Renal 2 Flashcards
Pseudomonas aerugnosa - in who and whats the rx
catheters/instruments - only ciprofloxacin works
rolex formation - chain of RBCs
myeloma
monoclonal immunoglobulin deposition
myeloma
positive cong red staining showing green birefringent
amyloidosis
2 types of renovascular hypertension
fibromuscular dyplasoa - familial
atherosclerosis renovascular - general atherosclerosis present
post strep GN
nephrotic syndrome 1-3 weeks after infection
silver stain
thickened BM in membranous GN
treatment of RPGN
steroids, cytoxins, monoclonal ABs, plasma paresis
frothy urine
3G/day
nephrotic
increased cholesterol
nephrotic syndrome
common causes of nephrotic syndrome
membranous, FCS, minimal change
risks of nephrotic syndrome
infections, renal vein thrombosis, volume depletion, Vit D deficiency, subclinical hypothyroidism
AFP
yolk salk component - never raised in seminoma
HCG
trophoblastic - teratoma
PCAP
seminoma
LDH
tumour load
potato appearance
seminoma
rare before puberty (testicular tumour)
seminoma
common in children (testicular tumour)
teratoma
what is BNH due to and where is it found commonly
oestrogen:androgen ratio
central - periurethral glands
risks of BNH
retention
hypertrophy - diverticulum
treatment of BNH
tamsulosin
squamous cell carcinoma of penis
uncircumcised, poor hygiene , HPV
invasive SCC of penis
red raised penis, fun gating mass, foul smelling
commonest prostate cancer
adenocarcinoma
where are the majority of prostate cancers and what age
peripheral zone
over 70s
PSA - sensitivity specificity what is it raised in
90% sensitive 40% specific
DRE, UTI, BNH, cancer, retention, catheter
treatment of prostate cancer
hormone therapy cyproterone, oestrogen
radio for bony mets
resect
what can RCC secrete
erythropoietin -> polycyctheamia
rennin -> hypertension
PTH -> hypercalcaemia
what type of TCC is striped
papillary
where do majority of TCC occur
trigone area - can lead to obstruction
angiofibroma is related to what
TB
what has a central scar on XR
cricocytoma
wills tumour is caused by what
residual primitive renal tissue
define AKI
absolute increase in Cr >26.4
increase of Cr by 50%
decrease in UO
stages of AKI
1.5-1.9 x reference Cr
2-2.9 x reference Cr
3 x reference, > or equal to 354 or need for RRT
6 consecutive hours
12 hours
2 hours or 12 hours of anuria
indications for HD
hyperkalaemia >7 or >6.5 and unresponsive to medical therapy
urea> 40, pericardial rub/effusion
acidosis
hyperkalaemia - rx
> 5.5 >6.5 life threatening
10ml of 10% calcium gluconate over 10 mins
insulin 10 units of act rapid in 50mls of 50% dextrose over 30 mins
nebs salbutamol over 90mins
calcium resonium
Risk of pre renal AKI
acute tubular necrosis if not treated
treatment of pre renal AKI
fluid rechallange - 0.9% saline over 2 mins - reassess
symptoms of renal AKI
fluid overload
uraemia with itch
pericarditis
oliguria
CKS stages
1.GFR 90 and kidney damage
2. GFR >60-90 and kidney damage
3A. 45-60 3B. 30-44
4. 15-30
5. less than 15
treatment of anaemia
Hb target
IV iron
if no improvement then epo by injection
Hb target 10.5-12.5
bone disease treatment
alfacalcidol. phosphate
agenesis
absence of 1 or 2 kidneys
alports
SHL
x-linked recessive
defect of type 3 collagen
variable thickness of GM
anderson fibrys disease
fabryzyme enzyme replacement
plasma/leucocyte alpha GAL activity
risks of ADPKD
intracranial aneurysms
hypertension
diverticulitis colonic perforation
cyst infection
treatment of ADPKD
tovaplatan
dialysis
cause of infection in PD
staph. strep. diphtheroids. coliform.
other risk factors of PD
membrane failure - doesn’t remove enough h2o
hernias - treat hernia and use smaller volumes
Tunneled catheter infection in HD
if not treated can lead to endocarditis etc
treat w vancomycin
line removal/exchange
risks of HD
fluid overload, blood leaks, loss of vascular access, hypokalamia and MI, intradialytic hypotension
Stones rx
diclofenic
small - tamsulosin
absence of cremosteric reflex
torsion of spermatic cord
bell clapper deformity
torsion of spermatic cord - collateral side not fixed
treatment of epididymitis
oflaxolin 400mg/day for 14 days
paraphimosis
painful swelling of foreskin
sugar. iced glove. decompress glans, dorsal slit
priapism ischaemic and non ischaemic
prolonged erection
ischaemic - decreased blood flow, dark blood
non ischaemic - normal/high flow, normal colour arterial blood
fourners gangrene
starts out as cellulitis
XR/US show gas in tissue
flame shaped collection contrast in pelvis
exztraperitoneal bladder injury
suprapubic catheter used when
urethral injury
treatment of urge incontinence
oxybutanin
emphysematous polynephritis
acute necrotising parenchymal and perineal infection
E.Coli
Diabetics
Nephrectomy
