done and it shows:
What medication is she given?
You are presented with the following patient:
It turns out this patient has kidney stones. They are treated with percutaneous nephrolithotomy. How could this situation have been prevented and how can it be prevented in the future?
Is haematuria more concerning if it is painful or painless?
- Painless- more suggestive of carcinoma
- Painful- suggestive of UTI
A transurethral resection of bladder tumour (TURBT) can be done for suspected transitional cell carcinoma. How is it done?
If a patient has a tumour of the lower urinary tract, it may require a chemotherapy and a cystectomy followed by bladder reconstruction using the ileum. What consequences can this have (if you haven’t got an ileum)?
Give some examples of long term complications of CKD that the GP should check for:
