Brainscape's Knowledge GenomeTM

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


See full index

CP3 @ UoN - Medicine & Surgery > Obstructive & Neoplastic Conditions of the Kidney & Ureter > Flashcards

Obstructive & Neoplastic Conditions of the Kidney & Ureter Flashcards

1
Q

What are the complications of acute ureteric obstruction?

A

Enlargement of the urinary tract superior to the obstruction

-dilation of renal pelvis (hydronephrosis)

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

What are the three parts of the ureter that can be affected, causing acute/chronic ureteric obstruction?

A

Luminal
Mural
Extramural

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

What are the luminal causes of acute/chronic ureteric obstruction?

A 
Calculus
Sloughed renal papilla
Blood clot
TCC of renal pelvis/ureter
Bladder tumour
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are the mural causes of acute/chronic ureteric obstruction?

A

Ureteric stricture
Congenital pelviureteric neuromuscular dysfunction
Congenital megaureter

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

What are the extramural causes of acute/chronic ureteric obstruction?

A

Pelviureteric compression

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

What are the Sx/signs of acute/chronic ureteric obstruction

A

Varying loin pain (greater w/ urine volume)
Anuria (bilateral blockage)
Polyuria (partial blockage causing renal failure)
Loin tenderness
Palpable hydronephrotic kidney

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

What are renal calculi?

A

Kidney stones

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Where do renal calculi form?

A

Collecting duct

-can be deposited anywhere from renal pelvis to urethra

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are the classic sites for renal calculi deposition?

A

Pelviureteric junction
Pelvic brim
Vesicoureteric junction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are renal calculi made from?

A

Calcium oxalate (75%) OR
Magnesium ammonium phosphate OR
Urate

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

How do renal calculi present?

A

Renal colic (excruciating loin to groin spasms, nausea/vomiting) OR
Dull loin pain OR
UTI

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

What investigations are appropriate in suspected acute ureteric obstruction?

A 
Urine MCS
USS (?upper tract dilation)
AXR
CT
Retrograde pyelogram
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are the management options for acute ureteric obstruction?

A 
Nephrostomy
   -decompresses pelvicalyceal system, preserves kidney function, prevents infection
Surgical management (stenting)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are the risk factors for renal calculi?

A 
15% lifetime risk
20-40yrs
3:1 male preponderance
Obesity
Dehydration/low fluid intake
Family/personal hx
Anatomical abnormalities
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What investigations are appropriate in suspected renal calculi?

A 
Bloods (Ca, PO4, G6, HCO3, urate)
Urine dip (95% +ve for blood)
Pregnancy test
Urine MCS
AXR (80% calculi visible)
Non-contrast CT (99% calculi visible)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are the acute management options for renal calculi?

A 
A-E resus
75mg diclofenac IM
IV metoclopramide (if N/V)
IV a/b (if infec)
Assess for admission/active treatment (surg)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What factors indicate hospital admission in renal calculi pts?

A

Severe pain at 1hr
Risk of AKI
Signs of shock/infection
Uncertainty over dx

18
Q

What are the indications for active treatment of renal calculi?

A 
Low chance of spontaneous passage (>10mm)
Persistent pain
Ongoing obstruction
Signs of infec
Renal insufficiency
19
Q

What are the conservative (medical) options for managing renal calculi?

A

Tamsolusin (1st line) OR Nifedipine (inc rate of spontaneous expulsion)
Advice on discharge
-80% pass naturally
-high fluid intake
-return if increase in pain/signs of infec
-if 1st stone catch in sieve for analysis
Refer to urology w/i 1wk

20
Q

What are the active (surgical) options for managing renal calculi?

A

Extracorporeal shockwave lithotripsy (ESWL)
Uretoscopy
Percutaneous nephrolithotomy

21
Q

Describe Extracorporeal Shocwave Lithotripsy (ESWL)

A

Outpt procedure focusing shockwaves on stone to break it up and allow spontaneous passage
-if hydonephrosis present may need percutaneous nephrostomy

22
Q

What is Wilm’s Tumour?

A

Undifferentiated mesodermal tumour

20% of childhood malignancies

23
Q

How does Wilm’s Tumour present?

A

3.5yrs w/ flank pain & abdo mass

24
Q

What are the management options for Wilm’s Tumour?

A

DO NOT BIOPSY

Nephrectomy & pre-op chemo

25
What are Renal Cell Carcinomas?
Vascular tumours arising from proximal tubular epithelium
26
What are the risk factors for RCCs?
90% of renal tumours | Prolonged haemodialysis main risk factor (15%)
27
How do RCCs present?
``` 50% incidental 10% w/ classic triad of sx -haematuria -loin pain -abdo mass + B sx Varicoele (if invasion of L renal vv) Polycythaemia/HTN (if renin/EPO secretion) ```
28
How should suspected RCCs be investigated?
``` Urine cytology USS (solid/cystic) CT/MRI CXR Renal angiography ```
29
What are the management options for RCCs?
``` Radical nephrectomy Partial nephrectomy -if peripheral tumours <5cm -if bilat tumours OR contralateral poor kidney func Post-op chemo ```
30
What is the prognosis of RCCs?
65% 5yr survival if N0 25% if nodal involvement 5% if distant mets
31
What are the common causes of renal cysts?
``` Solitary/multiple cysts occur commonly in the elderly -50% by 50yrs Polcystic kidney disease Medullary cystic disease Medullary sponge kidney ```
32
How do solitary/multiple cysts in the elderly present?
Often asymptomatic OR | Haematuria/pain
33
What are Transitional Cell Carcinomas?
Carcinoma of transitional cell epithelium | -most commonly bladder (50x more common)
34
What structures are lined by transitional cell epithelium?
``` Calyces Renal pelvis Ureter Bladder Urethra ```
35
What are the risk factors for TCCs?
Smoking Aromatic amines (rubber/plastic/dye industry workers) Chronic cystitis Pelvic irradiation
36
How do TCCs present?
Painless haematuria +/- clots Recurrent UTI Voiding sx Pain from local invasion
37
What investigations are appropriate in suspected TCC?
Urine MCS/cytology (?sterile pyuria) Cystoscopy/biopsy (gold standard) CT/MRI or lymphangiography
38
What are the management options for carcinoma in situ/T1 bladder carcinomas?
Transurethral resection of bladder tumour - at cystoscopy w/ intravesical chemo - 5yr survival 95%
39
What are the management options for T2/T3 TCC?
Radical cystectomy w/ pre-op chemo | -ileal conduit used to leave urostoma
40
What are the management options for T4 TCC?
Palliative treatment
41
What long term management is required for all TCCs?
Long term follow up w/ cystoscopy
42
Describe squamous cell carcinoma of the bladder
Rarer, present similarly to TCC | Risk factors - anything that irritates the bladder lining

CP3 @ UoN - Medicine & Surgery (135 decks)

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