Neph/Uro Flashcards
- MC CA in men after skin CA
- 2nd leading cause of CA deaths
- Mets to bone
PrCA
- 2nd MC GU CA
- Smoking increases risk
Bladder CA
- Kidney CA that affects kids; high cure rate
- Lung/liver mets
- Sx: Abd mass/swelling
Wilms’ Tumor
- Often asx and found incidentally
- Lung, bone mets
RCC
-Autosomal dominant disorder. Cysts replace mass of kidneys–> decreasing function–>failure
-Sx: Flank pain/mass; HTN; hematuria. Random: Cerebral aneurysm; mitral valve prolapse
-Dx: Renal Us
Tx: Observational to Sx Tx to transplant
Polycystic Kidney Dz
- Excretion of >3.5g protein in 24hrs
- Proteinuria, hypoalbuminemia, hyperlipids and edema
- Glomerular damage–>proteinuria–>hypoalbuminemia–>decreased plasma oncotic pressure–>edema
- Multiple etiologies: infx; neoplasia; pharm toxicity, etc.
- Sx: malaise, edema, abd distention, facial edema/eyelid puffiness, SOB
- Dx: Protein, Glu, heme, lipids on UA. Foamy urine. Casts on micro, hypoalbuminemia hyperlipidiemia
- Tx: Diruretics for edema, ACEI/ARBs to decrease intraglomerular pressure. Diet/statins for lipids. +/- steroids
-Increased clotting risk as liver increases protein production (and clotting factors 2/2 hypoalbuminemia)
Nephrotic syndrome
- Immune related inflamm. or glomeruli–>protein & RBC leakage
- IgA nephropathy p URI or GI infx
- Sx: Hematuria; cola colored urine, oliguria, anuria, facial/eye & feet/ankle edema, HTN
- Dx: UA( heme, RBC casts, dysmorphic RBCs)
- Tx: Steroids, ACEI, diuretics (edema), sx’s, self limted
Actue Glomerulonephritis
- MC acute intrinsic kidney injury
- Tubular epithelial destruction–>acute renal failure d/t toxic or ischemic injury
- Sx: Non specific
- Dx: Abrupt decrease in GFR, MUDDY BROWN CASTS, BUN:Cr ratio
Acute Tubular Necrosis
- Chronic interstitial nephritis 2/2 large consumption of analgesics
- Sx: HTN, limited sxs
- Dx: Protein, heme, sterile pyuria, sloughed papillae on UA
- Tx: Stop Analgesics, increased CA risk
Analgesic nephropathy
-Rapid deteriorating GFR w accumulation of nitrogenous waste (urea & creatine–>azotemia)
-Cr 50% above baseline
-Majority d/t decreased renal perfusion or acute tubercular necrosis
-Overall causes can be pre-renal, intrinsic or post-renal
Tx: Correct underlying cause. Dialize if Cr >5
Acute Renal Failure
These cause this type of renal failure:
Hypovolemia, hypotension, aortic aneurysm, renal artery stenosis/embolus
Pre-Renal
These cause this type of renal failure:
ATN, nephrotoxins, infection, GlomNeph, vasculiits
Intrinsic
These cause this type of renal failure:
Obstruction
Post-Renal
- Ongoing loss of kidney function
- GFR less than 60 or evidence of kidney damage (proteinuria, GlomNeph, structural damage) for 3+ mod
- MC 2/2 DM, HTN, GlomNeph, Polycystic Kidney Dz
- Sx: Insidious: fatigue, malaise, anorexia, N/V, WL, dyspnea, AMS
- Tx: Slow progression–> ACEI & ARBs; strong control of HTN, DM, Chol.
CKD
