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8. Urology (Clinical Skills) > Clinical Examination: Renal > Flashcards

Clinical Examination: Renal Flashcards

1
Q

Define urinary frequency

A

Abnormally frequent urination

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2
Q

Define urinary urgency

A

A sudden, strong need to urinate

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3
Q

Define nocturia

A

Need to urinate at night

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4
Q

Define polyuria

A

Excessive or abnormally large production or passage of urine (>2.5 L/ 3L and over in 24 hrs)

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5
Q

Define oliguria

A

Urine output of <0.5 ml/kg/hr

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6
Q

Define haematuria

A

Presence of blood in urine

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7
Q

Define Incontinence (Stress / Urge)

A
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8
Q

Define Incomplete emptying of bladder

A
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9
Q

Define acute urinary retention

A
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10
Q

Define chronic urinary retention

A

a persistent inability to completely empty the bladder despite maintaining an ability to urinate

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11
Q

Define fever

A

an elevation of body temperature above the normal daily variation

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12
Q

Define hesitancy

A

Involuntary delay in initiating urination

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13
Q

Define poor strem

A

Difficulty starting or maintaining a urine stream

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14
Q

Define dribbling

A

Involuntary leakage of urine

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15
Q

Define erectyle dysfunction

A

the inability to get and keep an erection firm enough for sex

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16
Q

What is important to do when performing urinary exam in females?

A

Also take gynea Hx

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17
Q

Define anuria

A

Absolute Anuria: no urine output
Relative Anuria: <100ml urine output in 24 hrs

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18
Q

Define proteinuria

A
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19
Q

In which patients is dialysis routine treatment?

A

Acute and chronic renal failure

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20
Q

What is haemodialysis?

A

A dialyser filters electrolytes and fluid from the blood when the kidneys are not functioning enough to do this adequately.

21
Q

What is peritoneal dialysis (PD)?

A

Procedure in which peritoneum in a patient’s abdomen is used as the membrane through which fluid and dissolved substances are exchanged with the blood.

22
Q

If a renal transplant is performed, where is it places?

A

One of iliac fossae

23
Q

What must you not do in a patient with an atreovenous fistula

A
  1. Never measure the blood pressure on the patient’s arm which has an arteriovenous fistula. You may damage the fistula!
  2. Never take blood from the fistula arm or the arm protected for a fistula (usually the non- dominant arm).
24
Q

Initial observation

Go over initial observation/general assessment of urinary system

A
25
Q

Go over introduction of urinary examination

A
26
Q

Section 3: Examination

Go over examination of hands and nails

A
27
Q

What is brown nail pigmentation a sign of?

A

Advanced renal failure

28
Q

Section 3: Examination

Go over examination of both arms

A
29
Q

What is the purpose of an atreovenous fistula?

A

Surgically created fistula to allow vascular access for dialysis in pts with renal failure

30
Q

What are bruising and scratch marks a sign of?

A

Advanced renal failure (can be found on legs too)

31
Q

Section 3: Examination

Go over examination of face and neck

A 
Yellow complexion
Pallor
Fundoscopy
Smell of pts breath: uraemia retro
Examination of JVP
32
Q

What does a yellow complexion indicate?

A

Renal failure

33
Q

What does pallor indicate?

A

Anaemia -> chronic renal failure

34
Q

Why is fundoscopy performed?

A

To check for hypertensive diabetic retinopathy

35
Q

Why is the patients breath examined?

A

Uraemia retro -> chronic renal failure

36
Q

Section 3: Examination

Go over examination of the chest

A
  • Lung base crepitus

* Additional heart sounds

37
Q

Section 3: Examination

Go over examination of the abdomen

A 
Inspect : Scars, Peritoneal dialysis
Palpate : kidney/bladder palpable?
Percussion: palpable bladder ( percussion from upper abdomen in midline towards symphysis pubis
Auscultation: Renal artery bruits
DRE
38
Q

When may a digital rectal examination be indicated in a urinary examination?

A

To examine the prostate as prostatic enlargement can cause urethral and bladder outflow obstruction

39
Q

Section 4: Closure

Go over closure of urinary exam

A
40
Q

What are some common causes of haematuria?

A 
Glomerulonephritis
• Urinary tract infection
• Renal stones
• Tumours of the kidney, ureter, bladder or
prostate
• Acute tubular necrosis
• Distance running or severe exercise
41
Q

What are some causes of proteinuria?

A
  • Diabetes mellitus
  • Glomerulonephritis
  • Infection
  • Severe hypertension
  • Burns
  • Drugs e.g. gold and penicillamine
42
Q

What are confusion and myoclonus signs of?

A

Uraemic encephalopathy

43
Q

What are excoriations a sign of?

A

Uraemic pruritus

44
Q

What is breathlessness a sign of?

Renbal cause

A

Fluid overload

45
Q

What may cause a postural tremor?

A

Calcineurin inhibitor side effects

46
Q

What is asterixis a sign of?

A

Flapping termor -> uraemic encephalopathy

47
Q

What are:
a) Leukonychia
b) Koilonychia
Signs of?

A

a) Hypoalbuminaemia -> nephrotic syndrome
b) Iron deficiency -> nephritic syndrome

48
Q

What may hlow pulse and high heart rate be caused by?

A

Blood loss

49
Q

What are some causes of proteinuria?

A

Diabetes Mellitus
• Glomerulonephritis • Infection
• Severe Hypertension
• Burns
• Drugs e.g. Gold & Penicillam

8. Urology (Clinical Skills) (4 decks)

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