Conditions summary Flashcards
lemon yellow skin fatigue weight loss nocturia GFR 65
G2 stage CKD
treatment of G1-G4 stage CKD (3)
ACE inhibitor
statins
lifestyle - decrease Na, K, PO4, fluid restriction
monitor GFR regularly
treatment of G5 stage CKD (established renal failure)
dialysis/transplant
CKD diagnosis
bone pain
fractures
vascular calcification
CKD mineral bone disease (causing secondary hyperparathyroidism bc calcium turn into calcium phosphate so is actually low)
CKD mineral bone disease treatment
alfacidol (hydroxylated vit D)
phosphate binders eg calcium carbonate
diarrhoea
oliguria (<0.5ml/kg/hour)
creatinine has more than doubled in last 24 hours
pre renal AKI (hypo perfusion)
untreated pre renal AKI (from hypoperfusion)
muddy brown casts of epithelial cells
acute tubular necrosis
treatment of acute tubular necrosis
fluids
bc the cause is untreated hypovolaemia
old person/alcoholic thats collapsed and lay on floor for 2 days before being found
oliguria <0.5ml/kg/hour
‘coca cola urine’
rhabdomyolysis causing renal AKI
AKI with inadequate monitoring (lazy nurses)
arrhythmias
hyperkalaemia
treatment of hyperkalaemia (associated with AKI) (4)
calcium gluconate
insulin dextrose
salbutamol nebulised
dialysis if K>7
proteinuria/haematuria
caused by either drugs (gold, penicillin, NSAIDs) or immune (lupus, ANCA pos vasculitis, good pastures)
glomerulonephritis
treatment of glomerulonephritis generally
ACE inhibitor/ARB
steroids (prednisolone 40-60mg)
glomerulonephritis
1-3 weeks after URTI
glomerular crescents on histology of biopsy
acute rapidly progressive glomerulonephritis
glomerulonephritis
rusty coloured urine after recent URTI/gastroenteritis
mesangial proliferation = haematuria
HSP purpuric skin rash on extensor surfaces
IgA nephropathy
chromosome 16 mutation in adults chronic flank pain palpable kidney hypertension! (with no other cause)
10 years later - hepatic cysts, berrys aneurysm
polycystic kidney disease (PCK) autosomal dominant
treatment of polycystic kidney disease (PCK) (autosomal recessive and dominant)
ACE inhibitor/ARB
tolvaptan
chromosome 6 mutation renal failure with hepatic lesions in a kid hypertension abdo mass renal failure
autosomal recessive polycystic kidney disease (PCK)
sensorineural hearing loss haematuria bulging of lens in eye x linked genetic condition thickened glomerular basement membrane from type IV collagen deposition
alports syndrome
lysosomal storage disease (every where = hence lots of random symptoms)
angiokeratoma (blue dots in umbilical area)
renal failure
Anderson fabrys disease
alports syndrome treatment
ACE inhibitor/ARB
Anderson fabrys disease treatment
fabrysyme enzyme replacement
20 y/o
genetic condition causing decreased kidney size
= polyuria, polydipsia, enuresis (unable to concentrate urine)
medullary cystic kidney
treatment of medullary cystic kidney
transplant (bc young)
genetic condition
renal medulla looks like a sponge from dilation of collecting ducts
medullary sponge kidney
tuberose sclerosis patient
abdo mass
CT scan - lots of fat and blood vessels in kidney
angiomyolipoma (fat/blood vessel filled benign renal tumour)
fluid filled lumps in kidney picked up as an incidental finding on US/CT
asymptomatic, no pain
benign renal cyst
benign renal cyst treatment
nothing - reassure patient
central scar in kidney on CT
abdo mass
nephrectomy - but not a renal cell carcinoma (couldnt tell until you took it out)
oncocytoma
most common abdo mass in kids
nephroblastoma (wilms tumour)
60 y/o male obese haematuria flank pain abdo mass hypertension
mass in kidney >3cm on CT
renal cell carcinoma (though probs cant tell until you take it out, might be a oncocytoma)
treatment of renal cell carcinoma (4)
?????? check this full nephrectomy - rare, if big PARTIAL NEPHRECTOMY - to retain some GFR radio ablation - if small tyrosinekinase inhibitors
loin to groin pain
10/10 pain, nothing makes it better
sudden onset
KUB xray then CT done
kidney stones
kidney stones initial treatment (3)
NSAIDs for pain
thiazide diuretic
alpha blocker
kidney stones treatment 1 month after initial presentation and still present
stent
woman
recently married
painful peeing (dysuria)
no microorganisms on culture
honeymoon cystitis (damage to urethra causing cystitis (inflammation))
supra pubic pain
burning pain when passing urine
nocturia
haematuria
lower UTI (Cystitis)
loin pain fever rigors malaise dysuria (pain/burning when passing urine)
upper UTI (pyelonephritis)
UTI treatment (4 options)
uncomplicated - trimethoprim/nitrofurantoin PO 3 days
males cystitis - trimethoprim/nitrofurantoin PO 7 days
complicated in GP - coamoxiclav/cotrimoxazole PO 14 days
complicated in hospital - amoxicillin/cotrimoxazole AND gentamicin IV 3 days
honeymoon cystitis treatment
carbonic anhydrase inhibitor (not an infection)
chronic smoker
leakage when coughing/laughing
stress incontinence
drinks caffeine
leakage when hearing water running/standing up
urge incontinence
stress incontinence treatment
stop smoking, increase exercise, loose weight
bladder retraining
duloxetine (rarely)
transvaginal tape
urge incontinence treatment
decrease caffeine/alcohol
oxybutynin (antimuscarinic)
botox injection
>50 y/o worked in a dye factory smoker painless haematuria sea anemone on cystoscopy
transitional cell bladder cancer
transitional cell bladder treatment
TURBT
cystectomy
stoma for urine
painless haematuria
schistosomiasis bladder infection
squamous cell carcinoma of bladder
> 65 y/o
bone pain (osteosclerotic mets)
weight loss
haematuria, no other urinary symptoms
investigation and result
prostate cancer
PR exam - hard, asymmetrical
PSA high
prostate cancer treatment
hormone therapy - if low risk
OR
surgery/chemo - if high risk
radiotherapy - if bone mets
urinary symptoms - incomplete voiding, urgency
smooth symmetrically enlarged prostate on PR exam
PSA high
benign prostatic hyperplasia
benign prostatic hyperplasia treatment
alpha blocker (tamsulosin))
5 alpha reductase inhibitor (finasteride)
TURP surgery
painless testicular swelling 20-30 y/o looks like a potato on pathology PLAP tumour marker lymphatic spread
seminoma
painless testicular swelling 30-50 y/o cysts, haemorrhage etc on pathology AFP and bHCG tumour marker haematogenous spread
teratoma
seminoma testicular cancer treatment
surgery (orchidectomy) and radiotherapy
teratoma testicular cancer treatment
surgery (orchidectomy) and chemo
neonate
nausea and vomiting, systemically unwell
red and bruised testicle
testicular torsion
teenager
wakes up in the middle of the night with excruciating scrotal pain
bellclappers deformity
red and bruised testicle
testicular torsion
testicular torsion treatment
emergency surgery
teenager
wakes up in the middle of the night with excruciating scrotal pain
blue dot on inspection
torsion of appendage
teenager
wakes up in the middle of the night with excruciating scrotal pain
red and bruised scrotum
take them to theatre and no testicular torsion
epididymitis
red and swollen testicle but with little pain
itchy
red groin
idiopathic scrotal oedema
idiopathic scrotal oedema treatment
antihistamines
pain relief if necessary
NOT surgery
painful swelling of foreskin
paraphimosis
prolonged erection >4 hours
priapism
priapism treatment if ischaemic
blood aspiration
priapism treatment if non ischaemic
cold packs, compression
genital swelling used to be cellulitis (swollen, red) now has purple areas crepitus air spaces on xray
fourniers gangrene (necrotising fasciitis of male genitalia)
fourniers gangrene (necrotising fasciitis of male genitalia) treatment
antibiotics and debridement
