Renal Flashcards by Chenjerai Gutu

What are the risk factors to developing a UTI?

Female
Intercourse
Spermicide
Pregnancy
Urinary tract obstruction

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Name 3 organisms that can cause a UTI?

E.coli, staph saprophyticus, Proteus mirabilis

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Name 4 symptoms of pyelonephritis?

Fever, vomiting, loin pain, rigors

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What are the signs of a UTI?

Fever, abdominal tenderness, foul smelling urine

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In a UTI, name a test you could perform and what you would be looking for?

Urine dip

Nitrites, Leukocytes, blood or protein

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How do you manage a UTI?

Advise to drink plenty of fluids
Prescribe trimethoprim (200mg/12hr;3-6days) or nitrofurantoin.
Upper UTI should have urine cultured

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Name the four types of renal stone?

Calcium oxalate
Cystine
Uric acid
Calcium phosphate

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What are the symptoms of a renal stone?

Loin to groin pain
Nausea and vomiting
Blood in urine
Urinary frequency/urgency
Dysuria

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You suspect a renal stone, name 2 investigations you would order and why?

Urine dip-blood
Renal imaging (US, CT)-showing the stones

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Give 4 steps of management in a renal stone pt?

Analgesia
IV fluids
?Lithotripsy
Pt. to drink plenty of fluids

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You suspect pyelonephritis, name 3 blood tests you would do and why?

FBC-high WCC and neutrophils in infection
CRP-high in infection
U+E-high urea and creatinine in renal impairement

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Apart from imaging and blood test in pyelonephritis, what other test could you do?

Urine dip and culture

Blood culture

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Give 3 steps in the management of pyelonephritis?

Analgesia
IV fluids
IV antibiotics
Monitor renal function

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Give 2 possible complications of pyelonephritis?

Acute renal failure
Sepsis
Perinephric abscess
Recurrence of pyelonephritis

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State 3 pieces of advice to prevent further UTI’s in a female?

Wipe from front to back
Wear cotton undergarments
Urinate after intercourse
Keep genital area clean
Drink plenty of fluids
Drink cranberry juice

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Name 3 symptoms of hypernatraemia?

Lethargy
Thirst
Weakness
Confusion

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Give 3 causes of hypernatraemia?

Fluid loss (diarrhoea, vomit or burns)
Incorrect fluid replacement (excessive saline)
Diabetes insipidus
Primary aldosteronism

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What is the appropriate management of hypernatraemia?

Water orally

If not then dextrose 5% IV guided by urine output and plasma sodium

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What are the concerning signs and symptoms of hyperkalaemia?

Fast irregular pulse
Chest pain
Weakness
Palpitations
Light headedness

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What are the ECG changes seen in hyperkalaemia?

Tall tented T waves
Small P waves
Wide QRS complex
Ventricular fibrillation

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Give 3 causes of hyperkalaemia?

Oliguric renal failure
Potassium sparing diuretics
Metabolic acidosis
Massive blood transfusion

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In a non emergency case, how do you manage hyperkalaemia?

Calcium resonium

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In an emergency case of hyperkalaemia, give 4 steps in the management?

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Calcium gluconate
Insulin+glucose
Nebulized salbutamol
Calcium resonium
?Dialysis

Name 5 symptoms of hypercalcaemia?

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Stones (renal/biliary)
Bones (bone pain)
Groans (abdominal pain, N&V)
Thrones (polyuria)
Psychiatric overtones (Depression, anxiety, insomnia etc.)

What is the usual genetic inheritance of Polycystic Kidney Disease?

Autosomal Dominant

Suggest 2 symptoms that a patient could suffer from in PCKD?

``` Abdo pain Noctouria Haematuria Drowsiness Joint pain ```

Give 2 aspects of the long term management of PCKD?

``` Anti hypertensives Diuretics Low salt diet Prompt treatment of UTI ?Renal transplant ```

Give 2 features of U+E which indicate AKI?

High urea High potassium High creatinine Low eGFR

What are the 3 categories of AKI and give 2 examples each?

Pre-renal •hypovolaemia •sepsis •renal artery stenosis Renal •acute tubular necrosis; drugs or ischaemia •pyelonephritis •glomerulonephritis Post-renal •bilateral kidney stones •prostatic enlargement •bladder cancer obstructing outflow

Give 5 aspects of management for AKI?

``` Urine microscopy US scan Palpable bladder Catheterise IV fluids Fluid balance and daily weights Stop any nephrotoxic medication Daily U&E to monitor renal function ```

Give 2 symptoms of AKI?

Oliguria/anuria N & V Confusion

Give 3 possible complications of AKI?

Metabolic acidosis Hyperkalaemia Pulmonary oedema Increased risk of bleeding

State 3 indications for acute dialysis and AKI patients?

``` Untreatable pulmonary oedema Persistent hyperkalaemia K>7mmol/L Severe metabolic acidosis pH<7.2 Uraemic Pericarditis Uraemic encephalopathy ```

Give 3 causes of Chronic renal failure?

Hypertension Diabetes Glomerulonephritis Obstructive uropathy

Give 3 symptoms of CKD?

``` Malaise Lethargy N&V Headache Pruritis Weight loss/loss of appetite Palpitations ```

Name 3 risk factors for developing CKD?

``` Diabetes Age Race Smoking Hypertension Family history ```

Give 3 complications of CKD?

Cardiovascular disease Anaemia Pericarditis

What is the indication for dialysis in a CKD patient?

GFR <15mL/min with symptoms

What are the possible complications of renal transplantation? 3 things

``` Rejection Drug toxicity Infection Malignancy Graft failure CVD ```

Name 4 things that can cause metabolic acidosis with increased anion gap?

Lactic acid (shock, infection, ischaemia) Urate (renal failure) Ketones (diabetes, alcohol) Drugs (salicylate, biguanides, methanol)

Give 3 causes of metabolic alkalosis?

Vomiting Burns Diuretics Ingestion of a base

What is a cause of respiratory acidosis?

Type 2 respiratory failure

Apart from living related donors, give 3 other sources of transplants?

Cadaver Living emotionally related donors Living non related donor Xenograft

List the triad which points to nephrotic syndrome?

Hypoalbuminaemia Proteinuria Peripheral oedema

List 3 causes of nephrotic syndrome?

Infection Lupus Diabetes Allergic reactions

List 2 complications of nephrotic syndrome?

Renal failure Renal vein thrombosis Sepsis

Give 4 causes of hypercalcaemia?

Malignancy (myeloma, bone mets) Primary hyperparathyroidism Dehydration Vit D excess

Give 2 management steps in hypercalcaemia?

``` Correct dehydration (IV Saline) Bisphophanates ```

Give 4 causes of hypocalcaemia?

High phosphate: CKD, Hypoparathyroidism, Vit D deficiency Low phosphate: Osteomalacia, Acute pancreatitis, Over hydration

Give 4 clinical features of hypocalcaemia?

``` SPASMODIC Spasms Perioral paraesthesiae Anxious Seizures Muscle tone up Orientation impared Dermatitis Impetigo Cataract ```

Name 4 things that can cause metabolic acidosis with a normal anion gap?

Renal tubular acidosis Diarrhoea Addisons disease Ammonium chloride ingestion

State 4 clinical features seen in metabolic acidosis?

Hyperventilation Air hunger Cardiovascular dysfunction (enzyme denaturing) Venoconstriction

Give 3 clinical features for metabolic alkalosis?

``` Hypoventilation Apathy Drowsiness Confusion Cardiac arrythmias ```

Give 4 contraindications to a renal transplant?

Active infection Cancer Severe heart disease Comorbidity

What are the advantages and disadvantages of haemodialysis? 3 of each

Advantages: Treatment free 4 days Effective (long term survivors) ``` Disadvantages: Fluid/diet restrictions AV fistula needed Time consuming Expensive Limits social life (no holidays) ```

What are the advantages and disadvantages of peritoneal dialysis? 4 of each

``` Advantages: Simple to perform Less complex equipment Perform at home Maintain mobility Cardiovascular stability ``` ``` Disadvantages: Peritonitis Exit site infection Hernias Back pain May not work (catheter malfunction, loss of membrane function) ```

Give 4 causes of painless haematuria?

Renal and urothelial tumours Prostatic hypertrophy Acute glomerulonephritis (IgA nephropathy) Bleeding disorders – anticoagulants, thrombocytopenia

Renal Flashcards

(57 cards)