Presentation of Kidney Disease Flashcards
name the 2 types of haematuria found in renal patients
microscopic
macroscopic
where is pain in the kidney usually felt?
loin
what conditions can present with uraemia?
pericarditis
encephalopathy
neuropathy
gastritis
what is the main electrolyte imbalance found in renal disease?
hyperkalaemia
main complication of hyperkalaemia?
arrhythmia
what acid base imbalance is most commonly found in renal disease?
metabolic acidosis
what happens if erythropoeitin is not made?
patient will get anaemia (no rbc’s made)
give examples of drugs that can be toxic to the kidneys
digoxin gabapentin gentamicin ACEi ARB NSAIDs diuretics PPIs
what techniques will be used to accompany kidney examination?
BP
urinalysis
how is GFR estimated?
biochemical screening
what dermatological symptoms are important in nephrology?
recent skin rash
what MSK symptoms are important in nephrology?
joint pain
bone pain
arthralgia
what GI symptoms are relevant to nephrology?
dyspepsia
nausea/vomiting
anorexia
what effect can oedema have on the kidney?
decreased pressure within the glomerulus -> decreased renal function
what effect can trimethoprim have on patients with CKD’s creatinine levels?
will rise
what signs on examination would suggest loss of kidney function?
pallor arrhythmia pericardial rub lung creps raised JVP oedema gout
pericardial rub is caused by what problem with the kidneys?
uraemia
renal disease is a risk factor for gout T or F?
T
hypertension is classed as a BP of…
> 140/90
accelerated hypertension is not an emergency T or F
F
what is the diastolic BP in accelerated hypertension?
> !20mmHg
what retinal symptoms will a patient with accelerated hypertension present with?
papilloedema
why are splinter haemorrhages important in renal?
allude to bacterial endocarditis or vasculitis which can both cause renal disease (eso glomerulonephritis)
symptoms of henoch schonlein purpura?
abdo pain
joint pains
acute kidney injury
what colour is urine in rhabdomyolysis
due to acute muscle damage causing myoglobin release
what findings on urinalysis would indicate a UTI?
leukocytes
blood
nitrites
presence of nitrites indicates…
bacteria
normal 24hr urine collection?
<150mg/24hr
normal urine protein/creatinine ratio?
0.5g/24hr
what weight of protein per day would be classed as heavy proteinuria?
1-3g/day
what type of urinary cast is indicative of chronic disease?
granular
what urinary cast is usually benign?
hyaline
red cell urinary casts indicate what problem?
nephritic syndrome
what urinary cast indicates inflammation?
leukocyte
what does rhabdomyolysis do to the kidneys?
causes acute kidney injury
hyperkalaemia presentation on ECG?
tall T waves
broadened QRS
flat p waves
bradycardia
normal K+ level?
5
Tx of hyperkalaemia
- IV calcium gluconate
- actrapid + glucose
- salbutamol
what test is the best overall measure of kidney function?
GFR
what levels indicate severe GFR in ml/min
15-29
kidney failure has what GFR level?
<15ml/min
the higher the GFR, the less likely there is kidney disease T or F
T
define acute kidney injury
decline in GFR over hours/days/weeks +/- oliguria
name the 3 main components of nephrotic syndrome?
proteinuria >3g/day
hypoalbuminaemia
oedema
why dont you get periorbital oedema in heart failure?
patients cant lie flat
what is renal function like in nephrotic syndrome?
normal
you cant get periorbital oedema in nephrotic syndrome?
F, you can because you can lie flat
symptoms of nephritic syndrome?
acute kidney injury oligura oedema hypertension positive urinalysis (blood, protein)
what tests need to be done before a renal biopsy is carried out and why?
FBC - any thrombocytopaenia?
coagulation screen- clotting problems?
renal USS- size/position of kidneys
contraindications to renal biopsy? why?
small kidneys (inc bleeding risk) uncontrolled HT (bleeding risk) untreated UTI (bleeding risk)
what dose of prednisolone is given for minimal change nephropathy?
40-60mg
in patients <45, isolated haematuria is most likely to be from…
the kidneys
in patients >45, isolated haematuria is most likely to be from…
the bladder
