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Medicine > Renal > Flashcards

Renal Flashcards

1
Q

What are the risk factors to developing a UTI?

A 
Female
Intercourse
Spermicide
Pregnancy
Urinary tract obstruction
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2
Q

Name 3 organisms that can cause a UTI?

A

E.coli, staph saprophyticus, Proteus mirabilis

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3
Q

Name 4 symptoms of pyelonephritis?

A

Fever, vomiting, loin pain, rigors

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4
Q

What are the signs of a UTI?

A

Fever, abdominal tenderness, foul smelling urine

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5
Q

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

A

Urine dip

Nitrites, Leukocytes, blood or protein

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6
Q

How do you manage a UTI?

A

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

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7
Q

Name the four types of renal stone?

A

Calcium oxalate
Cystine
Uric acid
Calcium phosphate

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8
Q

What are the symptoms of a renal stone?

A 
Loin to groin pain
Nausea and vomiting
Blood in urine
Urinary frequency/urgency
Dysuria
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9
Q

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

A 
Urine dip-blood
Renal imaging (US, CT)-showing the stones
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10
Q

Give 4 steps of management in a renal stone pt?

A

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

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11
Q

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

A

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

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12
Q

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

A

Urine dip and culture

Blood culture

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13
Q

Give 3 steps in the management of pyelonephritis?

A

Analgesia
IV fluids
IV antibiotics
Monitor renal function

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14
Q

Give 2 possible complications of pyelonephritis?

A

Acute renal failure
Sepsis
Perinephric abscess
Recurrence of pyelonephritis

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15
Q

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

A 
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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16
Q

Name 3 symptoms of hypernatraemia?

A

Lethargy
Thirst
Weakness
Confusion

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17
Q

Give 3 causes of hypernatraemia?

A

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

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18
Q

What is the appropriate management of hypernatraemia?

A

Water orally

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

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19
Q

What are the concerning signs and symptoms of hyperkalaemia?

A 
Fast irregular pulse
Chest pain
Weakness
Palpitations
Light headedness
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20
Q

What are the ECG changes seen in hyperkalaemia?

A

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

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21
Q

Give 3 causes of hyperkalaemia?

A

Oliguric renal failure
Potassium sparing diuretics
Metabolic acidosis
Massive blood transfusion

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22
Q

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

A

Calcium resonium

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23
Q

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

A 
Calcium gluconate
Insulin+glucose
Nebulized salbutamol
Calcium resonium
?Dialysis
24
Q

Name 5 symptoms of hypercalcaemia?

A 
Stones (renal/biliary)
Bones (bone pain)
Groans (abdominal pain, N&V)
Thrones (polyuria)
Psychiatric overtones (Depression, anxiety, insomnia etc.)
25
Q

What is the usual genetic inheritance of Polycystic Kidney Disease?

A

Autosomal Dominant

26
Q

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

A 
Abdo pain
Noctouria
Haematuria
Drowsiness
Joint pain
27
Q

Give 2 aspects of the long term management of PCKD?

A 
Anti hypertensives
Diuretics
Low salt diet
Prompt treatment of UTI
?Renal transplant
28
Q

Give 2 features of U+E which indicate AKI?

A

High urea
High potassium
High creatinine
Low eGFR

29
Q

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

A

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

30
Q

Give 5 aspects of management for AKI?

A 
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
31
Q

Give 2 symptoms of AKI?

A

Oliguria/anuria
N & V
Confusion

32
Q

Give 3 possible complications of AKI?

A

Metabolic acidosis
Hyperkalaemia
Pulmonary oedema
Increased risk of bleeding

33
Q

State 3 indications for acute dialysis and AKI patients?

A 
Untreatable pulmonary oedema
Persistent hyperkalaemia K>7mmol/L
Severe metabolic acidosis pH<7.2
Uraemic Pericarditis
Uraemic encephalopathy
34
Q

Give 3 causes of Chronic renal failure?

A

Hypertension
Diabetes
Glomerulonephritis
Obstructive uropathy

35
Q

Give 3 symptoms of CKD?

A 
Malaise
Lethargy
N&V
Headache
Pruritis
Weight loss/loss of appetite
Palpitations
36
Q

Name 3 risk factors for developing CKD?

A 
Diabetes
Age
Race
Smoking
Hypertension
Family history
37
Q

Give 3 complications of CKD?

A

Cardiovascular disease
Anaemia
Pericarditis

38
Q

What is the indication for dialysis in a CKD patient?

A

GFR <15mL/min with symptoms

39
Q

What are the possible complications of renal transplantation? 3 things

A 
Rejection
Drug toxicity
Infection
Malignancy
Graft failure
CVD
40
Q

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

A

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

41
Q

Give 3 causes of metabolic alkalosis?

A

Vomiting
Burns
Diuretics
Ingestion of a base

42
Q

What is a cause of respiratory acidosis?

A

Type 2 respiratory failure

43
Q

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

A

Cadaver
Living emotionally related donors
Living non related donor
Xenograft

44
Q

List the triad which points to nephrotic syndrome?

A

Hypoalbuminaemia
Proteinuria
Peripheral oedema

45
Q

List 3 causes of nephrotic syndrome?

A

Infection
Lupus
Diabetes
Allergic reactions

46
Q

List 2 complications of nephrotic syndrome?

A

Renal failure
Renal vein thrombosis
Sepsis

47
Q

Give 4 causes of hypercalcaemia?

A

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

48
Q

Give 2 management steps in hypercalcaemia?

A 
Correct dehydration (IV Saline)
Bisphophanates
49
Q

Give 4 causes of hypocalcaemia?

A

High phosphate:
CKD, Hypoparathyroidism, Vit D deficiency

Low phosphate:
Osteomalacia, Acute pancreatitis, Over hydration

50
Q

Give 4 clinical features of hypocalcaemia?

A 
SPASMODIC
Spasms
Perioral paraesthesiae
Anxious
Seizures
Muscle tone up
Orientation impared
Dermatitis
Impetigo
Cataract
51
Q

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

A

Renal tubular acidosis
Diarrhoea
Addisons disease
Ammonium chloride ingestion

52
Q

State 4 clinical features seen in metabolic acidosis?

A

Hyperventilation
Air hunger
Cardiovascular dysfunction (enzyme denaturing)
Venoconstriction

53
Q

Give 3 clinical features for metabolic alkalosis?

A 
Hypoventilation
Apathy
Drowsiness
Confusion
Cardiac arrythmias
54
Q

Give 4 contraindications to a renal transplant?

A

Active infection
Cancer
Severe heart disease
Comorbidity

55
Q

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

A

Advantages:
Treatment free 4 days
Effective (long term survivors)

Disadvantages:
Fluid/diet restrictions
AV fistula needed
Time consuming
Expensive
Limits social life (no holidays)
56
Q

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

A 
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)
57
Q

Give 4 causes of painless haematuria?

A

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

Medicine (17 decks)

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