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Yr 5 - Renal & Urology > Corrections 2 > Flashcards

Corrections 2 Flashcards

1
Q

Why are patients with nephrotic syndrome at an increased risk of thromboembolism?

A

Due to loss of antithrombin III in the urine

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2
Q

What are 2 key types of thromboembolism seen in nephrotic syndrome?

A

1) renal vein thrombosis: resulting in a sudden deterioration in renal function

2) DVT & PE

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3
Q

Give some complications of nephrotic syndrome

A

1) VTE

2) Hyperlipidaemia: increasing risk of ACS

3) CKD

4) Increased risk of infection due to urinary immunoglobulin loss

5) Hypocalcaemia (vitamin D and binding protein lost in urine)

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4
Q

What type of diabetes insipidus can haemochromatosis cause?

A

Cranial

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5
Q

What CVS features may be seen in ADPKD?

A

1) mitral valve prolapse
2) mitral/tricuspid incompetence
3) aortic root dilation
4) aortic dissection

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6
Q

What is the most common cardiac defect in ADPKD?

A

Mitral valve regurgitation

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7
Q

What are 3 key risk factors for focal segmental glomerulosclerosis (FSGS)?

A

1) HIV
2) Heroin use
3) Sickle cell

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8
Q

FSGS has a high recurrence rate in which patients?

A

Renal transplant patients

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9
Q

What is the preferred method of access for haemodialysis?

A

AV fistulas

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10
Q

Cause of osteomalacia in CKD?

A

High phosphate level ‘drags’ calcium from bones

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11
Q

What can be used instead of spironolactone in patients struggling with gynaecomastia?

A

Eplerenone

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12
Q

Mx of cranial vs nephrogenic diabetes insipidus?

A

Cranial –> vasopressin analogue (e.g. desmopressin)

Nephrogenic –> thiazide diuretics, low salt/protein diet

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13
Q

Inheritance of Alport’s syndrome?

A

X-linked dominant

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14
Q

What is Alport’s syndrome?

A

There is a defect in the gene which codes for type IV collagen resulting in an abnormal glomerular-basement membrane (GBM)

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15
Q

Features of Alport’s syndrome?

A

1) microscopic haematuria

2) progressive renal failure

3) bilateral sensorineural deafness

4) lenticonus: protrusion of the lens surface into the anterior chamber

5) retinitis pigmentosa

6) renal biopsy: splitting of lamina densa seen on electron microscopy

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16
Q

How long will it take for an AV fistula to be fully functioning?

A

6-8 weeks

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17
Q

Mx of increased VTE risk in nephrotic syndrome?

A

LMWH prophylaxis

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18
Q

Hyperacute vs acute vs chronic graft failure in renal transplant?

A

Hyperacute: minutes to hours

Acute: <6m

Chronic: >6m

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19
Q

What is seen on urinalysis in AIN?

A

White cell casts

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20
Q

What is Sevelamer?

A

A non-calcium based phosphate binder that treats hyperphosphataemia in patients with CKD mineral bone disease

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21
Q

How can myoglobinuria (in rhabdo) cause renal failure?

A

By tubular cell necrosis

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22
Q

Urinary sodium in pre-renal disease?

A

low (<20)

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23
Q

What is a key investigation in diagnosising early CKD?

A

Urine ACR

24
Q

What is the most common cause of peritonitis secondary to peritoneal dialysis?

A

Coagulase-negative Staphylococcus e.g. Staph. epidermis

25
Q

What is the most common cause of SBP 2ary to ascites?

A

E. coli

26
Q

What scrotal swelling may be the presenting feature of a renal cell carcinoma?

A

Varicocele

27
Q

Do varicoceles usually occur on the L or R?

A

L (because testicular vein drains into renal vein)

28
Q

What is the most important risk factor for bladder canceR?

A

Smoking

29
Q

What should be co-prescribed when starting GnRH agonists?

A

Anti-androgen treatment e.g. cyproterone acetate

30
Q

What is a common complication of a radical prostatectomy?

A

Erectile dysfunction

31
Q

What is the most common type of testicular cancer?

A

Germ cell tumours

32
Q

What are the 2 key types of germ cell tumours?

A

1) Seminomas

2) Non-seminomas: embryonal, yolk sac, teratoma and choriocarcinoma

33
Q

Give 2 types of non-germ cell testicular cancers

A

1) Leydig cell tumours

2) Sarcomas

34
Q

Tumours markers for seminomas vs non-seminomas?

A

Seminomas: hCG may be elevated

Non-seminomas: AFP and/or hCG are elevated

35
Q

Does a raised AFP indicate a seminoma or a non-seminoma?

A

Non-seminoma (a raised AFP excludes a seminoma)

36
Q

How does rhabdo cause AKI?

A

Due to ATN

37
Q

What can the causes of ED be split into?

A

1) Organic
2) Psychogenic

38
Q

Give 3 factors favouring an organic cause of ED

A

1) Gradual onset of symptoms

2) Lack of tumescence

3) Normal libido

39
Q

Which investigation would be of greatest use in demonstrating overactive bladder?

A

Urodynamic studies

40
Q

Mx of varicoceles?

A

Usually conservative

41
Q

Mx of asymptomatic renal stones <5mm?

A

Watch & wait

42
Q

What are varicoceles a significant risk factor for?

A

Infertility

43
Q

What investigation do adults with a hydrocele require?

A

US to exclude an underlying tumour

44
Q

can a lower UTI cause urinary retention?

A

Yes

45
Q

Mx of renal colic if NSAIDs are contraindicated or not giving sufficiency pain relief?

A

IV paracetamol

46
Q

Action of tamsulosin?

A

a-1 antagonist –> promote relaxation of the smooth muscle of the prostate and the bladder to reduce LUTS

47
Q

What is a useful investigation for priapism?

A

Cavernous blood gas analysis –> essential to differentiate between ischaemic and non-ischaemic priapism which would guide further management.

48
Q

Results of cavernous blood gas analysis in ischaemic vs non-ischaemic priapism?

A

In ischaemic priapism, pO2 and pH would be reduced whilst pCO2 would be increased.

49
Q

Following relief of urinary retention patients, what complication can occur?

A

Physiological diuresis can occur –> monitoring of U&Es is required

Can result in hypovolaemia, dehydration, and electrolyte imbalances.

50
Q

Features of a ‘tumour flare’ that can be caused by GnRH agonists?

A

Bone pain, bladder obstruction

51
Q

Most patients presenting with symptomatic renal cell carcinoma have what stage disease?

A

Stage 4 i.e. metastatic

52
Q

Most common site of metastasis of renal cell carcinoma?

A

Lungs

53
Q

Mx of BPH?

A

Alpha-1 antagonist & 5a-reductase inhibitor (tamsulosin & finasteride)

54
Q

What is seen on urinalysis in ATN?

A

Muddy brown casts

55
Q

What causes TURP syndrome?

A

Irrigation with glycine –> hyponatraemia

56
Q

What is the most effective management option in renal cell carcinoma?

A

Radical nephrectomy

57
Q
A

Yr 5 - Renal & Urology (9 decks)

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