Nephrology Flashcards
, stroke, raised HB, B/L renal masses, heamturia? female sound cyst in scan?
hepatic cysts common in Female. ADPKD
horse rider common urethral injury?
blunt trauma to perineum - anterior urethral injury. distal to the membraneous
urethral injury most common with pelvic #/ RTA?
posterior (near prostatic urethra. in the membranous
GN: most common 48 hrs post URTI
IGA nephropathy.
2-3 weeks post URTI GN?
PSGN. anti-streptolysin antibodies
rash, abdo pain, child, joint pain, GI bleed, similar histological findings to IGA nephropathy?
HSP
GN: asthma, GI, cardiac involvement?
Churg strauss syndrome/ oesiophillic granulomatous with polyangiitis. p anca
nephritis with sinusuitis, nasal discharge with blood, joint pain in knees, ankles, weight loss
wegener’s granulomatosis, (granulomatosis with polyangiitis)
nephritis with pulmonary haemorrhages?
Goodpasetur’s syndrome
nephritis, young boy, sensorineuronal HL
X linked alport’s syndrome
most common cx of nephrotic syndrome in adults?
focal segmental glomerulosclerosis
most common renal lesion from SLE?
diffuse proliferative glomerulonephritis
unexplained WL, fatigue, oedaema, resistent to diuretics?
nephrotic syndrome secondary to amyloidisis
CX of bladder cancer?
Tx?
cyclophosphamide, pioglitazone, schistosomiasis
TX: BCG vaccine, muscle invasive - chemo and cystectomy
chronic NSAID use, sudden flank pain?
do USS renal to obstruction from sloughed papilla
danube river, yellow palms and soles, HTN, renal failure?
balkan neuropathy
sterile pyruia cx?
appendicitis, treated UTI, renal stones, prostatis, chlamydia, PKD, interstitial cystitis
f RA, with B/L renal masses, HTN, oedaema?
on congo red stain?
amyloidosis -shines green.
Amyloidosis associated with?
RA, crohns, JIA, still’s, OM, TB, RCC,
blood/ pus in urine, unexplained infertility, repeated UTIs?
genitourinary TB
testicular lump, reducable with rpessure in deep inguinal ring?
inguinal hernia
testicular lump fluctuant swelling separate from rest, milky fluid
spermatocele
where is cryptoorchidism more likely?
right testes. complete surgery by 12-18 months age. refer at 3 months
chronic sx of pelvic pain, incontinencne, lakc of gynae sx, dx of exlcusion?
interstitial cystitis (bladder pain syndrome)
women <30YO, resistent HTN, took ace, worsened kidney function, flash pulmonary eodaema ?
renal artery stenosis
raised ESR, CRP, B/L hydronephrosis ureters drawing together at midline in XR, CT para-aortic mass?
retroperitoneal fibrosis
cx: cancers, autoimmune disorders, BB, methyl dopa, methysergide
BPH tx meds?
alpha 1 antagonists:smooth muscle relaxer in bladder tamsulosin, terazosin
5 alpha reductase inhibitors - finesteride
RF for testicular Ca?
klinfelters, young parent age, undescended, breech, infantile hernia.
Child, renal failure, frontal bossing, urine with po4. glucose, AA, frontal bossing, rickets?
Fanconi’s syndrome
60YO man multiple myeloma patchy caclification on kidneys on XR?
other causes?
nephrocalcinosis (cx by high Ca)
other cx: malignancy, <MM, sarcoid, hyperparathyroid, vit D intox,
CI of nitrofurantoin?
G6PD and acute porphyria
foods to avoid with kidney stones?
rhubarb, strawberry, spinach, beets, chocolate, reduce tea,
what may hydroceles in adutls be secondary to?
orchitis, epidiydmitis, TB, torsion, testicular tumours, trauma, post renal transplant, post radiation therapy
painless enlarged scrotum superior and anterior to testes?
hydroceles - testes may not always be felt. transilluminates
painless enlarges scrotum, lump superior and posterior to testes?
spermatocel
left side testicle, after puberty, bag of worms swelling?
varicocele - AF reduced function and infertility
before PSA test whaat to warn people?
no UTI, no ejaculation 48 hrs, no vigorous exercise, no prostate biopsy in 6 weeks
High PSA values?
CX?
50-59 YO 3+
60-69 YO 4+
70+ 5+
CX: age, cancer, catheter, retention, prostatitis, TURP, BPH,
post stabbing, transfusion, oliguria, urine Na is 70
ATN
post op patient with urine sodium of 7 and oliguria?
dehydration cause- pre renal sodium is <20
Post TURP colicky abdo pain, no urine passed and palpable bladder?
clot retention- bladder washout
AKI with Oliguria, explain ix?cx
no pain/ = , AKI or AKI on CKD, do U+Es, do USS, - if no dilation/ structural/ obstructive cx, then it is pre-renal or renal cx (ATN)
.then can do urine Na, osmol, creatinine, fractional sodium excretion,
Pre-renal oliguria vs ATN?
ATN: urine sodium 40+, osmol <350, urea <150, urine plasma osmol <1:1. poor response to fluid challenge
fractional urea excvretion:35%+, brown granular casts
pre-renal: urine Na <20, osmol 500+, urine:plasma osmol 1.5+, good response to fluid challenge
AD PKD AF conditions?
Hb?
RCC, colonic diverticula, mitral valve prolapse, berry anerurysm, hepatic cysts in women
hb - increase EPO
brown urine cx?
fava beans, nitrofuantoin, myoglobulin,levodopa, metronidazole,
Oe/ of urethral injury?
abnormally high riding prostate, blood/ bruiding perineum, scrotal haematoma
crohns/ diverticulitis hx, bubbles in urine stream, fowel smelling, brown discoloured
pneumaturia:
(vesicocolic fistula). growth: e.coli common. CTAP and cystoscopy
urine dipstick increased specific gravity?
dehydration, RAS, HF, SIADH,proteinura
decreased urine dipstick specific gravity cs?
excessive fluid, renal failure, peylonephritis, diabetes insipidus
common uti cx women?
klibsiella, e coli, stpah saprophyticus (sexually active), candida, enterococci, enterobacter, proteus
Na 175, urine osmol is 160 (low) and high serum osmol with B/G bipolar disorder and was NBM?
Neprogenic diabetes insipidus. after fluid deprivation and ADH (desmopressin), the osmol is still low <300. nbm - masked, likely cause was lithium for BPD. tx thiazide diuretics - inhibit NACL reabsorption in DCT
cx of nephrogenic DI?
acquired/ congenital?
acquired- lithium, demeclocycline, hypercalcaemia, CKD
common cx of sterile pyruia?
global scale?
in uk?
in people over 45YO?
sterile pyuria? presence of leukocytes without active infection
global - TB/ shistosomiasis
uk - partially tx uti/ sTI
45+ - renal/ bladder tumours
haematuria, flank mass and left sided varicocele?
past q
renal cancer
UTI tx abx?
nitro (if GFR is 45+/ CI G6PD) 3 days/ trimethoprim (if not pregnant). if no improvmeent in 48 hrs penicillin/ fosfomycin 3g single sachet
peylonephritis tx?
non pregnant/ cather/ men
cefalexin 7-10 days if culture pos- co-amox/trimeth/ciproflox
pregnant not needing admission - cefalexin
