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Renal + Urology > Nephrotic syndrome, hydronephrosis, nephropathies + HUS > Flashcards

Nephrotic syndrome, hydronephrosis, nephropathies + HUS Flashcards

1
Q

Describe IgA nephropathy

A

Occurs days after URTI or gastroenteritis Gross haematuria + RBC casts in urineNephritic syndrome

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2
Q

Describe post strep glomerulonephritis

A

Occurs weeks after strep infection (6 weeks after impetigo, 2 weeks after strep throat)
Type 3 hypersensitivity - IgG + IgM deposit in kidneys
Nephritic syndrome
Causes haematuria, HTN, oliguria, oedema

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3
Q

Describe Goodpasture’s syndrome

A

Anti GBM AbType 2 hypersensitivity reaction IgG ab - damage basement membrane Lung damage = cough, haemoptysisNephritic syndrome - haematuria, HTN, oedema Treat with steroids

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4
Q

Describe haemolytic uraemic syndrome

A

Blood clots in kidneys cause RBC break down + decrease in kidney function + nephritic syndrome Triggered by bloody diarrhoea Caused by E coli

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5
Q

Describe diabetic nephropathy

A

Causes damage to kidneys from glucose, microalbuminuria Causes nephrotic syndrome Treat with ACEi

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6
Q

What is nephrotic syndrome?

A

Disease causing inflammation to kidney that causes protein loss, low albumin in the blood + high cholesterol
Causes oedema, hypovolemia, AKI

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7
Q

Causes of nephrotic syndrome

A

Minimal change disease, diabetic nephropathy, amyloidosis, SLE

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8
Q

Management of nephrotic syndrome

A

ACEi or ARBs
Sodium restriction
Loop diuretics
Statins

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9
Q

Presentation of urinary tract obstruction

A

Pain, change in urine output, haematuria, increased serum creatinine
Distended abdomen, abdo mass

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10
Q

Assessment + management of urinary tract obstruction

A

US

CT if kidney stones suspected

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11
Q

Complications of urinary tract obstruction

A

Tubular atrophy

Renal injury

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12
Q

Genetics of polycystic disease

A

Autosomal dominant, defect on chromosome 16

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13
Q

S+S of polycystic disease

A 
HTN 
hematuria 
Proteinuria 
Decreased kidney function 
Flank pain due to hemorrhage, calculi or UTIs are common 
May present with cysts in other organs
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14
Q

Diagnosis of polycystic disease

A

Usually due to routine bloods in positive family history
US, then MRI if needed for asymptomatic
CT/ MRI for symptomatic pts

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15
Q

Management of polycystic disease

A

ACEi or ARBs for HTN
Tolvaptan
Dialysis if needed

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16
Q

Causes of urethral strictures in men

A

Trauma
Infection
Catheterisation

17
Q

S+S of urethral stricture

A 
Chronic obstructive voiding symptoms:
Decreased stream
Incomplete bladder emptying 
Recurrent UTIs 
Urinary spraying 
Dysuria 
Ejaculatory dysfunction
18
Q

Investigations for ?urethral stricture

A

Cystourethroscopy, retrograde urethrogram, voiding cystourethrogram or US urethrography

19
Q

Management of urethral stricture

A

Abx prophylaxis prior to cystourethroscopy or surgery

20
Q

What is vesicoureteral reflux?

A

Retrograde passage of urine from bladder to upper urinary tract

21
Q

2 types of vesicoureteral reflux

A 
Primary = due to incompetent or inadequate closure of ureterovesical junction 
Secondary = result of abnormally high voiding pressure in bladder
22
Q

How does vesicoureteral reflux present?

A

Prenatally as antenatal hydronephrosis on prenatal US

Postnatally aft§er initial UTI

23
Q

Imaging to diagnose vesicoureteral reflux

A

Contrast voiding cystourethrogram (VCUG)

DMSA renal scan

24
Q

Management of vesicoureteral reflux

A

Abx prophylaxis

Surgery to correct anatomy

25
Q

S+S of glomerulonephritis

A 
Haematuria 
Proteinuria 
Renal insufficiency 
HTN
Oedema 
Hypercoagulability
26
Q

What are the causes/ pathology of proteinuria?

A

Glomerular disease - this is picked up as protein on a dipstick
Tubular proteinuria
Overflow proteinuria (ie multiple myeloma)
Postrenal (UTI)

27
Q

What are the causes of proteinuria without nephrotic syndrome?

A

Orthostatic proteinuria
Transient proteinuria
Reflux nephropathy
Diabetic nephropathy

28
Q

Evaluation of glomerulonephritis

A

Kidney biopsy
C3 + C4 complement levels
ANCA, ANA
Hep B + C serology

29
Q

How can a diagnosis of thrombotic microangiopathy be made?

A

Microangiopathic hemolytic anemia
Thrombocytopenia
Kidney failure

30
Q

What is of orthostatic proteinuria?

A

Elevated protein excretion while in upright position

31
Q

Management of orthostatic proteinuria

A

Benign condition, doesn’t affect renal function so no intervention needed

Renal + Urology (6 decks)

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