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Medicine, Year 3, Metabolic Medicine > Clinical Topic 4: Benign Urological Disease > Flashcards

Clinical Topic 4: Benign Urological Disease Flashcards

1
Q

What is the vertebral reference for the kidneys location? Are they retroperitoneal or intraperitoneal?

A

T12 to L3

Retroperitoneal

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2
Q

State the names of the six types of kidney stones

A 
Calcium Oxalate stones
Calcium Phosphate stones
Uric acid stones
Struvite stones
Cysteine stones
Xanthine stones
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3
Q

Which renal calculi are radioluscent?

A

Uric acid stones

Xanthine stones

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4
Q

Which renal calculi are radiopaque?

A

Calcium oxalate stones
Calcium phosphate stones
Struvite stones

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5
Q

Which renal calculi are semi-radiopaque?

A

Cysteine stones

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6
Q

What is the most common type of renal calculi?

A

Calcium oxalate

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7
Q

What three things are Struvite renal calculi made up of?

A

Magnesium
Phosphate
Ammonium

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8
Q

What are the symptoms of Renal Calculi?

A

Renal colic, loin pain, nausea and vomiting, haematuria, dysuria, fever

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9
Q

What is the most common analgesia prescribed for Renal colic? How is it administered?

A

Diclofenac, IM

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10
Q

Which Renal calculi are associated with strictly acidic urine?

A

Uric acid stones

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11
Q

Which Renal calculi are associated with strictly alkaline urine?

A

Struvite stones

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12
Q

Which Renal calculi are commonly associated with Infection? What is the infectious agent?

A

Struvite stones

Associated with Proteus miribalis, Proteus vulgaris, Morganella morgani

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13
Q

Which Renal calculi form “staghorn” structures?

A

Struvite stones

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14
Q

Which Renal calculi are associated with a genetic condition? What is the genetic condition? What is the inheritance pattern?

A

Cysteine stones, commonly associated with Cysteineuria (autosomal recessive)

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15
Q

What are the three risk factors of Oxalate renal calculi formation?

A

Hypercalcaemia
Hypercalcuria
Hyperoxaluria (increased intake of oxalate rich foods such as rhubarb, spinach, chocolate)

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16
Q

Uric acid renal calculi are associated with which other condition?

A

Gouty arthritis

17
Q

The British Association of Urological Surgeons (BAUS) recommend which investigation of choice for suspected Renal Calculi? Under what time frame?

A

Non-contrast CT KUB within 14 hours

18
Q

What is the treatment for removing Renal Calculi?

A

Most stones < 5 mm will pass spontaneously

Otherwise, Lithotripsy or Nephrolithitomy is indicated

If there is several stones together plus infection, decompression is needed via Nephrostomy, Ureteric catheters and Ureteric stents

19
Q

What is the first most common causative agent of a Urinary Tract Infection?

A

E. coli

20
Q

What are some risk factors to a UTI?

A
  • Sexual intercourse (honeymoon’s cystitis)
  • Being female
  • Diabetes mellitus
  • Post menopausal women
  • Use of catheters
  • Uncircumsized young men
  • Urinary stasis
21
Q

What is the treatment for a UTI in non-pregnant women?

A

3 day course of Nitrofuratoin or Trimethoprim

22
Q

What are the four types of Incontinence?

A

Urge Incontinence
Stress Incontinence
Overflow Incontinence
Mixed Incontinence (Urge + Stress)

23
Q

What is the first-line treatments for Urge Incontinence?

A

Bladder training exercises

Anti-muscarinic drugs

24
Q

What is the first-line treatments for Stress Incontinence?

A

Pelvic floor kegel exercises

25
Q

What are the common symptoms associated with Urge Incontinence?

A

Having a sudden urge to urinate due to an overactive bladder. Typically urination occurs whilst asleep

26
Q

What are the common symptoms associated with Stress Incontinence?

A

Precipitated by coughing, sneezing, laughing, putting pressure on abdomen

27
Q

RENAL STONES

  1. What are some bedside, blood and imaging tests used to investigate Renal Stones?
  2. What is the conversative, medical and surgical management of Renal Stones?
A
  1. Bedside: Baseline observations, urine dipstick, urine MC&S

Bloods: FBC, U&E, CRP, Coagulation screen, Cultures, Bone profile i.e. Ca2+, VBG for lactate ?sepsis

Imaging: Non-contrast CT KUB within 14 hours

  1. Conservative management: If below 5mm, allow to pass expectantly. Plentiful hydration, low salt diet, low purine diet (avoid red meat, shellfish), low oxalate rich foods (chocolate, rhubarb, spinach, beer)

Medical management: IV Fluids, IV anti-emetics, IM / PR diclofenac.

For prevention: Allopurinol for uric acid stones, Thiazides for Calcium stones, Cholestyramine and Pyridoxine for reducing oxalate secretion, urinary alkalinisation i.e. sodium bicarbonate

Surgical management: Shockwave lithotripsy, percutaneous nephrolithotomy (if staghorn / complex), ureteroscopy (if pregnant). If infective / multiple stones, consider decompression with nephrostomy, catheters and stents

Medicine, Year 3, Metabolic Medicine (9 decks)

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