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Phase 2a Conditions > Genitourinary > Flashcards

Genitourinary Flashcards

1
Q

What is the definition of acute kidney injury?

A

Significant deterioration in renal function occurring over hours or days

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2
Q

What is the aetiology of acute kidney injury?

A

Pre-renal (decreased perfusion), renal (acute tubular necrosis, glomerulonephritis, post-renal (benign prostatic hyperplasia, kidney stones, tumour)

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3
Q

What is the clinical presentation of acute kidney injury?

A

Oliguria, fatigue, or tiredness, shortness of breath (severe cases: pulmonary oedema, encephalopathy, pericarditis)

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4
Q

What are the investigations of acute kidney injury?

A

o Creatinine: elevated
o Urine output: <0.5 ml/kg for > 6 consecutive hours
o Urea: elevated

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5
Q

What is the treatment of acute kidney injury?

A

Treat underlying cause, dialysis, manage complications (hyperkalaemia, pulmonary oedema, uraemia, acidaemia), fluid management

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6
Q

What is the definition of chronic renal failure?

A

Abnormalities of kidney structure or function present for > 3 months

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7
Q

What is the aetiology of chronic renal failure?

A

Acute renal failure, hypertension, diabetes, kidney disease

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8
Q

What is the clinical presentation of chronic renal failure?

A

Asymptomatic, tired, bone pain, fluid overload, anorexia

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9
Q

What are the investigations of chronic renal failure?

A

o Blood: low calcium, high phosphate, high PTH

o Kidney biopsy

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10
Q

What is the treatment of chronic renal failure?

A

BP control, ACE inhibitors, treat complications, dialysis, transplant

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11
Q

What is the classification of chronic renal failure?

A

o G1: GFR ≥ 90 (normal or high)
o G2: GFR 60-80 (mildly decreased)
o G3a: GFR 45-59 (mildly to moderately decreased)
o G3b: GFR 30-44 (moderately to severely decreased)
o G4: GFR 15-29 (severely decreased)
o G5: GFR <15 (kidney failure)

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12
Q

What is the definition of acute nephritic syndrome?

A

Inflammation and damage to the glomeruli due to an immune response triggered by an infection

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13
Q

What is the aetiology of acute nephritic syndrome?

A

IgA nephropathy, streptococcal infection, SLE, Goodpasture’s, ANCA

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14
Q

What is the pathophysiology of acute nephritic syndrome?

A

IgA immune complex deposition

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15
Q

What is the clinical presentation of acute nephritic syndrome?

A

Asymptomatic, visible haematuria, hypertension, oedema

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16
Q

What are the investigations of acute nephritic syndrome?

A

o Renal biopsy: IgA deposition
o Urinalysis: haematuria and red cell casts, proteinuria
o Urine output: low

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17
Q

What is the treatment of acute nephritic syndrome?

A

ACE inhibitors (reduce BP and proteinuria)

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18
Q

What is the definition of nephrotic syndrome?

A

Proteinuria due to podocyte pathology

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19
Q

What is the aetiology of nephrotic syndrome?

A

Minimal change disease (podocyte fusion), diabetes, amyloid, SLE, focal segmental glomerulosclerosis

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20
Q

What is the clinical presentation of nephrotic syndrome?

A

Pitting oedema, frothy urine

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21
Q

What are the investigations of nephrotic syndrome?

A

o Urinalysis: proteinuria

o Serum albumin: hypalbuminaemia

22
Q

What is the treatment of nephrotic syndrome?

A

Fluid and salt restriction, and diuretics (oedema), treat underlying cause (steroids in minimal change disease), ACE inhibitor (reduce proteinuria)

23
Q

What is the definition of polycystic kidney disease?

A

Inherited disorder in which clusters of cysts develop within the kidney causing them to enlarge and lose function

24
Q

What is the aetiology of polycystic kidney disease?

A

ADPKD (PKD1/2), ARPKD (PKHD1)

25
Q

What is the clinical presentation of polycystic kidney disease?

A

Hypertension, flank pain and mass, haematuria, polycystic liver disease, intracranial aneurysms (subarachnoid haemorrhage)

26
Q

What are the investigations of polycystic kidney disease?

A

Ultrasound scan

27
Q

What is the treatment of polycystic kidney disease?

A

High water intake (suppress cyst growth), BP control, cyst decompression

28
Q

What is the definition of nephrolithiasis?

A

Stones in the urinary tract, usually consisting of calcium oxalate

29
Q

What is the clinical presentation of nephrolithiasis?

A

Renal colic, loin pain which radiates to the groin, dysuria, urgency, frequency, recurrent UTI’s, haematuria, vomiting

30
Q

What are the investigations of nephrolithiasis?

A

o Bloods (calcium, phosphate, and urate)
o Urinalysis
o Ultrasound: hydronephrosis (swelling of the kidney)
o NCCT-KUB

31
Q

What is the treatment of nephrolithiasis?

A

Conservative (<5mm, IV fluids, analgesia, anti-emetics), medical (nifedipine), Lithotripsy (fragment stones), surgical (PCNL for larger stag horn stones)

32
Q

What is an epididymal cyst?

A

Benign cyst of the epididymis which presents with small paratesticular swelling which may be tender and can be removed if symptomatic

33
Q

What is hydrocele?

A

Accumulation of fluid in between the tunica vaginalis layers due to trauma. It presents with scrotal swelling and can spontaneously resolve, or require aspiration or surgery

34
Q

What is varicocele?

A

Persistent abnormal dilation of the pampiniform venous plexus which presents with nodularity, dull ache, distended scrotal blood vessels. Surgery can be performed if symptomatic

35
Q

What is the clinical presentation of a testicular torsion?

A

Sudden onset of pain in testes, abdominal pain, nausea and vomiting

36
Q

What are the investigations of a testicular torsion?

A

o Doppler ultrasound: lack of blood flow

o Surgical exploration

37
Q

What is the treatment of a testicular torsion?

A

Surgical untwisting

38
Q

What is the definition of benign prostatic hyperplasia?

A

Enlargement of the prostate gland due to an increase in cell number

39
Q

What is the clinical presentation of benign prostatic hyperplasia?

A

Frequency, nocturia, hesitancy, post void dribbling

40
Q

What is the treatment of benign prostatic hyperplasia?

A

Alpha-blockers (tamsulosin), 5-alpha-reducatse inhibitors, transurethral resection of prostate

41
Q

What is the aetiology of urinary treat infections?

A

E. coli, coagulase negative staphylococcus, proteus mirabililis, enterococci, klebsiella pneumonia

42
Q

What is the clinical presentation of urinary treat infections?

A

Frequency, urgency, dysuria, haematuria, suprapubic pain, (fever, rigors, vomiting, pyuria, loin pain if pyelonephritis)

43
Q

What are the investigations of urinary treat infections?

A

o Urinalysis: leucocytes or nitrates
o Microscopy: WBCs, RBCs, casts, bacteria
o MCS MSU: >105 organisms/ml

44
Q

What is the treatment of urinary treat infections?

A

Antibiotics (trimethoprim (avoid in pregnancy), nitrofurantoin)

45
Q

What is the clinical presentation of Chlamydia Trachomatis?

A

o Male: asymptomatic, urethritis, testicular pain

o Female: asymptomatic, vaginal discharge, bleeding, lower abdominal/pelvic pain

46
Q

How is Chlamydia Trachomatis diagnosed?

A

Nucleic acid amplification test

47
Q

What is the treatment of Chlamydia Trachomatis?

A

Avoid sexual intercourse, doxycycline (CI pregnancy) or azithromycin, contact tracing

48
Q

What is the clinical presentation of Neisseria Gonorrhoea?

A

o Male: asymptomatic, urethritis, purulent discharge, dysuria
o Female: endocervicitis (pelvic pain), vaginal discharge, itch, dysuria

49
Q

How is Neisseria Gonorrhoea diagnosed?

A

o Nucleic acid amplification test

o Microscopy: gram-negative diplococci with polymorphonuclear cells

50
Q

What is the treatment of Neisseria Gonorrhoea?

A

Ceftriaxone

Phase 2a Conditions (9 decks)

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