Oliguria Flashcards

1
Q

What is the most common composition of kidney stones

A

Calcium oxalate

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2
Q

Give some of the compositions of kidney stones

A

Calcium oxalate, calcium phosphate, struvite, uric acid

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3
Q

What are staghorn kidney stones

A

Stones which fill numerous major and minor calices

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4
Q

What size diameter of kidney stones have a 95% chance of being passed

A

5 mm

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5
Q

What are the risk factors of kidney stones

A

Middle aged
Caucasian/Indian
Male
Diet high in meat and salt

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6
Q

How will patients present with kidney stones

A

Renal colic

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7
Q

What are the management options for renal stones

A

Conservative - let the stone pass on its own
Non-invasive - fragment the stone
Invasive

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8
Q

How can kidney stones cause pyelonephritis

A

They block the flow of urine making the likelihood of an infection greater

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9
Q

Name 2 inhibitors of kidney stone formation

A

GAGs

Tamm Horsfall protein

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10
Q

What type of catheterisation may be done is there are problems

A

Supra-pubic

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11
Q

When might suprapubic catheterisation be carried out

A

Prostrate problems, clots, masses, prolapse

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12
Q

What are some causes of haematuria

A

Obstruction - bladder cancer, stone, inflammation, BPH
Sickle cell anaemia
Glomerular disease - IgA nephropathy, vasculitis, glomerulonephritis

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13
Q

How can haematuria be detected

A

Visibly

Non-visible by microscopy or dipstick test

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14
Q

What is the difference in presentation of acute and chronic urinary retention

A
Acute = Painful 
Chronic = not painful
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15
Q

What is the consequences of acute urinary retention

A

There is a high pressure system causing urine to back up to the kidneys causing a change in the medullary concentration gradient leading to renal failure

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16
Q

What are the acute male causes of urinary retention

A

BPH, prostrate cancer, structure, prostrate infection

17
Q

What are the acute female causes of urinary retention

A

Prolapse, pelvic mass, Botox treatment from stress urinary incontinence

18
Q

What is DSD

A

Detrouser-sphincter dysynergia

This is where the bladder contracts but the sphincter doesnt relax

19
Q

what is acute kidney injury

A

a decline in the GFR over a shot period of time giving a rise in serum creatinine

20
Q

what are the 3 types of AKI

A

pre renal
intrinsic
post renal

21
Q

what is pre renal AKI

A

where there is a reduction in the perfusion of the kidneys

22
Q

what are the causes of pre Rena AKI

A

hypovolemia, cardiac failure, renal artery stenosis, tutors, stones, drugs

23
Q

what are the afferent/efferent arterioles like in pre renal AKI

A

the afferent vasodilates and the efferent vasoconstrictions in order to try and increase the GFR

24
Q

what drugs affect the vasoconstriction/dilations of the arterioles

A

NSAIDS inhibit vasoconstriction

ACE inhibitors inhibit vasodilation

25
Q

what is the treatment for pre renal AKI

A

fluid resuscitation can reverse this as there is no cell injury

26
Q

what is intrinsic AKI

A

where there is acute tubular necrosis in the kidney

27
Q

what part of the nephron is most affected in intrinsic AKI

A

most metabolically active areas - PCT and ascending loop of henle

28
Q

what causes intrinsic AKI

A

sepsis
nephrotoxins
ischaemia

29
Q

what is rhabdomyolysis and how does it cause AKI

A

muscle necrosis causing the release of myoglobin - this toxic to tubule cells when filtered in the nephron causing intrinsic AKI

30
Q

what is post renal AKI

A

where there is an obstruction to urinary flow after the urine has left the tubules