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renal - mine > non-renal diseases > Flashcards

non-renal diseases Flashcards

1
Q

what is cystitis

A

persistent inflammation which results in squamous metaplasia

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2
Q

what are the causes of cystitis

A

parasites and mycotic infection
aseptic
in-dwelling catheters

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3
Q

what is the type of cystitis that is aseptic

A

interstitial cystitis

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4
Q

what are the symptoms of cystitis

A

UTI symptoms

pain

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5
Q

what is cystitis cystica

A

infolding of the bladder mucosa, it is a non-specific sign of inflammation

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6
Q

what does diverticulae in the bladder result in

A

stagnant urine

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7
Q

what are the symptoms of diverticulae in the bladder

A

infections
stones
cancer

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8
Q

list some causes of obstruction in the urinary system

A

prostatism
stones
tumours
strictures

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9
Q

what are the symptoms of obstruction

A

persistent back pressure
dilation of the collecting ducts = hydronephrosis
trabeculated bladder muscle

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10
Q

what is the investigation of obstruction

A

CT cystography

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11
Q

what are the causes of bladder outflow obstruction

A 
BPH
urethral stricture
prostate cancer
bladder stones 
drugs
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12
Q

what drugs would cause bladder outflow obstruction

A

anti-cholingerics

nasal decongestants

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13
Q

what are the symptoms that would make you suspect cancer in bladder outflow obstruction

A

haemturia
subprapubic pain
recurrent UTIs
weight loss

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14
Q

what are the symptoms of bladder outflow obstruction

A 
frequency/urgency 
nocturia 
bed-wetting
hesitancy 
poor/intermittent flow/dribbling
enlarged bladder/kidney/prostate
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15
Q

what are the investigations of bladder outflow obstruction

A 
IPSS or LUTS questionaire
PR/abdo exam
frequency-volume chart 
urinalysis
PSA
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16
Q

what investigation would you do if the PSA was elevated and the ado exam was abnormal

A

transrectal US

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17
Q

what symptom would make you suspect high pressure chronic retention

A

bedwetting

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18
Q

what is the treatment for a bladder causing bladder outflow obstruction

A

muscle relaxants: beta agonist = morabegron or betmiga

or anti-cholinergics

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19
Q

what is the treatment for a prostate causing bladder outflow obstruction

A

alpha blocker = tamsulosin
5-alpha reductase inhibitor
transurethral resection

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20
Q

what is urinary incontinence

A

involuntary leakage of urine

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21
Q

what are the types of urinary incontinence

A

stress
urge
mixed

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22
Q

what is stress urinary incontinence

A

leakage on exertion or effort

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23
Q

what causes stress urinary incontinence

A

bladder neck or urethral hypermobility

AND/OR

neuromuscluar defect resulting in sphincter deficiency

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24
Q

what is urge urinary incontinence

A

leakage accompanied by or immediately preceded by urgency

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25
Q

what causes urge urinary incontinence

A

bladder overactivity or pathology irritating the bladder

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26
Q

what causes a constant leakage of urine

A

fistula between bladder and vagina

presence of ectopic ureter draining into vagina

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27
Q

what causes a post-micturition dribble

A

urine pooling the the bladder urethra

28
Q

what are the symptoms of urinary incontinence

A 
pain
haematuria
recurrent UTI
significant voiding/obstruction symptoms
history of pelvic surgery/radiotherapy
mass
29
Q

what are the investigations of urinary incontinence

A 
abdo/PR/pelvic exam 
urinalysis ± culture 
flow rate and post-voiding residue
pad testing
imaging/cystoscopy
30
Q

what are the conservative treatments of urinary incontinence

A

pelvic floor exercises
biofeedback
lifestyle: weight, fluid intake

31
Q

what medication can be given to treat STRESS urinary incontinence

A

duloxetine

32
Q

what is the surgical treatment of urinary incontinence

A 
injections
retropubic suspension = female stress
suburethral tapes and slings
artifical urinary sphincter 
ileal conduit urinary diversion
33
Q

what is an overactive bladder

A

collection of symptoms usually affecting >40s

34
Q

what are the symptoms of an overactive bladder

A

urgency ± urge incontinence
frequency
nocturia

35
Q

what medication is given to treat an overactive bladder

A

anti-cholingerics

beta agonists = mirabegron/betmiga

36
Q

what is diabetic nephropathy

A

microvascular complication that develops over time due to metabolic and vascular effects

37
Q

what are the symptoms of diabetic nephropathy

A 
renal hypertrophy 
inflammation
proteinuria
tubule-intestital fibrosis
microalbuminuria
38
Q

what causes the renal hypertrophy in diabetic nephropathy, what does it result in

A

plasma glucose stimulates growth factors

resulting in mesangial expansion and nodule formation/diffuse glomerulosclerosis

39
Q

what causes proteinuria in diabetic nephropathy

A

basement membrane thickening

podocyte dysfunction

40
Q

what investigation must you do if haematuria is present in diabetic nephropathy

A

biopsy

41
Q

how does ischaemic neuropathy affect the kidneys

A

caused reduced GFR due to reduced renal blood flow beyond the level of auto regulatory compensation

42
Q

what is hypertensive neuropathy

A

reduction in renal perfusion pressure activates a series of hormonal and neuronal responses that raise systemic BP

43
Q

who is usually affected by renal artery stenosis

A

males >50 unilaterally

44
Q

what are the symptoms of renal artery stenosis

A 
hypertension 
AKI after treatment of high BP
flash pulmonary oedema
abdominal bruit
discrepancy in kidney size
45
Q

what are the investigations of renal artery stenosis

A

US

CT or MRI angiography

46
Q

what is the treatment of renal artery stenosis

A

statin
ACEI (unless bilateral)
anti-platelet angioplasty ± stenting

47
Q

what is fibromuscular dysplasia

A

non-inflammatory disease of the blood vessels that causes abnormal growth within the artery walls

48
Q

who is affected by fibromuscular dysplasia

A

females 15-50

49
Q

what vessels are affected by fibromuscular dysplasia

A

both renal arteries

occasionally cerebral arteries

50
Q

what is dysproteinaemia

A

overproduction of Ig by clonal expansion of cells from B-cell lineage

51
Q

what is myeloma

A

cancer of the plasma cells responsible for producing antibodies

52
Q

how does myeloma affect the kidneys

A

abnormal plasma cells accumulate in the bone marrow impairing the production of normal blood cells. paraproteins (abnormal antibodies) are the produced which causes renal dysfunction

53
Q

what is the classic presentation of myeloma

A

back pain and renal failure

54
Q

what are the symptoms of myeloma

A 
anaemia 
hypercalcaemia
renal failure
bone pain 
weakness/fatigue
weight loss
55
Q

what are the renal symptoms of myeloma

A

monoclonal Ig deposition in glomeruli
dehydration
hypercalcaemia

56
Q

what investigation are done for myeloma, what would you expect to find

A

bllods = free light chains
urine = bence jones proteins
bone marrow & renal biopsy
skeletal survey

57
Q

what is the treatment of myeloma

A

chemo
stem cell transplant
plasma exchange

58
Q

what is small vessel vasculitis, who does it affect

A

inflammation of small blood vessels

50-70yrs

59
Q

what are the types of small vessel vasculitis

A

GPA
microscopic polyangiitis
Churg-strauss

60
Q

what are the systemic symptoms of small vessel vasculitis

A

fever
weight loss
anorexia
malaise

61
Q

what are the systems involved in small vessel vasculitis caused by GPA

A

resp
renal
systemic

62
Q

what are the immunological marker for small vessel vasculitis

A

ANCA
Anti-MPO = microscopic polyangiitis
anti-PR3 = GPA

63
Q

what is lupus/SLE, who’d does it usually affect

A

chronic inflammatory disease of unknown origin

women 20-30

64
Q

what are the symptoms of SLE

A

malar rash
photosensitivity
renal disease
systemic

65
Q

what are the renal symptoms of SLE

A

lupus nephritis
proteinuria
granular casts

66
Q

what are the immunological markers for SLE

A

anti-DNA antibody

anti-SM antibody

67
Q

how would you treat the renal issues of SLE

A

hydroxycholorquine
steroids
add cyclophosphamide or MFF
add azathioprine

renal - mine (8 decks)

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