more kidney Flashcards
What drug would you use to alkalise urine?
Oral sodium bicarbonate
Name a cysteine binder.
Captopril
How would you treat hypercalciurea?
Thiazide - bendroflumethiazide
Give 6 causes of pre-renal AKI
- Hypotension
- Heart failure
- Hypovolaemia - eg dehydration
- Renal artery stenosis/thrombosis
- Liver cirrhosis
- SEPSIS
Give a post renal cause of AKI
Urinary tract obstruction
- Stones
- Prostate enlargement
Define AKI
An abrupt and sustained rise in serum creatinine, urea, and decrease in urine output Due to a rapid decline in GFR
How can kidney stones be prevented?
- Overhydration
- Reduce salt intake
- Reduce protein intake
- Drink citrus juice
- Lose weight
What are the risk factors for Renal Cell Carcinoma?
- Smoking
- Obesity
- HTN
- Polycystic Kidney disease
- von Hippel Lindau
- Renal failure and haemodialysis
CKD leads to uraemia. List 6 symptoms of uraemia?
- Anorexia
- Nausea
- Encephalopathy -> coma and death
- Pericarditis
- Bleeding
- Uraemic frost
List 6 symptoms of CKD (excluding uraemia symptoms)
- Oliguria
- Dyspnoea
- Peripheral oedema
- HTN
- Cardiomegaly
- Hyperkalaemia -> arrhythmias
What is the albumin creatinine ratio?
Albumin in urine can be diluted or concentrated depending on urine volume. Creatinine is excreted in urine at a constant rate. Therefore the ratio of albumin to creatinine should be constant irrespective of urine volume.
How would you treat CKD?
- Anti-hypertensives - ACD
- Statins and risk factor mod for CV disease
- Treat acidosis and anaemia
- Treat oedema with loop diuretic
- ESRF - dialysis/transplant
- Vitamin D/Calcium for bone disease
(points do not correlate to order of Tx, or to severity of CKD)
TNM for prostate cancer: What investigation would you do to find T?
DRE
TNM for prostate cancer: What investigation would you do to find N?
MRI/CT scan to imagine how many nodes it has spread to.
TNM for prostate cancer: What investigation would you do to find M?
Bone scan
What are the arguments for radical prostatectomy?
- Curative
- Reduced patient anxiety
- Prostate cancer has a high mortality
- Longitudinal studies show the benefit of surgery.
What are the arguments against radical prostatectomy?
- Disease of the elderly
- Many competing causes of death
- 30% of men with prostate cancer die OF prostate cancer, 70% don’t die of prostate cancer
- Adverse effects of treatment
What do you use for androgen deprivation therapy in prostate cancer?
- LHRH agonists - initially cause an increase in testosterone levels, but levels drop after a few weeks.
Increase in testosterone levels can increase size of bony mets, so androgen receptor antagonists are given alongside LHRH agonists for the first few weeks.
Name a chemotherapy drug for prostate cancer.
Docetaxel
Where is the PSA used?
- PSA is usually used to monitor response to treatment for advanced prostate cancer.
- Detection of recurrent disease e.g. after prostatectomy
Give 2 advantages and 2 disadvantages of screening in prostate cancer.
- Most common cancer in men
- Uncertain natural history
- Overtreatment - Morbidity of treatment
How can testicular tumours be divided?
- Germ cell
- Non-germ cell
- Seminoma
- Non-seminoma
- Embryonal carcinoma
- Yolk sac carcinoma
- Choriocarcinoma
- Teratoma
What is the first line treatment for cystitis?
Trimethoprim or cefalexin
