Oliguria and AKI

Question 1

What is the most common composition of kidney stones

Answer 1

Calcium oxalate

Question 2

Give some of the compositions of kidney stones

Answer 2

Calcium oxalate, calcium phosphate, struvite, uric acid

Question 3

What are staghorn kidney stones

Answer 3

Stones which fill numerous major and minor calices

Question 4

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

Answer 4

5 mm

Question 5

What are the risk factors of kidney stones

Answer 5

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

Question 6

How will patients present with kidney stones

Answer 6

Renal colic

Question 7

What are the management options for renal stones

Answer 7

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

Question 8

How can kidney stones cause pyelonephritis

Answer 8

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

Question 9

Name 2 inhibitors of kidney stone formation

Answer 9

GAGs

Tamm Horsfall protein

Question 10

What type of catheterisation may be done is there are problems

Answer 10

Supra-pubic

Question 11

When might suprapubic catheterisation be carried out

Answer 11

Prostrate problems, clots, masses, prolapse

Question 12

What are some causes of haematuria

Answer 12

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

Question 13

How can haematuria be detected

Answer 13

Visibly

Non-visible by microscopy or dipstick test

Question 14

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

Answer 14

Acute = Painful 
Chronic = not painful

Question 15

What is the consequences of acute urinary retention

Answer 15

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

Question 16

What are the acute male causes of urinary retention

Answer 16

BPH, prostrate cancer, structure, prostrate infection

Question 17

What are the acute female causes of urinary retention

Answer 17

Prolapse, pelvic mass, Botox treatment from stress urinary incontinence

Question 18

What is DSD

Answer 18

Detrouser-sphincter dysynergia

This is where the bladder contracts but the sphincter doesnt relax

Question 19

what is acute kidney injury

Answer 19

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

Question 20

what are the 3 types of AKI

Answer 20

pre renal
intrinsic
post renal

Question 21

what is pre renal AKI

Answer 21

where there is a reduction in the perfusion of the kidneys

Question 22

what are the causes of pre Rena AKI

Answer 22

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

Question 23

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

Answer 23

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

Question 24

what drugs affect the vasoconstriction/dilations of the arterioles

Answer 24

NSAIDS inhibit vasoconstriction

ACE inhibitors inhibit vasodilation

Question 25

what is the treatment for pre renal AKI

Answer 25

fluid resuscitation can reverse this as there is no cell injury

Question 26

what is intrinsic AKI

Answer 26

where there is acute tubular necrosis in the kidney

Question 27

what part of the nephron is most affected in intrinsic AKI

Answer 27

most metabolically active areas - PCT and ascending loop of henle

Question 28

what causes intrinsic AKI

Answer 28

sepsis nephrotoxins ischaemia

Question 29

what is rhabdomyolysis and how does it cause AKI

Answer 29

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

Question 30

what is post renal AKI

Answer 30

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