Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Medicine II > Nephro: Clinical Syndromes in Nephrology > Flashcards

Nephro: Clinical Syndromes in Nephrology Flashcards

1
Q

how do you analyse urine

A

urine dipstick

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

what is haematuria?

A

> 2 red cells/hpf in unspun urine

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

classification of haematuria

A
  • microscopic/macroscopic
  • persistent/transient
  • glomerular/non-glomerular
  • kidney/urinary tract
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

causes of glomerular haematuria

A

IgA nephropathy, thin basement membrane disease, Alport’s disease, other glomerulonephritis

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

causes of nonglomerular haematuria

A

tumours, cysts, calculi, pyelonephritis, papillary necrosis, renal vein thrombosis

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

causes of urinary tract bleeding

A

cystitis, prostate, tumours, stricture, schistosoma haematobium

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

most frequent causes of haematuria

A
  • inflammation/infection of the urinary tract or prostate
  • urinary calculi
  • malignant neoplasms
  • glomerular disorders
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

risk factors for malignancy

A
  • people older than 40yo
  • smoking
  • pelvic irradiation
  • cyclophosphamide treatment
  • analgesic abuse
  • occupational exposures
  • history of gross haematuria
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

when are glomerular disorders more likely?

A
  • proteinuria >0.5g/24hrs
  • dysmorphic erythrocytes present and RBCs cast on phase contrast microscopy
  • HTN
  • renal impairment
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

what do pyuria or dysuria entail?

A

UTI

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

what do RTIs entail?

A

postinfectious glomerulonephritis, IgA nephropathy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

why is family history important?

A

polycystic kidney disease, hereditary nephritides

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

what does back pain entail?

A

urethral obstruction

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

why is exercise or injury important in a nephro history

A

could rule out haematuria caused post-exercise or post-traumatic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

what do micturition disorders in older men entail

A

prostatic obstruction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

what does a history of bleeding from multiple sources?

A

coagulation disorders

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

investigations for haematuria

A
  • urinalysis
  • urine microscopy
  • urine culture
  • CBC
  • U&E
  • clotting screen
  • PSA
  • nephritic screen
  • imaging (CT mainly)
  • cystoscopy
  • urine cytology
  • renal biopsy (glomerular haematuria)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

why is proteinuria important?

A
  • marker for intrinsic renal disease
  • prognostic factor for progession of renal insufficiency
  • risk factor for CV mortality
  • treatment target in CKD
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

normal value for proteinuria

A

<150mg/day

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

value for microalbuminuria

A

30-300mg/day

ACR >2.0mg/mmol

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

classification for pathophysiology of proteinuria

A
  • glomerular
  • tubular
  • overflow (light chains in multiple myeloma)
  • secretory (bladder tumour, prostatitis, blood)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

classification of proteinuria (using values)

A
  • mild <1g/day
  • significant 1-3.5g/day
    nephrotic >3.5g/day
    the higher the value, the more likely is to be caused by glomerular disease
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

what causes leucocyturia

A

infection (neutrophilia)

tubular intersititial necrosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

causes of sterile pyuria

A

treated UTI, chlamydia, calculi, prostatitis, bladder tumour, papillary necrosis, TIN, TB

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

which mix of values has the worst prognosis (of protein and blood in urine)

A

nephrotic proteinuria and haematuria

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

criteria for nephrotic syndrome

A 
proteinuria of >3.5g/1.73m2/24h
hypoalbuminaemia
oedema
hyperlipidaemia
lipiduria
hypercoagulability
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

pathophysiology of nephrotic syndrome

A

primary insult = increased glomerular permeability; causing plasma protein leakage into urine
hypoalbuminaemia is the cause of the main clinical features

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

causes of nephrotic syndrome

A
  • membranous glomerulopathy
  • focal segmental glomerulosclerosis
  • minimal change glomerulopathy
  • miscellaneous proliferative GN
  • membranoproliferative GN
  • diabetes
  • amyloidosis
  • other disease
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

treatment of nephrotic syndrome

A
  • salt and water restriction
  • diuretic therapy
  • hypertension treat
  • anti-proteinuric drugs
  • immunosuppressive therapy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

definition of nephritic syndrome

A

glomerular inflammation causing:

  • decrease in GFR
  • moderate proteinuria
  • oedema
  • hypertension
  • haematuria (red cell casts)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

causes of acute nephritis

A
  • IgA A and HSP
  • lupus nephritis
  • postinfectious GN
  • Anti-GBM disease
  • ANCA positive small vessel vasculitis and idiopathic pauci-immune GN
  • idiopathic crescentic GN
  • mesangiocapillary GN
32
Q

investigations for nephritis

A
  • urine dipstick
  • 24h proteinuria variable U&E&C, LFTs
  • acute phase markers
  • full nephritic screen
  • US kidneys
  • renal biopsy
33
Q

immunological findings in poststrep GN

A
  • reduction in CH50 and C3 complement activity

- serial ASO titre measurements

34
Q

rapidly progressive GN

A
  • decrease in GFR in days/weeks

- acute uraemic or nephritic syndrome with quick renal insufficiency, risk renal failure

35
Q

extrarenal symptoms of rapidly progressive GN

A

pulmonary, skin, ORL, CNS

36
Q

definition of acute renal failure

A

rapid decrease in GFR (hours/days) due to urea, creatinine retention as well as electrolyte disorders, acid-base disorders, fluid homeostasis disorder

37
Q

is oligouria present in ARF?

A

maybe

38
Q

highest risk in ARF

A

pulmonary oedema, hyperkalaemia

39
Q

how is acute renal failure classified

A

RIFLE classification

- risk, injury, failure, loss, end-stage

40
Q

acute kidney injury classification

A

based on the creatinine level and the urine output

41
Q

causes of ARF

A
  • pre-renal
  • renal
  • post-renal
42
Q

pre-renal causes of ARF

A
  • hypotension from low GFR
  • arterial stenosis
  • NSA
  • ACEi
43
Q

intrinsic causes of ARF

A
  • ATN (ischaemic or nephrotoxic)
  • vascular
  • acute GN
  • acute TIN
44
Q

postrenal causes of ARF

A

obstruction

45
Q

risk factors for ARF

A
  • increasing age
  • diabetes mellitus
  • pre-existing renal disease
  • surgery
  • volume depletion
  • cardiac disease
  • cirrhosis
  • drugs (NSA, ACEi, ARB)
  • myeloma
46
Q

what are the two main tests in nephro?

A
  • eGFR

- ACR/PCR

47
Q

what are the main causes of CKD?

A

HTN and DM

48
Q

how can renal insufficiency be classified?

A
  • exocrine dysfunction (disbalance in ions and other catabolites)
  • endocrine dysfunction (EPO, Vit D metabolism, renin-angiotensin system)
49
Q

clinical features of uraemic syndrome

A
  • GI (anorexia, nausea, vomiting)
  • neurological (central and peripheral - uraemic encephalopathy and polyneuropathy)
  • respiratory (pulmonary oedema)
  • cardiac (uraemic pericarditis)
  • dermatological (pruritis)
  • haematological (fatigue from anaemia)
  • endocrinolohical (secondary hyperparathyroidism, dysmenorrhea)
50
Q

in which 3 clinical situations is uraemia present?

A
  • acute renal failure
  • chronic renal failure
  • dialysis-treated CRF
51
Q

what happens to toxic compounds in renal failure

A

they accumulate

52
Q

what happens to muscle in metabolic acidosis

A

there is proteolysis, causing a loss of lean body mass

53
Q

what happens to bone in metabolic acidosis

A

inhibition of osteoblasts and stimulation of osteoclasts, causing dissolution of the bone matrix and minerals

54
Q

which hormones decrease in metabolic acidosis?

A

vitamin D3, thyroxine, growth hormone

55
Q

which hormones increase in metabolic acidosis?

A

PTH level, cortisol, insulin resistance

56
Q

treatment of uraemia

A
  • Na, K, PO3 and protein diet restriction
  • HTN control
  • NaHCO3 treatment to reduce metabolic acidosis
  • anaemia management (erythropoietin)
  • secondary hyperparathyroidism
  • dialysis and renal transplant
57
Q

what are pulmonary-renal syndromes?

A

acute kidney injury associated with pulmonary haemorrhage

58
Q

clinical features of pulmonary-renal syndromes

A

cough, anaemia, dyspnoea, haemoptysis, hypoxaemia, alveolar shadowing on CXR, skin rush, sinusitis, arthritis, fever, fatigue

59
Q

main causes of pulmonary-renal syndromes

A

ANCA vasculitis, antiGBM nephritis, SLE, Henoch-Schonlein purpura

60
Q

types of hypertension

A

primary (kidney suffers itc)

secondary (kidney is the cause)

61
Q

why do we control HTN from a nephro POV?

A

control slows the progression of kidney disease

62
Q

what are the tubular syndromes which have a normal GFR

A

fanconi syndrome

isolated cases

63
Q

what happens in Fanconi syndrome

A
  • amino acids, phosphate and glucose, protein, calcium and high amounts of urine are excreted
  • Na and K are lost
  • bicarbonate defective reabsorption
64
Q

types of pain in nephro

A
  • loin pain
  • ureteric colic
  • suprapubic pain
  • bladder irritability
65
Q

characteristics of loin pain

A

constant dull ache, radiating to the abdomen, genitalia

66
Q

causes of loin pain

A

distension of the renal capsule

67
Q

differential for loin pain

A

nerve root irritation (T10-T12)

68
Q

characteristics of ureteric colic

A

sudden onset, extremely severe, pale, distressed patient

69
Q

where is ureteric colic localised?

A

loin, iliac fossa, genitalia, upper thigh

70
Q

causes of ureteric colic

A

passage of a calculus, blood clot or necrotic papillae

71
Q

cause of suprapubic pain

A

over-distension of the bladder, cystitis, bladder cancer

72
Q

symptoms associated with bladder irritability

A

dysuria, frequency, urgency

73
Q

causes of bladder irritability

A

over-distension of the bladder, cystitis

74
Q

obstructive symptoms of bladder outflow obstruction

A

hesistancy, impaired force of stream, incomplete emptying

75
Q

storage symptoms of bladder outflow obstruction

A

frequency, dysuria, urgency

76
Q

causes of bladder outflow obstruction

A

structural: prostatic hyperplasia, carcinoma, urethral stricture
functional: bladder neck dyssyngeria, DM, multiple sclerosis, spinal cord lesions, drugs

Medicine II (16 decks)

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