renal Flashcards
what is nephrogenic diabetes insipidus
insensitvity to ADH
treatment of diabetes insipidus
desmopressin can be used to treat central diabetes insipidus
correct hypernatraemia
stage 2 CKD
kidney damage with mild drop in GFR (60-89)
stage 3 CKD
moderate drop in GFR (30-59)
stage 4 CKD
severe drop (15-59) needs kidney transplant
stage 5 CKD
<15 GFR
complications of CKD
anaemia metabolic acidosis CVD hypertension gout renal bone disease hyperkalaemia
renal bone disease pathogenesis
high serum phosphate low plasma calcium secondary hyperparaathyroidism acidosis management is to reduce phosphate
management of CKD
treat reversible causes
decrease CV risk- antiplatelets and statins
diet- high calorie and normal protein
slow progression- ACEi/ARB
diet when on haemodialysis
fluid restriction and low salt/phosphate/potassium
graft rejection presentation
within 6 months
fever
flank pain
rigor
drugs to avoid in renal failure
tetracycline, nitrofurantoin
NSAIDs
lithium
metformin
investigations for renal artery stenosis
renal US
duplex US
CT angiography
prostatitis management
Ofloxacin 200mg bd or Ciprofloxacin 500mg bd. If high risk CDI: Trimethoprim 200mg bd (all 28 days)
Abdominal distension and suprapubic tenderness on a background of prostatic hyperplasia
acute urinary retention
most common cause of acute urinary retention in men
BPH
presentation of acute urinary retention
Inability to pass urine
Lower abdominal discomfort
Considerable pain or distress
an acute confusional state may also be present in elderly patients
Palpable distended urinary bladder either on an abdominal or rectal exam
Lower abdominal tenderness
investigation for acute urinary retention
bladder US to diagnose
urinalysis, bloods etc
management of acute urinary retention
decompression of bladder by urinary catheterisation
what indicated a bladder washouts
moderate or severe haematuria
nephrotic picture with history of IVDU
focal segmental glomerulosclerosis
first line investigation in suspected prostate cancer
multiparametric MRI
Urinary incontinence in a man with a history of gonorrhoea
urinary stricture
investigation for kidney stones
non-contrast KUB
type of drug is tamsulosin
alpha-1 antagonist
- promote relaxation of bladder and prostate
catheter used in long term urinary retention
intermittent self-catherterisation
low urea:creatinine ration
SIADH, rhabdomylosis, renal damage
high urea:creatinine ratio
dehydration, steroids, high protein diet or pre-renal failure
linear immunofluorescence
goodpastures
splitting of basement membrane
alports- hereditary
management of dry ARMD
Avoid smoking
Control blood pressure
Vitamin supplementation has some evidence in slowing progression- zinc with anti-oxidant vitamins A,C and E
management of wet ARMD
Anti-VEGF medications
ranibizumab, bevacizumab and pegaptanib
important thing to measure in HHS
serum osmolality
most common type of prostate cancer
adenocarcinoma
most common cause of erectile dysfunction
vascular cause
hypertension, hyperlipidaemia, diabetes mellitus, smoking, and major pelvic surgery
Homonymous hemianopia with macula sparing
lesion of occipital cortex
Hypercalcaemia, renal failure, high total protein
multiple myeloma
CKD with extremely high PTH and raised calcium
tertiary hyperparathyroid
type 1 renal tubular acidosis
pathology in distal tubule- unable to excrete hydrogens
causes of renal tubular acidosis type 1
genetic SLE sjogren's PBC hyperthyroidism sickle cell anaemia marfans
presentation of renal tubular acidosis type 1
failure to thrive
hyperventilation
CKD
bone disase
treatment of renal tubular acidosis type 1
bicarbonate
most common type of renal tubular acidosis
type 4
cause of renal tubular acidosis type 4
adrenal insufficiency
ACEi and spironolactone
SLE, HIV, diabetes
management of renal tubular acidosis type 4
fludrocortisone
sodium bicarbonate and treat hyperkalaemia
AKI
rash
fever
eosinophilia
acute interstitial nephritis
management of acute interstitial nephritis
steroids
treat underlying
