Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Renal > Background Renal Disease and Haematuria > Flashcards

Background Renal Disease and Haematuria Flashcards

1
Q

What are the functions of the kidney [8]

A 
Body fluid homeostasis
Electrolyte homeostasis
Acid base balance
Regulate BP
Remove physiological waste 
Vit D production 
Erythropoietin production 
Renin production
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

How do you measure kidney function [6]

A 
Dipstick 
eGFR 
U+E
BP
Urine output - good for acute illness 
Cystatin C
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is shown on dipstick and what does it suggest [9]

A 
Protein 
Haematuria
Leucocytes = UTI
Nitrites = gram -ve UTI 
Glucose = DM / preg / sepsis 
Ketones = DKA / starvation
Bilirubin = haemolysis 
Urobilinogen = haemolysis / liver disease
Specific gravity = dehydration
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is urea and what does increased level suggest [6]

A 
Breakdown product of AA so protein catabolism will increase
ACUTE GI BLEED
Acute illness
Increased intake
Steroids 
Dehydration
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What causes decreased urea

A

Liver disease

As its made in the liver

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

How do you differentiate a high urea caused by renal or dehydration [2]

A

Dehydration

  • Higher urea rise than creatinine
  • Associated hypernatramia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is creatinine [2]

A

By product of protein turnover

Higher risk in AKI than urea

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What causes other electrolyte disturbances

A

Renal disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is cystitis C

A

Predictor of CVD disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What does proteinuria suggest [5]

A 
GN
DM
Amyloidosis 
Myeloma 
Increased risk of CVD disease
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What should you do if proteinuria found on dipstick [4]

A

Bloods for CVD disease + autoimmune screen
ACR - picks up earlier stage
PCR
24 hour urine collection = gold standard

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are indications for renal biopsy [4]

A

Protein >1g / day
Decreased renal function but normal sized kidney
Suspected RPGN
Suspected multi-system disease e.g. RA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What does an atrophied kidney suggest

A

Damage been there for a while

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

How is a renal biopsy completed [3]

A

LA
USS guidance
Go in lower pole fixed in inspiration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are the main complications of renal biopsy and how do you prevent [4]

A

Haemorrhage

  • Check platelet, BP, coag
  • Stop anti-coagulation
  • Stay in bed 24 hours post
  • No heavy lifting for 2 weeks
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What should you do after biopsy [2]

A

Light + electronmicroscopy to see tubules

Immunoflurescence for immune deposition - IgA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What should you do if dysuria, frequency, nocturia, urgency

A

Primary Ddx = UTI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What suggests prostatic aetiology [3]

A

Difficulty initiating
Poor stream
Dribbling

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What should you do if oliguria

A

Assessment and investigation of AKI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is most common cause of polyuria and other DDX [5]

A 
High fluid intake = most common
DM
DI 
Hypercalcaemia
Renal medullary = impaired concentration
21
Q

What does loin colic pain suggest

A

Stone or clot

22
Q

What does loin constant pain suggest [3]

A

Pyelonephritis
Renal cyst
Infarct

23
Q

What are differentials of visible haematuria [3]

A

Malignancy
PKD
Glomerulus disease

24
Q

What do you do if someone presents with oedema/ nephrotic [2]

A

Dipstick to avoid missing renal disease

Biopsy if adult

25
Q

What are features of symptomatic CKD [8]

A 
Dyspnoea
Anaemia 
Weight loss
Pruritus
Bone pain
Sexual
Cognitive decline
26
Q

How is metabolic acidosis classified [2]

A

Normal anion gap

Raised anion gap

27
Q

What is the anion gap?

A

Na+K - Cl+HCO3
Normal = 10-18
If question supplies Cl then indicates to calculate to work out cause

28
Q

What will cause a normal anion gap? [5]

A 
Loss of bicarb or increase in H = acidosis
Addison's
Diarrhoea
Pancreatic fistula
Renal tubular acidosis 
Drugs
29
Q

What causes a raised metabolic acidosis [4]

A

Ketones - DKA / alcohol
Lactic acdisois
Urate renal failure
Acid poison

30
Q

What causes lactic acidosis [4]

A

Shock
Sepsis
Hypoxia
Metformin

31
Q

What causes a metabolic alkalosis?

A 
Loss of H or gain in bicarbonate 
Activation of RAAS due to ECF depletion - reabsorb Na in exchange for H 
Hypokalaemia - K shift out in exchange for H
Vomiting
Aspiration
Diuretic 
Primary aldosteronism - Conn's 
Cushing's
32
Q

What can haematuria be classed as [3]

A

Visible
Non-visible symptomatic
Non-visible asymptomatic

33
Q

What are important tests after haematuria found

A

Dipstick + urine culture to exclude UTI
ACR / PCR
FBC, U+E incase refer to renal
BP

34
Q

What are causes of haematuria in order of most common [4]

A

UTI / infection (urethritis)
Stone
Malignancy - often painless
GN

35
Q

What are other causes of hematuria

A 
TB
Obstruction 
Prostate / bladder / penile / renal / ureter malignany 
BPH 
Renal vein thrombosis - due to carcinoma 
Alport
PCKD 
Rhabdomyolysis
Coagulopathy
AV malformation
Endometriosis
Schistosomiasis
Catherer
RT 
Drugs that cause nephritis 
Dehydration 
Menstruation
Exercise
Sex
36
Q

What causes renal vein thrombosis

A

Malignancy

37
Q

Haematuria + other Sx and what do these indicate? [4]

A

Painless + smoking Hx = TCC
Mild renal impairment / painless = PCKD
Prostate Sx = BPH or catheter
Confusion = UTI / AKI

38
Q

Can you attribute haematuria to anti-coagulant

A

NO

Always investigate

39
Q

What do you do for all haematuria >40 [5]

A 
Exclude UTI 
U+E, PCR, BP
Urology assessment 
Renal USS or 
CT if RF or FH 
\+ cystoscopy to exclude malignancy

2 weeks if VH (25%)
4 weeks if NVH (5%)

40
Q

When should you refer [6]

A 
eGFR <60
Proteinuria
Hypertension
FH renal / cancer
Dysuria 
WCC raised
41
Q

What should also get referral in elderly [2]

A

> 60

Persistent UTI

42
Q

When do you admit to ward? [2]

A

If clot retention

Suspected Hb drop

43
Q

What suggest clot retention

A

Had visible haematuria

Now no urine output

44
Q

How do you manage clot retention [5]

A 
ABCDE 
Transfuse if <80 or <100 + IHD
Catheter +- wash out 
TWOC
Outpatient USS + cystoscopy
45
Q

Young female presents with hematuria [3]

A

MSSU
Pregnancy test
Renal USS

46
Q

What do you do if ongoing haematuria [2]

A

Irrigation

USS to look for clot / theatre to evacuate

47
Q

What do you do if no cause of haematuria found [4]

A

BP, eGFR, ACR every 6 months

48
Q

What do you do if <40, NVH, normal renal and no BP and bo protein

A

Manage primary care

Renal (29 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions