Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Phase 2a flashcards (Alec's) > GU > Flashcards

GU Flashcards

1
Q

What is nephrolithiasis?

A

Kidney stones (renal calculi or urolithiasis)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are the 5 types of kidney stone?

A

Most common
* Calcium oxalate
* Calcium phosphate
Less common below
* Uric acid
* Struvite
* Cystine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Which kidney stone is not visible on X-ray?

A

Uric acid stones

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What causes struvite stones to form?

A

Produced by bacteria (so during a renal infection)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What causes cystine stones?

A

Autosomal recessive condition causes amino acids to join together

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is it called when a calculus form in the shape of a renal pelvis?

A

Staghorn calculus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

When do staghorn calculus often form?

A

Recurrent UTIs causes bacteria to hydrolyse urea to ammonia forming a struvite stone to form

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are some risk factors for kidney stones (5)?

A
  • Chronic dehydration
  • Kidney diseases (e.g. PKD)
  • Hyperparathyroidism
  • UTIs
  • History of stones
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are the signs/ symptoms of renal stones (4)?

A
  • Renal colic
  • Haematuria
  • N+V
  • Low urine output
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is renal colic?

A

Pain felt with renal stones that is unilateral colicky (due to stones moving and settling) loin to groin pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

How are kidney stones investigated (4)?

A
  • Urine dipstick
  • Abdominal X-ray = first line
  • CT KUB (kidney, ureter, bladder) = gold
  • Ultrasound (if pregnant)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

How are kidney stones treated (4)?

A
  • Hydration
  • NSAIDs
  • Abx for UTIs
  • Surgery
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is the name of a strong NSAID used for kidney stones?

A

Diclofenac (IM)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What procedures are done for kidney stones (3)?

A
  • Extracorporeal shock wave lithotripsy (ESWL)
  • Percutaneous nephrolithotomy (keyhole retrieval)
  • Ureteroscopy (catheter with a LAZER on it basically)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

How can recurrent stone be prevented (2)?

A
  • Hydration
  • Avoid carbonated drinks
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What size kidney stones usually pass on their own?

A

< 5mm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is an example of an antiemetic?

A

Cyclizine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is acute kidney injury (AKI)?

A

An acute drop in renal function

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What are NICE criteria for AKI (3)?

A
  • Rise in creatinine of >26 micromol/ L within 48 hours
  • Rise in creatinine of >50% in 7 days
  • Urine output of < 0.5 ml/kg/hour for 6 hours
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is normal urine output?

A

0.5-1.5 ml/kg/hour

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What are the 3 types of AKI?

A
  • Pre-renal
  • Renal
  • Post-renal
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What causes pre renal AKI (5)?

A
  • Dehydration
  • Hypotension
  • Heart failure
  • NSAIDS
  • Renal artery stenosis/ blockage
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What causes renal AKI (4)?

A
  • Glomerulonephritis
  • Interstitial nephritis
  • Acute tubular necrosis
  • Sepsis (toxins)
    Intrinsic kidney disease –> reduced filtration of blood
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What causes post renal AKI (4)?

A
  • Stones
  • Cancer
  • Large prostate
  • Unsafe bladder
    Blocked urine outflow
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What important substances does AKI lead to the build up of (4)?

A
  • K+
  • Urea
  • Fluid
  • H+
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

AKI signs/ symptoms (4)?

A
  • N+V
  • Reduced urine output
  • Abdo pain
  • Confusion
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

How is AKI investigated (4)?

A

Establish cause:
* Urinalysis
* Bloods
* Kidney biopsy (for intra renal)
* Ultrasound (for post renal)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

How is AKI managed (3)?

A
  • Correct complications (electrolytes)
  • Treat underlying cause
  • Dialysis/ transplant if severe
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

What are some complications of AKI (4)?

A
  • Fluid overload (heart failure)
  • Hyperkalaemia
  • Metabolic acidosis
  • Uraemia (high urea)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

What can uraemia cause (2)?

A
  • Encephalitis
  • Pericarditis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

What is chronic kidney disease?

A

A chronic reduction in kidney function (usually permanent and progressive)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

What are the two main causes of CKD?

A
  • Hypertension
  • Diabetes
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

What other things can cause CKD (3)?

A

Any kidney disease:
* PKD
* Glomerulonephritis
* Nephrotoxic drugs (e.g. NSAIDs)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

How do NSAIDs damage the kidneys?

A

Inhibit the production of prostaglandins, which regulate vasodilation in the kidneys

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

How does the kidney compensate for CKD?

A

Release renin –> higher BP –> higher GFR

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

What effect does a compensatory release of renin have on the kidneys?

A

Increase BP –> increase transglomerular pressure –> high shearing force –> loss of BM selective permeability

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

How does diabetes damage the kidneys?

A

Glucose sticks to proteins in the walls of the efferent vessels (stiffening them), and making it hard for blood to leave the glomerular

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

What are the signs/ symptoms of CKD (6)?

A

Early stages = asymptomatic
* Oedema
* N+V
* Hypertension
* Loss if appetite
* Muscle cramps
* Pruritus (itching)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

What are some complications of CKD?

A
  • Anaemia (low EPO)
  • Renal bone disease (low activated vit D)
  • Neuropathy + encephalopathy (uraemia)
  • CVD
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

How is CKD investigated (3)?

A
  • FBC = anaemia
  • Urine dip
  • U+Es
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

What does a urine dipstick look for in CKD (2)?

A
  • Proteinuria
  • Haematuria
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

How is proteinuria quantified and what value is significant?

A

UACR (Urine albumin:creatinine ratio) > 3 mg/ mmol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

What is eGFR?

A

Estimated glomerular filtration rate?

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

What information does eGFR use to calculate?

A
  • Creatinine
  • Age
  • Gender
  • Ethnicity
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

What is a normal eGFR?

A

> 90 ml/min/1.73m^2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

What are the stages of CKD?

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

What are renal signs in stage 1 and 2 CKD?

A

Significant proteinuria

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

How is CKD treated?

A

Treat underlying cause and manage complications

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

How are the complications managed of CKD?

A
  • Anaemia = EPO + Fe
  • Renal bone disease = active vit D
  • Oedema = diuretics
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

What is classed as end stage renal failure?

A

CKD stage 5 (eGFR <15)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

How is end stage renal failure treated?

A

Dialysis / transplant

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

What is benign prostatic hyperplasia?

A

Increase in the number of cells (hyperplasia) and enlargement of the prostate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

What are 2 risk factors for BPH?

A
  • Older age
  • Afro-carribean (higher testosterone)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

Which part of the prostate proliferates and narrows urethra ?

A

Transitional zone (inner part)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

What are the three types of LUTSs?

A
  • Storage
  • Voiding
  • Post micturition
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

What are some examples of storage LUTSs (4)?

A
  • Increased frequency
  • Nocturia
  • Increased urgency
  • Incontinence
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

What are some examples of voiding LUTSs (4)?

A
  • Poor stream
  • Terminal dribbling
  • Incomplete emptying
  • Straining/ hesitancy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

What are some examples of post micturition LUTSs?

A
  • Post micturition dribbling
  • Incomplete emptying - usually considered voiding symptom
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

Which type of LUTSs do patients with BPH usually present with?

A

Voiding (as urethra obstructed)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

How is BPH diagnosed?

A

Rectal exam = smooth + enlarged prostate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
61
Q

What other test may be carried out for patients with enlarged prostates (depending on their wishes)?

A

PSA test (more commonly raised in those with prostate cancer)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
62
Q

What does a cancerous prostate feel like?

A

Irregular, central sulcus disrupted

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
63
Q

How is BPH treated (4)?

A
  • Lifestyle (decrease caffeine)
  • Medications
  • Self catheterisation
  • Surgery
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
64
Q

What medications are used to treat BPH (2)?

A
  • Alpha blockers (tamsulosin)
  • 5 alpha reductase inhibitors (finasteride)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
65
Q

What is a side effect of tamsulosin?

A

Postural hypotension (as alpha 1 receptors relax BV walls)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
66
Q

How do 5 alpha reductase inhibitors reduce prostate size?

A

Prevent conversion of testosterone to dihydrotestosterone (more potent androgen)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
67
Q

What surgery is offered for BPH (2)?

A
  • Transurethral resection of the prostate (TURP)
  • Prostatectomy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
68
Q

What is a complication of TURP?

A

Retrograde ejaculation (into bladder)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
69
Q

What is a complication of BPH?

A

Anuria –> hydronephritis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
70
Q

What is the most common renal cancer?

A

Renal cell carcinoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
71
Q

What is the most common type of renal cancer?

A

Renal cell carcinoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
72
Q

What are some risk factors for RCC (3)?

A
  • Smoking
  • Haemodialysis (due to the kidney disease)
  • Family history
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
73
Q

What is a auto dom hereditary condition that increases risk of RCC?

A

Von Hippel-Lindau syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
74
Q

What are the symptoms of an RCC?

A
  • Flank pain
  • Haematuria
  • Abdo mass
  • Swollen left testicle
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
75
Q

How is RCC investigated?

A
  • Ultra-sound = 1st line
  • CT = gold
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
76
Q

What is Wilms tumour?

A

Renal tumour (starts in mesenchymal cells)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
77
Q

What is Wilm tumour also known as?

A

Nephroblastoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
78
Q

What is a blastoma?

A

Cancer of developing cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
79
Q

What is the most common type of bladder cancer?

A

Transitional cell carcinoma (TCC)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
80
Q

What are some risk factors for bladder cancer (3)?

A
  • Exposure to dyes/ paints/ rubber
  • Smoking
  • Age (old)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
81
Q

What is the main symptoms of bladder cancer?

A

Haematuria

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
82
Q

How is bladder cancer diagnosed?

A

Cystoscopy + biopsy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
83
Q

What surgery is used to treat bladder cancer (2)?

A
  • Transurethral resection of bladder tumour (TURBT)
  • Cystectomy
84
Q

What is the most common type of cancer in the prostate gland?

A

Adenocarcinoma

85
Q

What part of the prostate gland does cancer usually form?

A

Outer, peripheral zone

86
Q

What are 3 risk factors for prostate cancer?

A
  • Genetics/ family history
  • Higher age
  • Afro Caribbean
87
Q

What 2 genes have been linked to the development of prostate cancer?

A
  • BRCA2
  • HOXB13
88
Q

What are the symptoms of prostate cancer (4)?

A
  • LUTSs (mainly voiding)
  • Haematuria
  • Erectile dysfunction
  • Systemic symtoms - if metastasised (e.g. fatigue, weight loss)
89
Q

Where does prostate cancer most commonly metastasise to (2)?

A
  • Bone (sclerotic lesions)
  • Lymph nodes
90
Q

How is prostate cancer investigated (4)?

A
  • Digital rectal exam
  • PSA test
  • Transrectal US / MRI
  • Biopsy
91
Q

What score is prostate cancer graded with by biopsy?

A

Gleason score

92
Q

How is prostate cancer treated (3)?

A
  • Prostatectomy
  • Hormone therapy
  • Chemo/ radio therapy
93
Q

What are the hormone therapies used to treat prostate cancer?

A
  • Bilateral orchidectomy (male castration)
  • GnRH agonists (initially increase testosterone, then receptor down-regulation)
94
Q

How do GnRH agonists work?

A

Reduce the levels of testosterone produced, results in suppression of the HPG axis. (initially increase testosterone levels, then receptor down-regulation)

95
Q

What is an example of a GnRH agonist?

96
Q

What are the 2 most common types of testicular cancer?

A
  • > 90% = germ cell cancer
  • <10% = non germ cell cancer
97
Q

What are the two types of germ cell cancer?

A
  • Seminomas
  • Teratomas
98
Q

What are 3 types of non-germ cell testicular tumour?

A
  • Sertoli
  • Leydig
  • Sarcoma
99
Q

What are testicular cancer risk factors (3)?

A
  • Cryptorchidism (undescended testes)
  • Infertility
  • Family history
100
Q

Symptoms of testicular cancer (2)?

A
  • Painless lump in testicle (does not transiluminate - light does not shine through)
  • Gynaecomastia (leydig cell tumour)
101
Q

How is testicular cancer diagnosed?

A

Scrotal ultrasound

102
Q

What are testicular cancer markers in the blood (2)?

A
  • Alpha- fetoprotein (in teratomas)
  • Beta hCG (in seminomas)
103
Q

What is a general tumour marker?

A

Lactate dehydrogenase (general tumour marker, released when tumour destroy healthy cells)

104
Q

How is testicular cancer treated?

A

Surgery (radical orchidectomy) + chemo/ radiotherapy for metastasise

105
Q

What is offered to people with testicular cancer?

A

Sperm storage

106
Q

What is obstructive uropathy?

A

Blockage of urine flow anywhere along the urinary tract

107
Q

Where would a blockage have to occur to obstruct both kidneys?

108
Q

Give some causes of obstructive uropathy (5)?

A
  • BPH
  • Stones
  • Strictures (due to scar tissue)
  • Cancers
  • Neurogenic bladder
109
Q

What can obstructive uropathy cause within the kidney?

A

Hydronephrosis (backlog of urine into the renal pelvis)

110
Q

What can hydronephrosis result in (2)?

A
  • AKI / CKD
  • Infection (stagnant urine)
111
Q

What are the symptoms/ signs of obstructive uropathy (4)?

A
  • Loin to groin pain
  • Reduced urine output
  • N + V
  • Kidney damage blood markers (e.g. creatinine)
    May be asymptomatic if only 1 kidney down
112
Q

How is obstructive uropathy treated?

A
  • Ureteric catheterisation (through back)
  • Ureteric stent
113
Q

What are the two types of UTI by location?

A
  • Upper
  • Lower
114
Q

What organ is affected in upper UTI and what is its inflammation called?

A

Kidney –> pyelonephritis

115
Q

What inflammation can occur in lower UTIs (4)?

A
  • Cystitis
  • Urethritis
  • Prostatitis
  • Epididymo orchitis
116
Q

What is the most common infective organism in UTIs?

117
Q

What percentage of UTIs are E. coli?

118
Q

What are some other infective organisms in UTIs (4)?

A
  • Klebsiella
  • E. coli
  • Enterococci
  • P. aeruginosa
  • S. saprophiticus
119
Q

What fungi can commonly cause UTI?

A

Candida albicans

120
Q

Which gender is more commonly affected by UTIs and why?

A

Women - have shorter urethra so bacteria enter bladder more easily

121
Q

What are some signs/ symptoms of lower UTI (3)?

A
  • Dysuria
  • LUTSs
  • Confusion (especially in older patients)
122
Q

When would pyelonephritis be suspected (3)?

A
  • Fever
  • Back pain/ tenderness
  • Pyuria (pus in urine)
    More systemic symptoms + general feeling of unwellness
123
Q

How are UTIs investigated?

A
  • Urine dip stick
  • Midstream urine (culture + sensitivity testing)
124
Q

What is present in urine dipstick in those with UTIs?

A
  • Nitrites (most important)
  • Leukocytes
  • Haematuria (less common)
125
Q

Why are nitrites present in UTIs?

A

Bacteria break down nitrates to nitrites

126
Q

What are the most common/ first line antibiotics in the community for UTIs (2)?

A
  • Trimethoprim
  • Nitrofurantoin
127
Q

What is a contraindication for the use of trimethoprim and nitrofurantoin?

A

Pregnancy:
* Nitrofurantoin - not used in 3rd trimester due to haemolytic anaemia of newborn risk
* Trimethoprim - not used 1st trimester as anti-folate

128
Q

What is a risk factor for UTIs and complicates the treatment of UTIs?

A

The presence of a catheter

129
Q

What is considered a non complicated UTI?

A

UTI in a non pregnant woman

130
Q

What antibiotics are used for the treatment of pyelonephritis (2)?

A
  • Ciprofloxacin
  • Co-amoxiclav
131
Q

What is the most common way urethritis is picked up?

A

Sexually transmitted infection

132
Q

What are the two types of infective urethritis?

A
  • Gonococcal
  • Non-gonococcal
133
Q

What causes gonococcal urethritis?

A

N. Gonorrhoeae (gonorrhoea)

134
Q

What is the most common cause of non-gonococcal urethritis?

A

Chlamydia trachomatis

135
Q

Which type of urethritis is more common?

A

Non-gonococcal

136
Q

How are gonorrhoea and chlamydia detected?

A

Nucleic acid amplification test (of urine sample)

137
Q

How is neisseria gonorrhoeae treated?

A

IM Ceftriaxone or Azithromycin

138
Q

How is chlamydia trachomatis treated?

A

Azithromycin or doxycycline

139
Q

What can also cause urethritis?

A

Reactive arthritis

140
Q

What are the symptoms of reactive arthritis?

A
  • Cant See (conjunctivitis)
  • Cant Pee (urethritis)
  • Cant climb a tree (arthritis)
141
Q

What is epididymo orchitis?

A

Inflammation of epididymus (extending to testes)

142
Q

What are the symptoms of epididymo orchitis?

A

Soctral pain + swelling (relived when elevated testicle)

143
Q

What are nephrOtic and nephrItic syndrome?

A

2 separate groups of symptoms that occur consistently together

144
Q

What are the symptoms of nephrotic syndrome (3)?

A
  • Proteinuria
  • Hypoalbuminaemia
  • Peripheral oedema
    + other weird stuff: Hyperlipidaemia, thrombosis formations, immunodeficiency
145
Q

What are the symptoms of nephritic syndrome (4)?

A
  • Proteinuria
  • Haematuria
  • Hypertension
  • Oliguria (low urine production)
146
Q

What can present as both nephrotic and nephritic syndrome?

A
  • Diffuse proliferative glomerulonephritis
  • Membrano-proliferative glomerulonephritis
147
Q

What 3 conditions can cause intrinsic nephrotic syndrome?

A
  • Minimal change disease
  • Focal segmental glomerulosclerosis
  • Membranous nephropathy
148
Q

What is minimal change disease?

A

Podocyte foot process effacement (destruction) by unknown mechanisms

149
Q

Why is it known as minimal change disease?

A

The histological changes can only be picked up by electron microscopy, not light microscopy

150
Q

Who does minimal change disease occur in most often?

A

Young children 2-7 years old

151
Q

What is focal segmental glomerulosclerosis?

A

Segmental sclerosis of glomeruli secondary to numerous causes (e.g. drugs, HIV, sickle cell)

152
Q

What percent of glomeruli are affected in focal segmental glomerulosclerosis?

153
Q

What is membranous nephropathy?

A

Thickening of glomerular basement membrane and sub epithelial immune complex deposition

154
Q

What is the most common nephrotic syndrome in adults?

A

Focal segmental glomerulosclerosis

155
Q

How are these intrinsic nephrotic syndromes treated?

156
Q

Which nephrotic syndromes respond best and which not so well to steroids?

A
  • Best = minimal change
  • Not so well = focal segmental glomerulosclerosis, membranous nephropathy
157
Q

What other type of nephrotic syndrome is common and is secondary to an underlying illness?

A

Diabetic nephropathy

158
Q

How does diabetes cause nephropathy?

A

The efferent arteries harden/ thicken due to glucose sticking to proteins (glycation) in the endothelium. This increase the pressure in the glomerulus, damaging it.

159
Q

What 5 conditions cause nephritic syndrome?

A
  • IgA nephropathy
  • Post strep glomerulonephritis
  • Goodpastures syndrome
  • SLE nephropathy
  • Haemolytic uraemic syndrome
160
Q

What type of hypersensitivity are these nephritic syndromes?

A

All type 3, except goodpastures = type 2

161
Q

What is IgA nephropathy also known as?

A

Bergers disease (NOT Buergers - this is something else)

162
Q

What is IgA nephropathy?

A

IgA immune complex deposition in the kidneys (usually after infection)

163
Q

How is IgA nephropathy treated (2)?

A
  • Steroids
  • Reduce BP (e.g. ACE inhibitors)
164
Q

What can IgA nephropathy frequently progress to?

A

End stage renal failure (30% of time)

165
Q

What condition is related to IgA nephropathy?

A

Henoch schonlein purpura (IgA deposition in blood vessels - small cell vasculitis)

166
Q

What is post strep glomerulonephritis?

A

Sub endothelial immune complex deposition in the glomeruli post strep A infection

167
Q

What can often be found deposited in post strep glomerulonephritis (3)?

A

IgM, IgG, C3 (compliment component 3)

168
Q

How does SLE cause nephritis?

A

ANA (anti-nuclear antibody) deposition in endothelium causing inflammation

169
Q

How is SLE nephritis treated (2)?

A
  • Prednisolone (steroid)
  • Hydroxychloroquine (DMARD)
170
Q

How does goodpastures cause glomerulonephritis?

A

Autoimmune condition whereby anti-glomerular basement membrane (anti-GBM) antibodies are produced

171
Q

How is goodpastures treated (2)?

A
  • Steroids
  • Plasma exchange
172
Q

What is haemolytic uraemic syndrome?

A

Bacterial toxins damage blood vessels in kidneys and clots form causing inflammation

173
Q

What is polycystic kidney disease?

A

Formation of cysts thought kidneys

174
Q

What are the two types of PKD?

A
  • Autosomal dominant
  • Autosomal recessive
175
Q

What genes are affected and which gene is affected more in dominant PKD?

A
  • PKD 1 gene (85%)
  • PKD 2 gene (15%)
176
Q

How is recessive PKD inherited?

A

Requires mutation on both copies of polycyctic kidney hepatic disease 1 gene (PKHD1)

177
Q

How do the gene mutations in PKD cause cyst formation?

A

PKD 1 and 2 code for polycystin which is a Ca 2+ channel –> Ca 2+ prevents cells from multiplying –> lack of Ca 2+ = cilia overgrowth –> over absorption of water = cyst formation

178
Q

Which type of PKD is more serious and presents in childhood and which is less serious and presents in adulthood?

A

Recessive = severe childhood illness
Dominant = less severe adult illness

179
Q

What are the sign/ symptoms of PKD (4)?

A
  • Bilateral flank/ abdo pain
  • Hypertension
  • Haematuria
  • Oedema
180
Q

What are 3 extra renal manifestations of PKD?

A
  • Berry aneurysm
  • Hepatic cysts
  • Aortic root dilatation
181
Q

How is PKD diagnosed?

A
  • Kidney US
  • Family history + genetic testing
182
Q

How is PKD treated?

A
  • Manage symptoms (e.g. ace inhibitors)
  • Renal transplant
  • Tolvaptan (ADH antagonist)
183
Q

Name some scrotal diseases (4)?

A
  • Epididymal cyst
  • Hydrocele
  • Varicele
  • Testicular torsion
184
Q

What is an epididymal cyst (where does it form)?

A

Extratesticular cyst, above and behind testes

185
Q

How can an epididymal cyst be diagnosed?

A

Scrotal US

186
Q

Where does a hydrocele form?

A

Between the visceral and parietal layers of tunica vaginalis

187
Q

How is a hydrocele diagnosed?

A

Scrotal US

188
Q

What causes a varicocele?

A

Pampinform distension due to high left renal vein pressure

189
Q

Why is a varicocele usually on the left?

A

The right testicular vein directly joins IVC therefore it would require high IVC pressure to back up there blood

190
Q

What does a varicocele resemble/ feel like?

A

Bag of worms

191
Q

What is a complication of varicocele?

A

Infertility

192
Q

What can a varicocele sometimes be an indication of?

A

Retroperitoneal tumours (e.g. renal cell carcinoma)

193
Q

How is a varicocele diagnosed?

A

Clinical examination (can be confirmed with an ultrasound)

194
Q

What is testicular torsion?

A

Spermatic cord twists on itself, occluding the testicular artery

195
Q

What is a risk factor for testicular torsion?

A

Bell clapper deformity - horizontal lying testicle

196
Q

What are some symptoms of testicular torsion (4)?

A
  • Severe unitesticular pain
  • Abdominal pain
  • N+V
  • Cremasteric reflex lost
197
Q

What is a cremasteric reflex?

A

Stroke inner thigh –> testicle should elevate

198
Q

How is testicular torsion diagnosed?

A

If clinical suspicion –> immediate explorative surgery

199
Q

What is performed surgically to reduce the risk of further testicular torsions?

A

Orchiplexy = fixing of testicles to scrotum

200
Q

What is a testicular appendage torsion?

A

Twisting of a small piece of tissue attached to the upper testicle

201
Q

What are the 4 types of urinary incontinence?

A
  • Urge
  • Stress
  • Overflow
  • Functional
202
Q

What is urge incontinence?

A

Overactivity of detrusor muscle –> suddenly need to micturate

203
Q

What is stress incontinence?

A

Week sphincter –> high intra abdominal pressure overcomes sphincter strength

204
Q

What is overflow incontinence?

A

Bladder does not empty fully –> urine frequency dribbles out (due to overfilling)

205
Q

What is functional incontinence?

A

Physical/ mental impairment prevents you reaching toilet in time (e.g. arthritis)

Phase 2a flashcards (Alec's) (13 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions