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Kidney disorders Flashcards

1
Q

What is obstructive uropathy

A

blockage of urinary flow which can affect one or both kidneys depending on the degree of blockage.

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2
Q

how long does it take for obstructive uropathy to become prevalent

A

it can develop slowly over days weeks or even months

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3
Q

what are the two different types of obstruction

A

upper and lower

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4
Q

what are the lower obstruction

A

ureter or below e.g. Benign prostatic hyperplasia (prostate gland enlargement)

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5
Q

what are the upper obstruction

A

obstruction above ureter e.g. kidney stones

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6
Q

obstruction to the kidneys can result in what

A

a condition known as hydronephrosis which can lead to renal failure

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7
Q

what is hydronephrosis

A

swelling of the kidney and appear distended, which can lead to an infection to develop in the kidneys as the bacteria aren’t being flushed out. If both kidneys are obstructed.

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8
Q

what are the most common causes of obstructive uropathy in children

A

structural abnormalities

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9
Q

what are the most common causes of obstructive uropathy in young adults

A

stone in the kidney, ureter or elsewhere in the urinary tract

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10
Q

what are the most common causes of obstructive uropathy in adults

A

benign prostatic hyperplasia (enlarged prostate)

prostate cancer

retroperitoneal or pelvic tumours

calculi

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11
Q

what is calculi

A

kidney stone

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12
Q

what are some other possible causes of obstructive uropathy

A

polyps in the ureter

tumour in or near the ureter

disorders of the muscles or nerves in the bladder or ureter

formation of scar tissue in or around ureter

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13
Q

what are the symptoms of obstructive uropathy if the patient has a distended kidney (swollen)

A

renal colic can develop (stone)

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14
Q

what are the symptoms of obstructive uropathy if the patient has a BPH

A 
hesistancy
frequency
nocturia
terminal dribbling 
bladder discomfort (voiding, storage)
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15
Q

what is nocturia

A

condition in which you wake up during the night because you have to urinate.

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16
Q

what are the symptoms of obstructive uropathy if the patient has developed a urinary tract infection

A

pus or blood in urine

fever

discomfort in the area of the bladder of kidneys

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17
Q

what tests can we carry out to diagnose obstructive uropathy

A

imaging testing

endoscopy

blood and urine tests

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18
Q

how can ultrasound on the bladder be used to diagnose obstructive uropathy

A

Ultrasound of the bladder will tell us the volume of urine retained in the bladder.

If patient is in severe retention then a catheter will be inserted

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19
Q

how can ultrasound on the kidney be used to diagnose obstructive uropathy

A

tell us if hydronephrosis is present

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20
Q

how can CT scan be used to diagnose obstructive uropathy

A

pick up renal stones

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21
Q

how can endoscopy be used to diagnose obstructive uropathy

A

a camera can be used to examine the urethra, prostate, bladder, ureters or kidneys to identify sites of obstruction

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22
Q

what is endoscopy

A

A long, thin tube with a small camera inside, called an endoscope, is passed into your body through a natural opening such as your mouth.

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23
Q

how can blood tests be used to diagnose obstructive uropathy

A

blood may reveal high urea or creatine levels

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24
Q

how can urine tests be used to diagnose obstructive uropathy

A

may reveal high WBCs

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25
what is the aim of treatment for obstructive uropathy
to relieve the cause of the obstruction
26
how do we treat BPH or prostate cancer
medications or surgery
27
how do we treat hydronephrosis
nephrostomy tube or ureteral stent
28
renal calculi stones
removal
29
in what ages are kidney stones (calculi) common
20 - 40
30
in what gender are kidney stones common
male
31
where do calculi begin to form
kidney but may enlarge in the ureter or bladded
32
what are the 4 types of renal calculi
calcium oxalate uric acid stone (urate) cystine stone infection stones
33
what is the most common kidney stone
calcium oxalate
34
what is oxalate
waste product of food that sticks to calcium
35
what are the causes of calcium oxalate stones
dehydration high protein diet high oxalate diet medical conditions
36
what are urate stones caused
result of hyperuricaemia and or when urine is too acidic
37
what are cystine genetic disorder
causes cysteine to leak from kidneys to urine
38
infection stones also known as
struvite stones
39
what are infection stones made up of
made up of minerals such as magnesium and ammonium and phosphate
40
what are the causes infection stones
urinary tract infection
41
What are some overall causes of calculi
may form if the urine is too saturated with salts or if the urine lacks the normal inhibitors for stone formation hyperparathyroidism dehydration renal tubular acidosis diet high in animal source protein or vitamin C family history of stone formation bariatric surgery rarely drugs
42
what are some symptoms of renal calculi
bladder stones may cause lower abdomen pain ureter or renal pelvis stones may cause back pain or renal colic nausea and vomiting sweating blood or a stone piece in the urine infection signs
43
what are the ways in which we can diagnose renal calculi
symptoms urinalysis x ray intravenous urogram Ct scan
44
how can urinalysis be used to diagnose renal calculi
will pick up on the presence of blood or pus in the urine
45
how can xray be used to diagnose renal calculi
not super accurate however will pick up on calcium stones
46
how can intavenous urogram be used to diagnose renal calculi
the dye will be able to determine the degree of blockage and the location.
47
why is intravenous urogram not preffered to diagnose renal calculi
is risky due to the dye's potential to worsen kidney failure or cause an allergic reaction thus is not preferred
48
how can Ct scane be used to diagnose renal calculi
can locate the stone and indicate the degree to which the stone is blocking the urinary tract.
49
out of all the methods to diagnose renal calculi which is preferred
Ct Scan
50
How do we manage the symptoms of renal calculi
paracetamol is a safe option NSAIDs or opioids but be careful of both due to potentially reduced renal function anti emetics
51
what are the two types of stone removal
non invasive | invasive
52
describe non invasive management
increase fluid intake to encourage the smaller stones to be flush out take alpha adrenergic blockers to relax the smooth muscle of the ureter and allow stones to pass penicillamine can be used to dissolve cystine stones Extracorporeal shock wave lithotripsy (ESWL) use of sound waves to shatter kidney stones so that they can be flushed out
53
what are three forms of invasive management
Ureteroscope Percutaneous nephrolithotomy Open surgery
54
what is ureteroscope and how is it used to break kidney stones
small viewing telescope inserted into the urethra and through the bladder to remove small stones in the lower part of the ureter
55
what is percutaneous nephrolithotomy and how is it used to break kidney stones
Small into the back and a probe is inserted through the nephroscope to break the stone into smaller pieces
56
how often is open surgery used
rare and only used if theres a very large stone or abnormal anatomy
57
What is a UTI
Urinary tract infection which is an infection of any part of your urinary system
58
what are the different types of UTIs
``` acute and chronic pyelonephritis cystitis urethritis epididymitis prostatitis ```
59
What bacteria is the most common cause of a UTI in community
Escherichia Coli is responsible for 80-90% of infections in the community
60
what are the symptoms of a UTI
Increase in urinary frequency, urgency and or strangury Dysuria offensive smelling & cloudy urine Haematuria and or pus in the urine Constant lower abdominal ache Nausea, tiredness and cold sweats Urge incontinence
61
does asymptomatic UTI need to be treated
only needs to be treated in pregnant woman as it can lead to developmental delay, cerebral palsy or foetal death
62
what are some complication of UTI's
Ascending infection can lead to pyelonephritis Renal failure, especially in the elderly sepsis can lead to permanent damage to the kidneys can lead to infection stones
63
what is acute pyenlonephritis
sudden and severe infection which can result in the kidneys swelling causing permanent damage.
64
how can we treat acute pyenlonephritis
antibiotics e.g. co - amoxiclav but may differ depending on local resistance pattern
65
what are the risk factors of acute pyenlonephritis
chronic kidney stones older adults immunocompromised patients vesicoureteral reflux BPH diabetes pregnancy catherter use utrinary tract surgery nerve or spinal cord damage
66
what are the complications of chronic pyelonephritis
``` progressive renal scarring hydronephrosis CKD secondary hypertension pyonephrosis focal segmental glomerulosclerosis ```
67
what is polycystic kidney disease
mainly an inherited kidney disorder which is the fourth leading cause of kidney failure it can be acquired in patients who already have kidney fialure or are on dialysis. Causes filled cysts to form in the kidneys and may impair kidney function and eventually cause kidney failure
68
what are the symptoms of PKD (polycystic kidney disease)
pain or tenderness in abdomen and or back hameaturia frequent urination UTI + kidneys stone fatigue joint pain skin that bruises easily pale skin colour
69
How do we treat PKD
Tolvaptan, slows the progression of cyst development and helps protect renal function which significantly delays the need for dialysis or kidney transplant.
70
what is the problem with TOLVAPTAN
prescriber needs specialist training prior to prescribing.
71
what is an auto immune disease
immune system creates antibodies or immunoglobulins that attack the body itself
72
what is systemic lupus erythematosus
a type of autoimmune disease that can affect the kidneys causing lupus nephritis
73
what is goodpasture syndrom
an autoimmune disease that can target the lungs and kidneys
74
what is glomerulonephritis
inflammation of the glomeruli which caused by autoimmune or non autoimmune disease which can lead to kidney failure
75
what is nephrotic syndrome
result of glomerulonephritis, damage of the glomeruli causes proteins to leave blood and be passed into tubules with the filtrate and enter the urine
76
how do we treat nephrotic syndrome
diet modification blood pressure control immunosuppressants for the glomerulonephritis

Therapeutics (50 decks)

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