Brainscape's Knowledge GenomeTM

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


See full index

Year 2 > Presentation of renal disease > Flashcards

Presentation of renal disease Flashcards

1
Q

How might heavy proteinuria present in terms of the urine?

A

“Frothy” urine

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

Accelerated hypertension is a medical emergency. T/F

A

True

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

Relate the functions of the kidney to clinical symptoms/signs which result from the loss of each function

A

Excretion of urea - uraemia

Fluid balance - retention & oedema

Electrolyte balance - hyperkalaemia & arrhythmia

Acid-base balance - metabolic acidosis & kassmall’s respiration

Vitamin D metabolism/phosphate excretion - renal bone disease & vascular calcification

Erythtopoietin - anaemia

Drug excretion - drug toxicity

Barrier to protein loss - proteinuria and nephrotic syndrome

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

Define uraemia

A

Serum urea over 40

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

Pericarditis occuring from renal disease is a result of what being elevated?

A

Urea

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

How does renal bone disease present?

A

Asymptomatic

Pathological fracture

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

Name two drugs which can cause drug toxicity in renal disease?

A

Gabapentin

Digoxin

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

What clinical and biochemical signs may indicate renal disease?

A

Microscopic haematuria
Proteinuria
Reduced GFR
Raised blood pressure

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

How does Alport syndrome present?

A 
Haematuria
Proteinuria
High BP
Oedema 
Deafness 
Family history
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What systemic diseases are related to kidney disease?

A

Vascular disease
Diabetes mellitus
Connective tissue disorder

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

What systemic symptoms may the patient present with which are related to kidney disease?

A

Uraemia
Fluid retention (oedema)
Anaemia
Bone pain

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

What local symptoms may the patient present with in kidney disease?

A

Loin pain
Macroscopic haematuria
UTI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

How do most patients with renal disease present?

A

Asymptomatic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What questions are important to ask a patient with suspected renal disease?

A 
Appetite 
Weight loss
Nausea & vomiting (dehydration can cause AKI)
Dyspepsia 
Dyspnoea 
Urinary symptoms
Joint pain
Arthralgia 
Skin rash
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

List the lower urinary tract symptoms

A 
Frequency
Urgency 
Hesitancy
Polyuria
Nocturia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What aspects of a patients past medical history would be relevant to a renal history?

A 
Kidney disease
Diabetes
Vascular disease
Previous surgery
TB
Rheumatological conditions
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What aspects of a family history are relevant to a renal history?

A

Kidney disease

Hypertension

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Which aspects of a drug history are relevant to a renal history?

A

ACE/ARB
Diuretic
NSAIDs
Antibiotics (gentamicin, trimethoprim - high potassium)
PPI
Radiology contrast (contrast nephropathy)
Over the counter

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

ACE inhibitors are used to treat which biochemical derangement (in relation to the kidney)? In which condition is this commonly found?

A 
Proteinuria
Diabetic nephropathy (microalbuminuria+)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

List the systemic signs of kidney disease

A 
Pyrexia
Skin rash
Murmur
Arrhythmia 
Pericardial rub
Retinopathy (BP & DM)
Bruits
ENT (vasculitis)
Rheumatoid
Raised JVP
Oedema
Gout
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

List the local signs of kidney disease

A

Tenderness
Bruits
Palpable kidneys

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What clinical measurement is it always important to ask about in the context of kidney disease?

A

Blood pressure!

23
Q

Define accelerated hypertension. What sign is seen in the eye in accelerated hypertension? What happens to the organs?

A

Diastolic BP over 120
Papilloedema
Decompensation (encephalopathy, fits, renal failure, heart failure, etc)

24
Q

What is leukonychia a sign of in relation to the kidney?

A

Acute illness

Profound hypoalbuminaemia

25
Q

What are gouty tophus a sign of in relation to the kidney?

A

Chronic kidney disease

26
Q

What are splinter haemorrhages a sign of in relation to the kidney?

A

Subacute bacterial endocarditis associated with nephritis

Vasculitis

27
Q

Vasculitic skin rashes are blanching or non-blanching? What might it be associated with in terms of the kidney?

A

Non-blanching

Acute glomerulonephritis

28
Q

Purpura found on extensor surfaces of the skin and buttocks are typically what type of vasculitis?

A

Henloch-schonlein purpura

29
Q

Malar rash is associated with which connective tissue disease?

A

SLE

30
Q

What are the two causes of “smoky” (dark red/brown) urine?

A

Haematuria (old blood) in nephritic syndrome

Myoglobin (muscle breakdown & dehydration)

31
Q

Explain the biochemical markers used in urinalysis

A 
Specific gravity (1.01-1.02) - concentration of urea
Haematuria - RBC/free Hb/myoglobin
Proteinurea 
pH (4.5-7)
Leukocytes + nitrites - UTI
32
Q

What tests can be carried out to determine the level of protein in the urine?

A

24 hr urine collection (

33
Q

Classify the levels of proteinuria

A

Asymptomatic low grade (3g)

34
Q

Isomorphic RBC in urine would indicate blood coming from where?

A

Lower urinary tract

If dysmorphic then coming from kidney

35
Q

Describe urinary cast analysis

A

Hyaline - benign
RBC - pathological (nephritic)
Leukocyte - infection or inflammation
Granular - indicative of chronic disease

36
Q

How are urinary casts formed?

A

Precipitation of Tamm-Horsfall mucoprotein secreted by renal tubules

37
Q

Formation of urinary casts are increased when?

A

Low urine flow

low pH

38
Q

You can use microscopy to determine composition of urinary tract stones. T/F

A

True - can determine crystals

39
Q

What is a sign of hyperkalaemia on ECG?

A

Peaked T waves

40
Q

What is the best measure of kidney function?

A

GFR

41
Q

What is stable chronic kidney disease?

A

Kidney function low but not deteriorating

42
Q

What is progressive chronic kidney disease?

A

Kidney function declining steadily

43
Q

What is acute kidney injury?

A

Decline in GFR over hours/days/weeks
+/- oliguria
In a patient with normal/impaired baseline renal function

44
Q

Define oliguria

A
45
Q

Patients with acute kidney injury don’t need dialysis. T/F

A

False - they may need dialysis temporarily or long term

46
Q

What is nephrotic syndrome?

A

Proteinuria >3g
Hypoalbuminuria
Oedema (periorbital common)

47
Q

Can you have proteinuria >3g per day and not be nephrotic?

A

Yes - albumin has to have dropped

48
Q

What is associated with nephrotic syndrome?

A

Hypercholesterolaemia

49
Q

Do patients with nephrotic syndrome have normal renal function?

A

Often

50
Q

Why do patients with nephrotic syndrome get periorbital oedema?

A

Oedema is dependent and since they don’t get pulmonary oedema (as in heart failure) they are able to lie flat - oedema collects in face

51
Q

Do patients with nephrotic syndrome get pulmonary effusions?

A

Yep they can do

52
Q

What causes nephrotic syndrome?

A

Glomerulonephritis
Uncontrolled diabetes
Lead poisoning

53
Q

What is nephritic syndrome? What are the symptoms and signs?

A 
Nephritis caused by acute kidney injury 
Olguria 
Oedema/retention (oedema or pulmonary oedema)
Hypertension
Haematuria 
Proteinuria

Year 2 (72 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions