Genitourinary - Patholigies

Question 1

Name 5 kidney dysfunctions

Answer 1

Filtration failure 
Hypertension, water retention
Metabolic acidosis
Anaemia
Vitamin D deficiency

Question 2

4 causes of inflammation in kidney

Answer 2

Infection
Metabolic- diabetic nephropathy
Nephritic syndrome
Nephrotic syndrome

Question 3

2 examples of obstructive urinary disorders

Answer 3

Stones

Benign prostatic hypertrophy

Question 4

2 genetic kidney diseases?

Answer 4

Horshoes kidney

Polycystic kidneys

Question 5

Inflammation of the bladder and kidney?

Answer 5

Cystitis
Pyelonephritis

Bacteria most com,on cause

Question 6

3 forms of management in UTIs?

Answer 6

Antibiotics
Pain control
Support eg. Hydration

Question 7

How might a UTI present in a dipstick test?

Answer 7

Leukocytes +ve
Nitrite
Trace of blood

Question 8

How can immunological kidney diseases present?

Answer 8

Proteinuria
Nephrotic syndrome
Nephritic syndrome

Question 9

Nephrotic vs nephritic

Answer 9

Proteinuria

Haematuria

Question 10

How can nephritic syndrome present?

Answer 10

Haematuria
Variable proteinuria 
Hypertension
Reduced urine output
Increased urea and creatinine

Question 11

What is the most common primary glomeruneohritis?

Answer 11

IgA nephropathy

Question 12

What is the pathophysiology of IgA nephropathy?

Answer 12

IgA antibody deposited in kidney
Leads to scarring and inflammation
Nephritic syndrome
Can progress to kidney failure

Question 13

What are the treatment options for IgA nephropathy?

Answer 13

Treat hypertension - angiotensin receptor inhibitor / ACE inhibitor 
Reduce proteinuria
Reduce sodium intake
Immunotherapy
Renal replacement therapy

Question 14

What is goodpastures disease?

Answer 14

Affects kidneys and lungs
Anti glomerular basement membrane mediated
Antigen = a3chain of type 4 collagen

Question 15

What is the most common cause of chronic kidney disease and fia,ure in the west?

Answer 15

Diabetic nephropathy

Question 16

Risk factors for diabetic neon?

Answer 16

Hypertension
Poorly managed diabetes
Smoking

Question 17

Clinical features of diabetic nephropathy?

Answer 17

Microalbuminuria
Proteinuria
Retinopathy, neuropathy

Question 18

Treatment options for diabetic nephropathy?

Answer 18

Diabetic control
Hypertension treatment
Reduce proteinuria - ARB/ACEI
Stop smoking
SGLT2 inhibitor
Dialysis, transplant

Question 19

How can nephrotic syndrome present? (6)

Answer 19

Peripheral oedema, pitting 
Severe proteinuria
Low serum albumin
Variable microscopic haematuria 
Hyperlipidaemia
Frothy urine

Question 20

4 causes of nephrotic syndrome?

Answer 20

Minimal change glomerulopathy
Membranous nephropathy
Focal segmental glomerulosclerosis
Lupus nephritis

Question 21

How can minimal change glomerulopathy present?

Answer 21

Children most common
Podocyte effacement (flattened) under electron microscope

Question 22

Nephrotic syndrome treatment?

Answer 22

Immunotherapy - corticosteroids, tacrolimus (targets B cell pathway)
Diuretics to reduce oedema
Anticoagulant to prevent thrombosis

Question 23

Where can stones be found?

Answer 23

Kidney
Bladder
Ureter

Question 24

How can stones present?

Answer 24

Abdomen, back pain
Haematuria
Urine infection
Radio - opaque stones (90%)

Question 25

Give 3 specific treatments for stones?

Answer 25

Shockwave lithotripsy (sound waves break up stones)
Ureteroscopy
Percutaneous nephrolithotomy

Question 26

What are the 2 main types of polycystic kidneys?

Answer 26

Neonatal - autosomal recessive

Adult - autosomal dominant

Question 27

What is the treatment for polycyclic kidneys?

Answer 27

Tolvaptan slows down cyst formation (vasopressin receptor 2 antagonis)
Treat hypertension and infection
Pain control
Renal replacement therapy

Question 28

How can diabetic nephropathy cause tiredness?

Answer 28

More toxins in the blood

Reduced erythropoietin output leading to anaemia