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Renal/Urology > Lecture 12 - Presentation of Diseases of the Kidneys and Urinary Tract > Flashcards

Lecture 12 - Presentation of Diseases of the Kidneys and Urinary Tract Flashcards

1
Q

What are the two divisions of the urinary tract?

A

Upper urinary tract (kidneys + ureter)

Lower urinary tract (bladder + bladder outflow tract)

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2
Q

What are the parts of the kidneys?

A

Parenchyma

Pelvi-calyceal system

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3
Q

What are the parts of the ureters?

A

Pelvi-ureteric junction
Ureter
Vesico-ureteric junction

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4
Q

What are the parts of the bladder outflow tract?

A 
Bladder neck (intrinsic urethral sphincter)
Prostate
External urethral sphincter/pelvic floor
Urethra
Urethral meatus
Foreskin
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5
Q

What things are on a surgical sieve?

A 
Infection 
Inflammation 
Iatrogenic 
Neoplasia
Trauma
Degenerative
Congenital 
Genetic/hereditary 
Vascular
Endocrine
Failure 
Idiopathic
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6
Q

Which drug is used for UTIs but CANNOT be used in renal failure?

A

Trimethoprim

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7
Q

What are infectious renal diseases?

A

Pyelonephritis

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8
Q

What are inflammatory renal diseases?

A

Glomerulonephritis

Tubulointerstitial nephritis

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9
Q

What are iatrogenic causes of renal disease?

A

Nephrotoxicity

PNCL

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10
Q

What are neoplasic causes of renal disease?

A

Renal tumours

Collecting system tumours

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11
Q

What are vascular causes of renal disease?

A

Atherosclerosis
Hypertension
Diabetes

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12
Q

What are hereditary causes of renal disease?

A

Polycystic kidney disease

Nephrotic syndrome

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13
Q

How can renal diseases present?

A 
Pain
Pyrexia
Haematuria
Proteinuria
Pyuria
Mass on palpation 
Renal failure
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14
Q

Define proteinuria

A

Urinary protein excretion >150mg/day

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15
Q

How many types of haematuria are there?

A

3 -
Macroscopic - gross/visible haematuria
Microscopic - visible on microscope
Dipstick positive - pick up on dipstick

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16
Q

Define microscopic haematuria

A

3+ RBCs per high power field

17
Q

Define oliguria

A

Urine output <0.5ml/kg/hr

18
Q

Define anuria

A

Absolute anuria - no urine output

Relative anuria - <100,l/24h

19
Q

Define polyuria

A

Urine output >3L/24h

20
Q

Define nocturia

A

Waking up at night on 1+ occasion to urinate

21
Q

Define nocturnal polyuria

A

Nocturnal urine output >1/3 of total urine output in 24h

22
Q

What criteria is used to stage AKI?

A

RIFLE

23
Q

What does the R in RIFLE stand for?

A

RISK

Increase in serum creatinine level (1/5x) or decrease in GFR by 25% or UO <0.5ml/kg/h for 6 hours

24
Q

What does the I in RIFLE stand for?

A

Injury

Increase in serum creatinine level (2.0x) or decrease in GFR by 50%, or UO <0.5 mL/kg/h for 12 hours

25
Q

What does the F in RIFLE stand for?

A

Failure
- Increase in serum creatinine level (3.0x), or decrease in GFR by 75%, or serum creatinine level >355μmol/L with acute increase of >44μmol/L; or UO <0.3 mL/kg/h for 24 hours, or anuria for 12 hours

26
Q

What does the L in RIFLE stand for?

A

Loss

Persistent ARF or complete loss of kidney function >4 weeks

27
Q

What does the L in RIFLE stand for?

A

End stage renal disease

Complete loss of kidney function >3 months

28
Q

List 6 functions of the kidney

A 
Electrolyte homeostasis
Acid-base homeostasis
Regulation of vascular tone
Body fluid homeostasis
Endocrine functions
Excretory functions
29
Q

How does chronic renal failure present?

A 
Can be asymptomatic
Fatigue
Anaemia
Oedema
HTN
Bone pain due to renal bone disease
30
Q

What are features of advanced renal failure?

A 
Pruritus
NV
SoB
Pericarditis
Neuropathy
Coma
31
Q

What kind of lesions may cause neurogenic bladder dysfunction?

A

Supra-pontine lesions (e.g. stroke, Alzheimer’s, PD)
Infrapontine suprasacral lesions (e.g. spinal cord injury, disc prolapse, spina bifida)
Infra-sacral (e.g. MS, DM, CES)

32
Q

What part of the brain is responsible for bladder sensation and conscious inhibition of micturition?

A

Cortical centre of micturition

33
Q

Where is the micturition centre?

A

Pons

34
Q

What sacral segments are involved in the micturition reflex?

A

S2-4 (these relax the IUS, EUS and contract the detrusor)

35
Q

What are the two types of UTI?

A

Uncomplicated - sexually active female

Complicated - everyone else, always investigate!

Renal/Urology (29 decks)

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