Renal Flashcards
What are the key things about igA nephropathy?
Nephitis
Young males
Post upper respiratory tract infection (few days)
Frank haematuria
MACROSOPIC haematuria
How does iGA nephropathy and post streptococcal glomerulonephritis compare?
Both post upper respiratory tract infection
IgA is a couple of days post vs post strep is a couple of weeks.
Both have haematuria but igA is frank.
Main difference: post streptococcal glomerulonephritis will have proteinuria.
What is Goodpastures syndrome?
Anti GBM (glomerular basement membrane) antibodies
Autoimmune disease
Haemoptysis
Haematuria
What is the most common NEPHROTIC syndrome in children and adults?
Children: Minimal change
Adults: Focal segmental glomeruloscelrosis
Complications of nephrotic syndrome?
Renal vein thrombosis due to hypercoagulable state.
High lipids (hyperlipaemia)
Predisposition to infection
How does Vesicoureteric reflux present in children?
Antenatally- hydronephrosis on scan
Children- recurrent UTIs
Chronic pylonephritis
How to diagnose vesicoureteric reflux?
Micturating cystourogram
What drug is started in diabetic nephropathy ?
Ace Inhibitor.
How would a renal adenocarcinoma present?
Renal mass/ haematoruia/ flank pain
Left hydrocele and Hypercalcaemia.
Cannon ball mets in the lung are most commonly caused by?
Mets from RCC.
Antibiotics for epididymo-orchitis if suspected any STI cause?
- if suspected chlaymida cause?
IM cef + doxycycline
If suspected chaylmydia cause: Oral doxycycline or Ofloxacin
What is the gold standard for diagnosing renal artery stenosis?
Angiography
What is the mx for Urge (overflow) incontinence? (conservative, medical and surgical)
Bladder training
Oxybutanin (anticholingerics)
Surgical- botox/ sacral nerve stimulator)
Features of Takaysau arteritis?
Large vessel vasculitis-
Aortic regurgitaiton
Renal artery stenosis
Anuerysms
Weak or absent pulses
How does Granulomatosis with polyangiitis usually present?
Chronic sinusitis
Respiratory symptoms
Glomerulonephritis (microscopic haematouria)
What are the indications for dialysis?
Uraemia (causing encephalopathy)
Hyperkaemia
Acidosis
Pulmonary oedema
What are the types of testicular ca?
Non germ cell (less common) eg. Leydig
Germ cell - more common
Germ cell divided into
Seminoma
Non seminoma
What tumour markers are raised in each of these?
- Germ cell (broadly)
- Seminoma
- Non Seminatous
Germ cell- Raised LDH
Seminoma- Elevated HCG
Non Seminoma- AFP/ bHCG
Broad overview of prostate ca. management?
Surgical approaches (radical prostectomy/ beam radiotherapy)
Medical- Goserelin GNRH agonist ( decreased libido/ erectile dysfunction/ gynaecomastia)
Cryoprostone acetate- Antiandrogen
What is cryptorchidism?
When a testes is absent from the scrotum
5 steps of management of BPH
- Tamsulosin- alpha antagonist
- Finasteride - 5 alpha reductase
- Combination of above
- Antimusclarinic
- Surgery - TURP
What is the score for prostate Ca?
Gleason score.
Classic presentation of testicular cancer?
Painless lump
Can have reports of trauma!
Can also have hydrocele
What is Phimosis. VS Paraphimosis
Phimosis is tight foreskin in children. Can be physiological or pathological.
Paraphiosis is a urological emergency. (eg failing to put the foreskin back after catetherisation)
Amyloidosis- most common presentation?
Diagnosis
Renal dysfunction (nephrotic syndrome)
Diagnosis is with biopsy- Congo red stain goes apple green!
What is the treatment of nephrogenic diabetes inspidius?
Desmopressin
Thiazide like diuretics
NSAIDS
What is the classic examination finding in Epidymitis ?
Elevation of the scrotum reduces pain.
VS torsion where doesn’t make a difference!
Treatment of anaemia in renal disease?
EPO! yay (previously transfusion dependent)
What is renal osteodystrophy? Treatment
Low calcium
Raised phosphate
(Most common cause is secondary hyperparathyroidism)
Treatment is = Vit D and calcium
Hydrocele - what is the hallmark feature?
TRANSILLUMINATE!
beta HCG is a tumour marker for?
Testicular teratoma
NON SEMINOMA
What is the triad for nephrotic syndrome?
- Oedema
- Hypoalbuminea
- Proteinuria
Complications of nephrotic syndrome?
Increased vulnerability to infections
Hypercoagulable - renal vein thrombosis
Hyperlipidaemia
HYPOCALCAEMIA
Treatment of SIADH?
Fluid restriction
Demelocycline
ADH
How does genitourinary TB present?
Sterile pyuria
Dysuria
Fertility problems
Dysuria
Repeated UTIs
What is sterile pyuria and what are the causes?
Sterile pyuria= leucocytes, (no nitrites/ and no evidence of UTI)
Gentourinary TB!
Recently treated/ partially treated UTI
Chlamydia is a common cause
What is the management of renal stones?
Less 5mm and asymptomatic= watchful waiting
5-10= lithotripsy
10-20= lithotripsy or stereoscopy
>20 = percutaneous nephrolithotomy
What is the treatment for acute prostatitis?
Ciprofloxacin or Ofloxacin
Seminoma (testicular ca) which marker is raised?
HCG
What are the common neprotoxic drugs?
ACEi
NSAIDS -particularly naproxen
Thiazide like diuretics
Loop diuretics - furosemide
Aminoglycosides
What are some common causes of change in colour of urine?
Rifamicin- orange/ red
Nitrofuratoin - Brown (also SE of Pulmonary fibrosis)
What are some of the drug causes of SIADH?
Carbamazepine, Sulphonyureas, TCAs/ SSRIs
What criteria is used to diagnose CKD?
eGFR and Albumin/ creatinine ratio
Urine microscopy: what do these findings suggest:
- Red or white cell casts
- Granular casts
- Red or white cell casts- INFLAMMATION
- Granular casts - CKD
When would 7 days of abx be indicated for UTI?
UTI in pregnancy
UTI in a man
UTI in catheterised patient
What is the reference range for Sodium?
135-145
Prolonged PR interval and flattened T waves indicate which electrolyte abnormality?
Hypokaleamia
Epidymal cyst vs spermatocele
Cannot distinguish clinically
Spermatocele - if aspirated would be milky fluid compared to epididymal cyst would be CLEAR
Seminoma vs non seminoma - what age group? and what is a Teratoma?
Seminoma- 30-40yo
Non seminoma (Teratoma) 20-30yo
