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Renal Flashcards

1
Q

What may green urine suggest?

A

Propofol
Amitryptiline

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2
Q

What may red urine suggest?

A

Haematuria

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3
Q

What may orange urine suggest?

A

Rifampicin

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4
Q

What may black urine suggest?

A

Malignancy
Haemolysis (pre-renal AKI)

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5
Q

What is the most dominant type of PKD?

A

ADPKD

85%

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6
Q

How do you diagnose PKD?

A

US-Kidney

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7
Q

How do you manage PKD?

A

Control hypertension e.g. Tolvaptan (vasopressin receptor 2 antagonist)

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8
Q

What are the main risk factors for renal cell cancer?

A

Smoking
VHL Syndrome
Tuberous sclerosis

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9
Q

How may RCC present?

A

Haematuria
Loin pain
Abdominal mass

PUO
weight loss

Varicocele (LHS)

Paraneoplastic syndrome - EPO, ACTH, PTHrp

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10
Q

How is RCC managed?

A

Surgical management - Radical, Partial or Total nephrectomy

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11
Q

What forms of congenital renal obstruction are you aware of?

A

Potters Syndrome

UPJ obstruction
Posterior urethral valves

Renal dysplasia

Renal hypoplasia

Horseshoe kidney

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12
Q

What drugs should be stopped in AKI?

A

DAMN

Diuretics
ARBs/ACEi
Metformin
NSAIDs

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13
Q

When should you refer to a nephrologist in an AKI?

A

Poor response to treatment Renal transplant
Complicated (ITU/GN/TN/Vasculitis/Cancer)
Stage 3
CKD 4<
RRT (AEIOU)

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14
Q

What type of casts are seen in AKI?

A

Muddy brown casts

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15
Q

What are the key differences between ATN and AIN?

A

ATN:
- Toxins
- Muddy brown casts
- Histology shows epithelial cells in collecting tubules and desquamation

AIN:
- Drugs
- Systemic disease

  • Haematuria, Fever, rash and arthralgia
  • AKI
  • White cell casts
  • Sterile pyuria
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16
Q

What signs are present in a testicular torsion?

A

Abdominal pain
Elevated testes
Negative Cremasteric test
Negative Prehn’s Sign

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17
Q

What are the causes of epididymo-orchitis?

A

Young: STI

Older: E.coli

18
Q

What are the clinical signs present in Epididymo-orchitis?

A

Unilateral testicular pain and swelling
Urethral meatus discharge
Elevation of testes relieves pain (

18
Q

What are the clinical signs present in Epididymo-orchitis?

A

Unilateral testicular pain and swelling
Urethral meatus discharge
Positive Prehn’s sign (Elevation of testes relieves pain)

19
Q

What may visualisation of a blue dot suggest on a background of acute onset testicular pain?

A

Hydatid of Morgagni Torsion

20
Q

How should you treat epididymoorchitis?

A

Empirical ABX: Ceftriaxone IM 500mg STAT + Doxycycline 100mg BDSPO 14/7

21
Q

What investigations may you wish to conduct in a patient presenting with erectile dysfunction?

A

Bloods: FBC, U+E, Lipids, CRP, Testosterone

22
Q

What are the risk factors for BPH?

A

Male

African

23
Q

Name the main storage symptoms.

A

FUN

Frequency
Urgency
Nocturia

24
Name the main voiding (obstructive) symptoms.
Weak stream Intermittency Straining Emptying
25
What PSA level is considered raised?
Age-dependent however above 3 generally
26
What else may raise PSA?
BPH Prostatitis Ejaculation Vigorous exercise Urinary retention Instrumentation
27
What is the most common cause of prostatitis?
E. coli
28
What are the differences between a direct and indirect inguinal hernia?
Direct inguinal hernia protrudes through Hesselback triangle, passing medial to inferior epigastric artery Indirect inguinal hernia passes lateral to the inferior epigastric artery
29
What is the term for a hernia which cannot be reduced?
Incarcerated hernia
30
Which proportion of hernias become strangulated?
1 in 500
31
What are the symptoms of a strangulated hernia?
Pain Fever Erythema SBO (N/V/distension) Bowel ischaemia (bloody stools)
32
What should you do with a strangulated hernia?
DO NOT manually reduce This can cause generalised peritonitis
33
What differentials exist for a potential femoral hernia?
Lymphadenopathy Abscess Femoral artery aneurysm Hydrocele Varicocele Lipoma Inguinal hernia
34
How do you manage a hernia?
Refer to general surgery for a laparoscopic repair or open repair
35
Should you use belts/ trusses for femoral hernias?
No, do not use in case of risk of strangulation
36
How may a hydrocele present?
Soft, non-tender swelling of the semi-scrotum Transilluminates with pen torch
37
How do you manage a hydrocele?
Should resolve by 2 years old, otherwise conservative management and rule out underlying cause e.g. tumour
38
What investigations would you do in a suspected UTI?
Urinalysis (if <65 years old) ± MS+C Bloods CT-KUB Ultrasound
39
What are the indications to send for a MCS in suspected UTI?
Recurrent UTI (>3 in 12 mo.) Men Pregnant women Haematuria Child Pyrexia
40
What is the recommended management of UTI in women?
Trimethoprim; Nitrofurantoin Pregnant: Amoxicillin for 7 days
41
What is the recommended management of UTI in men?
Trimethoprim; Nitrofurantoin 7 days

OSCE (8 decks)

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