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Long Case > Genitourinary > Flashcards

Genitourinary Flashcards

1
Q

Causes of chronic kidney disease

A

Diabetes
HTN
Glomerulonephritis

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2
Q

Things to discuss in history for CKD

A 
SOB
Nausea vomitting
Bone pain
Confusion, depression
Ankle swelling
Gout
Recurrent UTIs
SLE/scleroderma
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3
Q

Which medications to ask about in CKD?

A

ACEi
Erythropoetin
Steroids/immunosuppresant

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4
Q

Key examination findings in CKD

A 
Hyperventilation
Pigmentation and purpura
Asterixis
BP
AV fistula for dialysis
Anaemia/jaundice
Balot kidneys
Renal bruits
Gout
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5
Q

Bloods for CKD?

A

eGFR, creatinine, plasma creatinine/urea level
Electrolytes, phosphate, uric acid, calcium, albumin
FBC

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6
Q

Imaging for CKD?

A 
Renal ultrasound
CT scan
Cystoscopy
Renal artery doppler
Renal biopsy
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7
Q

Complications of CKD

A 
Anaemia
Bone disease
Dry skin
Decreased gastric emptying
Gout
Carpal tunnel
Restless leg syndrome
Pericarditis
Heart failure
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8
Q

Lifestyle management of CKD

A

Smoking cessation
Physical activity
Diet(reduce fats and monitor salt and water balance)

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9
Q

Cardiovascular management of CKD

A

ACEi (if diabetic take even if normal BP)
Statins for lipids
Aspirin low dose

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10
Q

Renal management CKD

A

Erythropoeitin if CKD <3 and HB <100
Correct iron deficiency first
If renal bone disease: calcitriol/calcitab
If restless legs: gabapentin

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11
Q

Indications for dialysis

A 
Acute renal failure
Fluid overload despite mx
Uraemic symptoms despite mx
Creatinine >1000
Hyperkalemia
Electrolyte abnormalities
Drugs eg dabigatran
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12
Q

Complications of dialysis

A 
Bone disease
Infection
Protein malnutrition
CVD
Amyloid, arythralgia
Malignancy
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13
Q

Define nephrotic syndrome

A

Proteinuria, hypoalbubinaemia, severe oedema and hyperlipidaemia

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14
Q

Define nephritic syndrome

A

Proteinuria, haematuria, oliguria, hypertension

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15
Q

Common causes of nephrotic syndrome

A

Minimal change disease, membranous nephropathy, focal segmental glomerulosclerosis, diabetes, myeloma

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16
Q

Common causes of nephritis syndrome

A 
IgA nephropathy
Post strep
Goodpastures's syndrome
SLE
myeloma
17
Q

Investigations for glomerulonephritis

A 
Urinalysis-albumin creatinine ratio more accurate than dipstick
eGFR and creatinine
Bloods
Autoantibodies
Renal ultrasound +- biopsy
18
Q

Things to ask in prostate history

A 
Urgency
Frequency
Dysuria
Feeling of incomplete emptying
Hesitancy
Nocturia
Terminal dribbling
Haematuria
19
Q

Investigations of prostate issues

A 
PSA CR U+Es
MSU
IPSS
Abdo ultrasound
Voiding studies
Biopsy
20
Q

Lifestyle management of BPH

A

Avoid caffeine and alcohol

Physiotherapy

21
Q

Medical management of BPH

A

a-blockers: doxazoxin, tamulosin

5a-reductase inhibitors: Finasteride

22
Q

Surgical management of BPH

A

if prostate <100g TURP (transurethral resection of the prostate)
if >100g HOLEP (holmium laser enucleated prostate)

23
Q

What is TURP syndrome?

A

Hyponatremia due to excessive irrigation fluid during a TURP operation

24
Q

Complicated UTI vs uncomplicated

A

Complicated: abnormal renal tract, voiding difficulty, reduced renal function or virulent organism eg staph aureus
Uncomplicated: normal renal tract and function

25
Q

Differentiate between pyelonephritis, cystitis, and prostatitis

A

Pyelo: fever, rigors, loin pain
Cystitis: frequency, dysuria, urgency, haematuria
Prostatitis: Flu-like symptoms, back ache, enlarged prostate

26
Q

Risk factors for breast cancer

A

obesity
smoking
estrogen exposure
family history (BRCA-1 breast and ovarian)

27
Q

Questions to ask about breast cancer presentation

A 
Painless lump
Peau d'orange
Paget's disease of the nipple
Nipple discharge
Tethering
Asymmetry
28
Q

Investigation for breast cancer

A

Triple assessment
Examination
Imaging: Ultrasound (+mammogram if over 35)
Biopsy: FNA (C2 benign, C5 maligant)

29
Q

Most common types of breast cancer

A

Ductal carcinoma 80%

Lobular carcinoma 20%

30
Q

Management of breast cancer

A

Surgery: Partial mastectomy, total mastectomy +- sentinel node biopsy or axillary node clearance
Radiation
Chemotherapy if high risk
Tamoxifen or herceptin if HER2

Long Case (11 decks)

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