Genitourinary

Question 1

AKI

-main symptoms for pre-renal, renal and post renal and causes

Answer 1

Pre-renal
Cause - hypovolaemia (shock, haemorrhage, trauma ect.) , hepatorenal syndrome, sepsis
Symptoms - tachycardia, hypotension, liver failure symptoms

Renal
Cause - Acute tubular necrosis 
Glomerulonephritis 
Interstitial nephritis
renal vascular disease
Symptoms/Hist - drug intake - amino glycosides, NSAIDS penicillins 

Post renal
Cause - Renal tract - stone, infection, stricture
extrinsic - pelvic malignancy , prostatic hypertrophy
Symptom - decreased urine output, distended bladder, bladder scan shows postvoid residual >50ml

Question 2

AKI

Main investigations

Answer 2

• Urine dipstick (proteinuria, haematuria → suggest intrinsic disease)
• K+ - ECG changes – t waves, pr segment prolonged → TREAT URGENLTY
• USS – within 24 hrs, unless obvious cause or it is improving – asymmetric – renal vascular disease, and smaller – CKD
• LFT – hepatorenal syndrome
• Intrinsic renal disease tests – immunoglobulins, autoantibodies (ANA, ANCA, AntiGBM)