Renal Flashcards
Polycystic kidneys screening for aneurysm
Screen for SAH in first degree relatives of those with SAH and PKD
Acute kidney rejection
Fever, graft pain
Increase in creatinine
Cell mediated cytotoxic T cells
UTI Management
Uncomplicated women - nitro/tri
Pregnant woman - amoxicillin.
Avoid nitro at term
Avoid tri in first trimester
Men - 2 week quinolone
Alports syndrome
X- linked dominant A-5 chain of type IV collagen Haematuria proteinuria. renal failure Systemic - sensorineural deafness. Ocular defects Thickened gbm with splitting
Loop diueretic action
Inhibit na/k/2cl co transporter in thick ascending limb loop of Henley
Can cause:
- hyponatraemia, hypokalaemia, ototoxcity. Hypocalcaemia
Thiazide diuretics site of action
Inhibit nacl transport in DCT
can cause hypokalaemia
Glucose intolerance
Hyperlipidaemia
Increase uric levels
What determines the egfr?
CAGE C creatinine A age G gender E ethnicity
Complications of AKI
Hyperkalaemia
Pulmonary oedema
Acidosis
Reduced conscious level
Indications for dialysis
Progressive decline in renal function - CKD stage 5
Steal syndrome
Distal tissue ischaemia, AV fistula
Haematuria
Renal calculi UTI Renal cancer Bladder cancer Coagulopathy Trauma - post TURP/catheter/cystoscopy Schistomosiasis Prostatic problems
Analgesic to avoid in renal disease
Pethidine
Urgent referral criteria
> 45 + visible haematuria
>60 + unexplained non visible haematuria
Bergers disease
=IgA nephropathy
Anti-GBM disease
=Goodpastures
autoantibodies to type IV collagen
–> haemoptysis and haematuria
Management of AKI
Stop nephrotoxics Re-check U&Es Urine dip/MSU Fluid balance USS Referral to renal/ICU CXR/ECG
Indications for acute dialysis in AKI
- refractory pulmonary oedema
- persistent hyperkalaemia
- pH
Post-streptococcal GN
low complement levels
Proteinuria + macrohaematuria –> coca cola urine
Recent URTI
Stages of CKD
1 >90 2 60-89 3 A 45-59 3 B 30-44 4 15-29 5
Nephrotic syndrome triad
Proteinuria >3g/24hour
Hypoalbuminanemia
most common cause of nephrotic syndrome
Minimal change glomerulonephritis
PKD genetic defects
Type 1 85% chromosome 18
type 2 15% chromosome 4
Bladder cancer in schistosomiasis
Squamous cell carcinoma
Suspected renal cancer referral guidelines
Over 45 and macroscopic haematuria
Over 69 and non visible haematuria AND dysuria, or raised WCC
Wilms tumour
Nephroblastoma
Most common abdominal malignancy in children
Abdo mass and haematuria
Causes of prostatitis
S.faecalis
E.coli
Also chlamydia
Levofloxacin/doxycycline
Bladder cancer in schistosomiasis
Squamous cell carcinoma
Suspected renal cancer referral guidelines
Over 45 and macroscopic haematuria
Over 69 and non visible haematuria AND dysuria, or raised WCC
Wilms tumour
Nephroblastoma
Most common abdominal malignancy in children
Abdo mass and haematuria
Causes of prostatitis
S.faecalis
E.coli
Also chlamydia
Levofloxacin/doxycycline
Robson staging of renal carcinoma
I confined to kidney
II perinephric fat involved (not gardas fascia)
III renal vein involved
IV local or distant organs spread
Inheritance of PKD
AD - 1/1000
Genes involved - chromosome 16 (PKD1) and 4 (PKD2)
AR - 1/40,000 - chromosome 6
Wegeners granulomatosis
Necrotising granulomatosis inflammation, Vasculitis - small/medium
C-ANCA positive
Investigations for rhabdomyolysis
CK >1000
Positive urinary myoglobin
Treatment of nephrotic syndrome
Oedema - diuretics and salt restriction Steroids / cyclophosphamide Ace inhibitor Anti coagulation Statin
What is bence Jones protein seen in?
Myeloma
