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Renal 2020 > 4th Year Additions > Flashcards

4th Year Additions Flashcards

1
Q

what happens if hydronephrosis causes a reduction in kidney function?

A

post-renal AKI

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2
Q

options for relieving blockage in urinary tract?

A

nephrostomy (drain inserted into the back)
urethral catheter
suprapubic catheter

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3
Q

what is idiopathic hydronephrosis?

A

narrowing of the pelvicureteric junction (PUJ)

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4
Q

management of idiopathic hydronephrosis

A

pyeloplasty

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5
Q

what is vesicoureteral reflux?

A

urine refluxing from the bladder back into the ureters

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6
Q

where is the renal angle?

A

12th rib and vertebral column posteriorly

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7
Q

catheter indications

A 
pre-surgery
post-surgery
monitoring UO in unwell patient
relieve obstruction
neurogenic complications
medication delivery
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8
Q

what cells produce PSA?

A

epithelial cells in the prostate

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9
Q

what is orchitis?

A

inflammation of the testicle

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10
Q

parotid gland swelling + orchitis?

A

mumps (can also cause pancreatitis)

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11
Q

presentation of epididymo-orchitis

A 
pain
dragging/ heavy sensation
swelling
urethral discharge
systemic symptoms
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12
Q

management of epididymo-orchitis

A

ofloxacin

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13
Q

management of prostatitis

A

ciprofloxacin

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14
Q

causes of testicular lumps

A 
hydrocele
varicocele (should disappear when lying flat)
epididymal cyst
testicular cancer
epididymo-orchitis
inguinal hernia
testicular torsion
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15
Q

what can a left-sided varicocele indicate?

A

renal cell carcinoma (obstruction to left testicular vein as it drains into the left renal vein)

also called Stauffer’s syndrome

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16
Q

what to consider if varicocele does not disappear when lying flat?

A

retroperitoneal tumour

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17
Q

leydig tumour presentation

A

testicular cancer

gynaecomastia

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18
Q

risk factors for bladder cancer

A

dyes and rubber (aromatic amines)
smoking
schistosomiasis (SCC)

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19
Q

management of bladder cancer

A 
resection
cystectomy
chemotherapy
BCG vaccine
urostomy (ileal conduit)
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20
Q

most common type of kidney stone?

A

calcium oxalate

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21
Q

types of kidney stones

A

calcium stones
uric acid
struvite
cystine

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22
Q

conservative/ lifestyle management of renal stones

A 
increase oral fluid intake
add lemon juice
avoid carbonated drinks
reduced salt
maintain calcium intake

recurrence= potassium citrate or thiazides

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23
Q

most common types of renal cell carcinomas

A

clear cell
papillary
chromophobe

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24
Q

who get’s Wilm’s tumour?

A

<5

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25
Q

renal transplant typical immunosuppression regime?

A

tacrolismus
mycophenolate
prednisolone

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26
Q

side effect of renal transplant immunosuppression

A

seborrheic warts and skin cancer
tacrolimus= tremor
cyclophosphamide= gum hypertrophy
cushing’s

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27
Q

renal biopsy criteria

A

BP <160/95
Hb >9
platelets >100
clotting/ stopping anticoagulants

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28
Q

do renal patients have ideal weight?

A

yes

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29
Q

where does Fanconi’s syndrome affect in the kidney?

A

PCT

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30
Q

what are thiazides good for?

A

OP and renal stones

caution in gout and DM

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31
Q

what can acute tubulointerstitial nephritis present with?

A

eosinophilia

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32
Q

what is erectile dysfunction?

A

inability to maintain or develop an erection during sex

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33
Q

causes of ED

A 
finasteride
psychological
back/pelvic trauma
stroke
MS
endocrine
hypertension/ diabetes
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34
Q

point and shoot

A

erection is parasympathetic and ejaculation is sympathetic

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35
Q

what is an indicator that ED is psychogenic?

A

spontaneous morning erection

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36
Q

management of ED

A

PDE-5 inhibitors e.g. sildenafil
testosterone treatment
vacuum erection devices
prosthetic implants

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37
Q

side effect of azathioprine

A

bone marrow suppression

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38
Q

ciclosporin side effect

A

lymphoma

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39
Q

what antibiotic should be avoided in renal transplant?

A

trimethoprim

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40
Q

causes of green urine

A

amitriptyline

propofol

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41
Q

causes of white urine

A

pyuria

phosphate crystals

42
Q

what can cause hyaline casts

A

diuretics

43
Q

what does uric acid crystals + ARF indicate?

A

tumour lysis syndrome

44
Q

what is TURP-syndrome?

A

hyponatraemia post-TURP due to glycerine and venous plexus absorption

45
Q

how to calculate anion gap?

A

(Na+ + K+) – (Cl- + HCO3-).

indicator this needs to be done is being given chloride in the question

46
Q

normal anion gap?

A

10-14 or 8-14?

47
Q

normal anion gap metabolic acidosis causes

A

GI losses
RTA
acetazolamide
addison’s

48
Q

raised anion gap metabolic acidosis causes

A

lactate
ketones
urate
acid poisoning (salicylates)

49
Q

definition of AKI

A

rise in creatine to >26umol/L

<0.5 urine UO for >6 hours

50
Q

causes of peritonitis on PD

A

staph epidermidis

staph aureus

51
Q

management of peritonitis while on PD

A

vanc + ceftazidime or ciprofloxacin

52
Q

usual immunosuppression regime in renal tranpslant

A

tacrolismus
mycophenolate
prednisolone

53
Q

management of septic renal stones

A

percutaneous nephrostomy

JJ stent

54
Q

management of of stones <7mm

A

repeat CT in 3-4 weeks

55
Q

management of stones >7mm

A

shock wave lithotripsy
laser lithotripsy
ureteric stents (last 1 year)

56
Q

screening for diabetic neprhopathy?

A

annual ACR

57
Q

ACR that indicates microalbuminuria

A

> 2.5

58
Q

when are diabetics given ACEI?

A

ACR >3

59
Q

TNM staging for renal cell carcinoma

A

T1 <7cm
T2 >7cm
T3 beyond
T4 beyond Gerota’s fascia

60
Q

what is acute tubular necrosis?

A

death of epithelial cells

61
Q

can you recover from acute tubular necrosis?

A

yes, epithelial cells regenerate in 7-21 days

62
Q

diagnosis of ATN

A

muddy brown casts

63
Q

management of ATN

A

IV fluids

stop nephrotoxics

64
Q

what acidosis does RTA cause?

A

hyperchloremic metabolic acidosis

65
Q

four types of RTA?

A
  • Type 1= distal tubule is unable to secrete H+
  • Type 2= proximal tubule unable to resorb bicarbonate, usually Fanconi’s anaemia
  • Type 3= combination of above
  • Type 4= lack of aldosterone
66
Q

what is rhabdomyolysis?

A

muscle cell death releasing myoglobin, K+, phosphate and CK

67
Q

how does rhabdomyolysis cause AKI?

A

myoglobin release

68
Q

diagnosis of rhabdomyolysis

A

CK
U&Es
urinalysis
ECG

69
Q

management of rhabdomyolysis

A

IV fluids
IV sodium bicarbonate (for myoglobin)
hyperkalaemia management if needed

70
Q

when to review alpha blockers?

A

6 weeks

71
Q

how long do 5-alpha reductase inhibitors take to work?

A

6 months

72
Q

superficial bladder cancer management

A

resection, chemo

73
Q

invasive bladder cancer management

A

radical cystectomy

radical radiotherapy

74
Q

when to avoid trimethoprim for treatment of UTI?

A

first trimester (folate antagonist)

75
Q

when to avoid nitrofurantoin in UTI?

A

3rd trimester (haemolysis)

76
Q

hormonal therapies used in prostate cancer

A

anti-androgens (testosterone antagonists) e.g. bicalutamide
GnRH agonists (goserelin
GNRH e.g. degarelix (bone spread)
bilateral orchidectomy

77
Q

what must be used with GnRH antagonists?

A

anti-androgen cover as initially increases test and can cause spinal cord compression

78
Q

examples of anti-androgens

A

bicalutamide
cyproterone acetate
flutamide

79
Q

side effects of finasteride?

A

ED

secreted into semen so needs condoms

80
Q

what causes green urine?

A

amitriptyline

propofol

81
Q

what is TURP syndrome?

A

hyponatraemia post-TURP due to venous damage

82
Q

how to calculate the anion gap?

A

(Na+ + Cl-) - (H+ + HCO3-)

83
Q

what is the normal range of the anion gap?

A

8-14mmol/L

84
Q

causes of normal anion gap?

A

hyperchloraemic metabolic acidosis

  • GI bicarbonate loss (diarrhoea)
  • RTA
  • drugs e.g. acetazolamide
  • ammonium chloride injection
  • Addison’s
85
Q

causes of a raised anion gap?

A

lactate ( shock, sepsis, hypoxia, metformin)
ketones (DKA, alcohol)
urate (renal failrue)
acid poisoning (salicylate, methanol)

86
Q

swelling that you cannot get above in teh testicle?

A

hernia

87
Q

which swelling is separate from the body of the testicle?

A

epididmyal cyst

88
Q

diagnosis of urethral injury

A

ascending urethrogram

89
Q

which diuretics cause renal stones?

A

loop

90
Q

ACR sample

A

first pass urine

91
Q

paediatric fluid prescribing

A

100ml/24 hours for every 0-10 kg
50ml/24 hours for every 11-20kg
20ml for each kg after that

92
Q

maximum K+ infusion rate?

A

10mmol/hr

93
Q

DI results

A

high plasma osmolality

low urine osmolality

94
Q

what GFR should you stop metformin?

A

<45

statins <10

95
Q

can you continue aspirin in AKI?

A

yes if cardioprotective dose (75mg)

96
Q

what does fat stranding indicate?

A

recent passage of stone

97
Q

method for removing stones if pregnant?

A

ureteroscopy

98
Q

USS criteria for ADPKD

A
  • two cysts, unilateral or bilateral if aged <30
  • two cysts in both kidneys if aged 30-59
  • four cysts in both kidneys if aged >60
99
Q

staging of hyperkalaemia

A 
mild= 5.5-5.9
mod= 6.0-6.4
severe= 6.5 or more
100
Q

which drug should be held before coronary angiography?

A

metformin if at risk of contrast induced nephropathy

Renal 2020 (26 decks)

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