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J Renal > Conditions summary > Flashcards

Conditions summary Flashcards

1
Q 
lemon yellow skin 
fatigue 
weight loss
nocturia 
GFR 65
A

G2 stage CKD

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2
Q

treatment of G1-G4 stage CKD (3)

A

ACE inhibitor
statins
lifestyle - decrease Na, K, PO4, fluid restriction

monitor GFR regularly

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3
Q

treatment of G5 stage CKD (established renal failure)

A

dialysis/transplant

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4
Q

CKD diagnosis
bone pain
fractures
vascular calcification

A

CKD mineral bone disease (causing secondary hyperparathyroidism bc calcium turn into calcium phosphate so is actually low)

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5
Q

CKD mineral bone disease treatment

A

alfacidol (hydroxylated vit D)

phosphate binders eg calcium carbonate

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6
Q

diarrhoea
oliguria (<0.5ml/kg/hour)
creatinine has more than doubled in last 24 hours

A

pre renal AKI (hypo perfusion)

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7
Q

untreated pre renal AKI (from hypoperfusion)

muddy brown casts of epithelial cells

A

acute tubular necrosis

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8
Q

treatment of acute tubular necrosis

A

fluids

bc the cause is untreated hypovolaemia

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9
Q

old person/alcoholic thats collapsed and lay on floor for 2 days before being found
oliguria <0.5ml/kg/hour
‘coca cola urine’

A

rhabdomyolysis causing renal AKI

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10
Q

AKI with inadequate monitoring (lazy nurses)

arrhythmias

A

hyperkalaemia

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11
Q

treatment of hyperkalaemia (associated with AKI) (4)

A

calcium gluconate
insulin dextrose
salbutamol nebulised
dialysis if K>7

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12
Q

proteinuria/haematuria

caused by either drugs (gold, penicillin, NSAIDs) or immune (lupus, ANCA pos vasculitis, good pastures)

A

glomerulonephritis

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13
Q

treatment of glomerulonephritis generally

A

ACE inhibitor/ARB

steroids (prednisolone 40-60mg)

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14
Q

glomerulonephritis
1-3 weeks after URTI
glomerular crescents on histology of biopsy

A

acute rapidly progressive glomerulonephritis

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15
Q

glomerulonephritis
rusty coloured urine after recent URTI/gastroenteritis
mesangial proliferation = haematuria
HSP purpuric skin rash on extensor surfaces

A

IgA nephropathy

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16
Q 
chromosome 16 mutation 
in adults 
chronic flank pain 
palpable kidney 
hypertension! (with no other cause)

10 years later - hepatic cysts, berrys aneurysm

A

polycystic kidney disease (PCK) autosomal dominant

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17
Q

treatment of polycystic kidney disease (PCK) (autosomal recessive and dominant)

A

ACE inhibitor/ARB

tolvaptan

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18
Q 
chromosome 6 mutation 
renal failure with hepatic lesions in a kid
hypertension 
abdo mass 
renal failure
A

autosomal recessive polycystic kidney disease (PCK)

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19
Q 
sensorineural hearing loss 
haematuria 
bulging of lens in eye 
x linked genetic condition 
thickened glomerular basement membrane from type IV collagen deposition
A

alports syndrome

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20
Q

lysosomal storage disease (every where = hence lots of random symptoms)
angiokeratoma (blue dots in umbilical area)
renal failure

A

Anderson fabrys disease

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21
Q

alports syndrome treatment

A

ACE inhibitor/ARB

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22
Q

Anderson fabrys disease treatment

A

fabrysyme enzyme replacement

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23
Q

20 y/o
genetic condition causing decreased kidney size
= polyuria, polydipsia, enuresis (unable to concentrate urine)

A

medullary cystic kidney

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24
Q

treatment of medullary cystic kidney

A

transplant (bc young)

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25
Q

genetic condition

renal medulla looks like a sponge from dilation of collecting ducts

A

medullary sponge kidney

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26
Q

tuberose sclerosis patient
abdo mass
CT scan - lots of fat and blood vessels in kidney

A

angiomyolipoma (fat/blood vessel filled benign renal tumour)

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27
Q

fluid filled lumps in kidney picked up as an incidental finding on US/CT
asymptomatic, no pain

A

benign renal cyst

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28
Q

benign renal cyst treatment

A

nothing - reassure patient

29
Q

central scar in kidney on CT
abdo mass
nephrectomy - but not a renal cell carcinoma (couldnt tell until you took it out)

A

oncocytoma

30
Q

most common abdo mass in kids

A

nephroblastoma (wilms tumour)

31
Q 
60 y/o male 
obese
haematuria 
flank pain 
abdo mass
hypertension

mass in kidney >3cm on CT

A

renal cell carcinoma (though probs cant tell until you take it out, might be a oncocytoma)

32
Q

treatment of renal cell carcinoma (4)

A 
?????? check this 
full nephrectomy - rare, if big 
PARTIAL NEPHRECTOMY - to retain some GFR
radio ablation - if small 
tyrosinekinase inhibitors
33
Q

loin to groin pain
10/10 pain, nothing makes it better
sudden onset
KUB xray then CT done

A

kidney stones

34
Q

kidney stones initial treatment (3)

A

NSAIDs for pain
thiazide diuretic
alpha blocker

35
Q

kidney stones treatment 1 month after initial presentation and still present

A

stent

36
Q

woman
recently married
painful peeing (dysuria)
no microorganisms on culture

A

honeymoon cystitis (damage to urethra causing cystitis (inflammation))

37
Q

supra pubic pain
burning pain when passing urine
nocturia
haematuria

A

lower UTI (Cystitis)

38
Q 
loin pain 
fever
rigors 
malaise 
dysuria (pain/burning when passing urine)
A

upper UTI (pyelonephritis)

39
Q

UTI treatment (4 options)

A

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

40
Q

honeymoon cystitis treatment

A

carbonic anhydrase inhibitor (not an infection)

41
Q

chronic smoker

leakage when coughing/laughing

A

stress incontinence

42
Q

drinks caffeine

leakage when hearing water running/standing up

A

urge incontinence

43
Q

stress incontinence treatment

A

stop smoking, increase exercise, loose weight
bladder retraining
duloxetine (rarely)
transvaginal tape

44
Q

urge incontinence treatment

A

decrease caffeine/alcohol
oxybutynin (antimuscarinic)
botox injection

45
Q 
>50 y/o
worked in a dye factory 
smoker 
painless haematuria 
sea anemone on cystoscopy
A

transitional cell bladder cancer

46
Q

transitional cell bladder treatment

A

TURBT
cystectomy
stoma for urine

47
Q

painless haematuria

schistosomiasis bladder infection

A

squamous cell carcinoma of bladder

48
Q

> 65 y/o
bone pain (osteosclerotic mets)
weight loss
haematuria, no other urinary symptoms

investigation and result

A

prostate cancer

PR exam - hard, asymmetrical
PSA high

49
Q

prostate cancer treatment

A

hormone therapy - if low risk
OR
surgery/chemo - if high risk
radiotherapy - if bone mets

50
Q

urinary symptoms - incomplete voiding, urgency

smooth symmetrically enlarged prostate on PR exam
PSA high

A

benign prostatic hyperplasia

51
Q

benign prostatic hyperplasia treatment

A

alpha blocker (tamsulosin))
5 alpha reductase inhibitor (finasteride)
TURP surgery

52
Q 
painless testicular swelling 
20-30 y/o
looks like a potato on pathology 
PLAP tumour marker 
lymphatic spread
A

seminoma

53
Q 
painless testicular swelling 
30-50 y/o
cysts, haemorrhage etc on pathology
AFP and bHCG tumour marker 
haematogenous spread
A

teratoma

54
Q

seminoma testicular cancer treatment

A

surgery (orchidectomy) and radiotherapy

55
Q

teratoma testicular cancer treatment

A

surgery (orchidectomy) and chemo

56
Q

neonate
nausea and vomiting, systemically unwell
red and bruised testicle

A

testicular torsion

57
Q

teenager
wakes up in the middle of the night with excruciating scrotal pain
bellclappers deformity
red and bruised testicle

A

testicular torsion

58
Q

testicular torsion treatment

A

emergency surgery

59
Q

teenager
wakes up in the middle of the night with excruciating scrotal pain
blue dot on inspection

A

torsion of appendage

60
Q

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

A

epididymitis

61
Q

red and swollen testicle but with little pain
itchy
red groin

A

idiopathic scrotal oedema

62
Q

idiopathic scrotal oedema treatment

A

antihistamines
pain relief if necessary
NOT surgery

63
Q

painful swelling of foreskin

A

paraphimosis

64
Q

prolonged erection >4 hours

A

priapism

65
Q

priapism treatment if ischaemic

A

blood aspiration

66
Q

priapism treatment if non ischaemic

A

cold packs, compression

67
Q 
genital swelling
used to be cellulitis (swollen, red) 
now has purple areas 
crepitus 
air spaces on xray
A

fourniers gangrene (necrotising fasciitis of male genitalia)

68
Q

fourniers gangrene (necrotising fasciitis of male genitalia) treatment

A

antibiotics and debridement

J Renal (12 decks)

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