7. BAMS Nephrology Flashcards
Renal Failure and Acute Renal Failure
List 4 features of renal failure
List 3 types of causes of renal failure with examples of each
Features of acute renal failure
Main cause of acute renal failure
Treatment of acute renal failure
Loss of excretory function, loss of acid bace balance, loss of renal endocrine replacement, loss of water/electrolyte balance
Pre-renal (kidney hypo perfusion - shock), intra-renal (drug damage, trauma, chronic disease, rhabdolysis), post-renal (outflow obstruction)
Rapid loss of function (creatinine >200umol/l), anuric with volume overload (ankle/sacral oedema, increase JVP, weight gain, SoB, pulmonary oedema), gradual progression to polyuria, hyperkalaemia, uraemia, acidosis development
Usually pre-renal cause, usually reversible
Support (nutrition, dialysis) until recovery
Chronic Renal Failure
List 2 causes of primary chronic renal failure
List 5 causes of secondary chronic renal failure
Management of chronic renal failure
List 5 symptoms of chronic renal disease
PKD, glomerulonephritis
Diabetes, HTN, renal artery disease, drug therapy, vasculitis
Control underlying causes, correct fluid balance and deficiencies, remove outflow obstruction
Anaemia, HTN, tired, weak, nausea, polyuria, nocturia
Renal Vascular Disease and Malignancies
What 2 things does renal vascular disease cause
When can ESRD be diagnosed
Name 2 types of renal malignancies
Reduced blood flow to kidneys and microangiopathy
When eGFR <15ml/min and creatinine 800-1000umol/l
Renal cell carcinoma, transitional cell carcinoma
Dialysis
What is dialysis
Name 2 types of dialysis and the difference between them
Intermittent correction of changes in plasma concentration of small molecules
Haemodialysis (actively altered, 8hr sessions) and peritoneal dialysis (continuous, daily at home)
Renal Endocrine Replacement and Urinary Tract Diseases
Name 3 ways to improve renal endocrine function
Name optimal ESRD treatment and what it does
List 4 complications of optimal ESRD treatment
What, in urine, suggests infection and why
EPO injection, vitamin D supplement (bone mass maintenance), HTN control (ACE inhibitors)
Transplant - normal energy/fertility, no dietary restrictions, restores renal function
Rejection, immunosuppression, osteoporosis risk, high CV mortality
Urine is usually sterile, so WBCs/microscopic blood suggests infection
Urinary Tract Infections
Affected population
What is the main bacteria associated with UTIs
Name 2 predisposing factors to UTIs
List 4 symptoms of UTI
How is a UTI treated
Females > males (due to urethra length)
E. coli
Poor bladder emptying, low urinary flow rates
Dysuria, offensive smelling urine, cloudy urine, frequency, suprapubic pain
Increase fluid intake, antibiotic (trimethoprim, amoxicillin)
Urinary Tract Obstructions
List 4 symptoms of UOO
What is renal calculi
How is a renal calculi treated
Slow stream, hesitancy, frequency, urgency, nocturia, incomplete voiding
Stones in bladder/kidney
Lithotripsy - ultrasonic sound energy
Prostate Disease
What is BPH
How is it treated
Is prostate adenocarcinoma common
Explain the advantages and disadvantages of PSA in relation to prostate adenocarcinoma
How is it treated
Name the primary site of metastasis from a prostate malignancy
Benign prostate hyperplasia - enlargement of the prostate gland
Surgery - open prostatectomy, TURP and a-adrenergic blockers
Yes - 90% men 90yrs+ have it
PSA - useful for monitoring disease activity in those known to have disease. Problems with specificity/sensitivity exclude PSA use for screening
Surgery, radiotherapy, hormone treatment (block hormone-dependent tumour growth)
Bone
