Anatomy of the kidney

Question 1

What is reflux nephropathy?

Answer 1

Incompetant vesicoureteric junction - on voiding urine passes up ureter. On completion of voiding urine returns to bladder. Risk of stagnation of infection - pyelonephritis, injury and scarring. CKD.

Question 2

What is the clinical presentation of reflux nephropathy?

Answer 2

Child with - fever of unknown origin, fails to meet develomental milestones (bedwetting).

Treatment - prophylactic antibiotics.

Question 3

What are the anatomical findings of reflux nephropathy?

Answer 3

Irregular renal outline, clubbed calyces, cortical scars, dilated ureter and incompetant valve.

Question 4

What would you suspect if you found haematuria in a person under 45 years?

Answer 4

Glomerulonephritis (inflammation in glomerulus) - refer renal physician.

Question 5

What would you suspect if you saw haematuria in a patient older than 45 years?

Answer 5

Supect lesion - refer to urologist.

Question 6

What are the clinical features of nephrotic syndrome?

Answer 6

Proteinuria, hypoalbuminaemia, oedema and hypercholesterolaemia.

Question 7

What is the aetiology of nephrotic syndrome?

Answer 7

Injury to the epithelial foot processes of the nephron - minimal change disease (children), membranous nephropathy, amyloid, focal segmental glomerulosclerosis