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Summary of Stuff > Renal > Flashcards

Renal Flashcards

1
Q

Massive bilateral renal enlargement, adult in 50s, chromosome 16&4, hepatic cysts, berry aneurysms

A

Autosomal dominant Polycystic kidney disease

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2
Q

Bilateral and symmetrical cysts on kidneys, childhood, chromosome 6, congenital hepatic fibrosis, ESRD by adolescence

A

Autosomal Recessive Polycystic Kidney disease

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3
Q

“Potato tumour”, PLAP, v.sensitive to radiotherapy

A

Seminoma

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4
Q

Primitive cells, b-HCG, younger than seminomas, variable appearance: solids, cysts, haemorrhage, necrosis

A

Teratoma

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5
Q

BHCG

A

Teratoma

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6
Q

AFP

A

Never raised in pure seminoma

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7
Q

PLAP

A

Seminoma

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8
Q

Particular risk factor for testicular cancer

A

Testicular maldescend

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9
Q

A glycoprotein enzyme produced by secretory epithelial cells of the prostate

A

PSA

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10
Q

Prostate cancer:

  • Organ confined
  • Locally advanced
  • Metastatic
A
  • Watchful waiting
  • Watchful waiting/hormonal therapy
  • Androgen deprivation therapy
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11
Q

Painful swelling of foreskin distal to phimotic ring

A

Paraphimosis

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12
Q

Prolonged erection >4hrs with no sexual arousal

A

Priapism

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13
Q

Necrotising Fasciitis in male genital region

A

Fournier’s gangrene

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14
Q

UTI micro: bacteria associated with calculi

A
  • Proteus

- Produces erase which breaks down urea to form ammonia

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15
Q

UTI micro: bacteria in women of child bearing age

A

Staphylococcus Saphyticus

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16
Q

UTI micro: catheters and sensitive to Ciprofloxacin

A

Pseudomonas Auruginosa

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17
Q

UTI micro: Kass’ Criteria in Women bearing age

  • > 10^5 organisms
  • 10^4 organisms
A
  • Probable UTI
  • Not significant bacteria
  • Repeat specimens, contaminated
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18
Q

UTI micro: Pure growth is more significant than mixed growth T/F?

A

True

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19
Q

Resistant to all Abx

A

CPE

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20
Q

Resistant to all cephalosporins and almost all penicillins

A

ESBL

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21
Q

UTI micro: Abx which inhibits bacterial folic acid synthesis, avoid in 1st trimester

A

Trimethoprim

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22
Q

UTI micro: Abx which cannot be used to treat pyelonephritis as it only reaches effective conc in bladder urine, only useful in uncomplicated lower UTI

A

Nitrofurantoin

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23
Q

UTI micro: max number of days Gentamicin can be used for

A

3 days

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24
Q

UTI micro: Abx for female lower UTI

A

Trimethoprim or Nitrofurantoin orally for 3 days

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25
Q

UTI micro: Abx for male UTI

A

Trimethoprim or Nitrofurantoin orally for 7 days

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26
Q

UTI micro: Complicated UTI or Pyelonephritis (GP)

A

Co-amoxiclav or Co-trimaxazole for 14 days

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27
Q

UTI micro: Complicated UTI or Pyelonephritis (hospital)

A

Amoxicillin and Gentamicin IV for 3 days

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28
Q

Criteria for Nephritic Syndrome

A
  • Proliferative process
  • Damage to mesangial cells
  • “Blood in urine”
  • Acute renal failure
  • Oliguria
  • Oedema
  • Hypertension
  • Acute urinary sediment
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29
Q

Criteria for Nephrotic Syndrome

A
  • Non proliferative
  • Damage to podocytes
  • “Protein in urine”
  • Proteinuria >3g/day
  • Hypoalbuminuria
  • Oedema
  • Normal renal function
  • Hypercholeaemia
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30
Q

Urinary incontinence: Bladder chronically distended, men with BPH, huge palpable bladder, insidious onset, catheter to relieve obstruction

A

Overflow

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31
Q

Urinary incontinence: Detrusor overactivity, increased bladder pressure, idiopathic or neurological, small volume of voided urine, avoid caffeine and bladder retraining

A

Urge

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32
Q

Urinary incontinence: Increased abdominal pressure, weak pelvic floor due to childbirth, triggered by cough, sneezing or exertion, lose weight, stop smoking, pelvic floor exercises

A

Stress

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33
Q

Urinary incontinence: Mixed

A

Stress + Urge

34
Q

Majority are transitional cell carcinomas in the trigone area leading to ureteric obstruction, 80% have “stippled” appearance, “halo” sign

A

Urinary bladder cancer

35
Q

Prostate: transitional oestrogen sensitive part is involved. Irregular proliferation of both glandular and stromal prostatic tissue

36
Q

Prostate: Peripheral ducts and lobes, particularly posterior lobe

A

Carcinoma of the prostate

37
Q

eGFR

  • Overestimates when ____
  • Underestimates when ____
A
  • Overestimates if muscle mass is low

- Underestimates when muscle mass is high

38
Q

Stages of CKD

A 
Stage 1: >90 with kidney damage
Stage 2: 60-90 wit kidney damage
Stage 3a: 45-60
Stage 3b: 30-45
Stage 4: 15-29
Stage 5:
39
Q

Causes of CKD

A 
Diabetes
Hypertension
Vascular disease
Chronic glomerulonephritis
Polycystic kidneys
40
Q

Symptoms of CKD

A

Non specific: tiredness, poor appetite, sleep disturbance

41
Q

Complications of CKD

A
  • Anaemia: give IV iron or subcut erythropoietin

- Bone disease: phosphate binders and alfacalcidol

42
Q

AKI: Pre-renal causes

A
  • Impaired perfusion
  • Hypovolaemia
  • Sepsis
  • Dehydration/blood loss
43
Q

AKI: Renal causes

A
  • Small vessel vasculitis
  • Glomerulonephritis
  • Necrosis
  • Drugs
  • Infection
44
Q

AKI: Post renal causes

A
  • Urinary calculi
  • BPH
  • Prostate/cervical cancer
45
Q

Complications of AKI

A
  • Hyperkalamia
  • Pulmonary oedema
  • Severe acidosis
  • Pericardial effusion
46
Q

Untreated pre-renal AKI

A

Risk of advancing to Acute Tubular Necrosis

47
Q

Loss of “p” wave, Tall tented T waves, widened QRS

A

Hyperkalaemia

48
Q

Treatment of hyperkalaemia

A

-10mls of 10% Calcium Gluconate every 2-3mins
to protect myocardium
-Insulin (10 units of rapid active) to drive K back into cells
-50mls of 50% dextrose (30mins)

49
Q

Indications for haemodialysis in AKI

A
  • Hyperkalaemia >7

- Severe acidosis pH 40

50
Q

Positive congo red staining showing apple green birefringence under polarised light

A

Amyloidosis

51
Q

AKI, bone pain, normocytic anaemia, Bence Jones Protein, >50yrs, renal impairment at presentation in 50%

52
Q

2 causes of Renovascular disease

A

Atherosclerotic disease or Fibromuscular dysplasia

53
Q

Young woman, hypertension, carotid artery dissection, associated with Ehlers Danlos and Marfans, renovascular disease

A

Fibromuscular Dysplasia (rare)

54
Q

Older patient with renovascular disease, risk factors for generalised atherosclerosis

A

Atherosclerotic Renovascular disease (more common)

55
Q

Flash pulmonary oedema

A

Renal artery stenosis

56
Q

What drug do you not give in Renal artery stenosis?

57
Q

Kimmelstein-Wilson lesion on kidney biopsy

A

Diabetic Nephropathy

58
Q

How is the diagnosis of Diabetic Nephropathy made?

A
  • Retinopathy +proteinuria= no biopsy

- Rapid decline in GFR= biopsy

59
Q

Absolute contraindications to renal transplantations

A
  • Malignancy (within 2years and 5 years for breast and colorectal)
  • Untreated TB
  • Severe Ischaemia heart disease
  • Severe airways disease
  • Active vasculitis
  • Severe peripheral vascular disease
60
Q

Types of kidney implant rejection

A
  • Immediate (80%)
  • Delayed (will work after 10-30days)
  • Primary non function (will never work)
61
Q

Late onset asthma, necrotising granulomatous inflammation, asthma and eosinophilia, lung most commonly involved

A

Churg Strauss

62
Q

cANCA PR3

A

Wegener’s

63
Q

pANCA MPO

A

Churg Strauss

64
Q

Lupus Nephritis Classification I-VI

A 
Class I: Minimal
Class II: Mesangial Proliferation
Class III: Focal proliferative 
Class IV: Diffuse proliferative 
Class V: Membranous
Class VI: Advanced sclerosing
65
Q

3 most common locations of Renal Stones

A
  • Pelvicoureteric junction
  • Vesicoureteric junction
  • Within ureter at pelvic brim
66
Q

Investigation for renal colic

A

CTKUB of kidneys, ureters and bladder

67
Q

Drug reaction: dose dependent and predictable, pre-renal/renal/post renal drug interactions, Drug-drug, drug-disease, drug-food

68
Q

Drug reaction: dose independent and unpredictable, high mortality

69
Q

Drug reaction: Prolonged therapy e.g. long term Beta blockers or steroids

70
Q

Drug reaction: delayed, many years after prescribing med

71
Q

Drug reaction: when a drug is suddenly stopped–> rebound effect

72
Q

X-linked, disorder of Type IV collegen, haematuria, bilateral sensorineural hearing loss and visual problems

A

Alports Syndrome

73
Q

Most common cause of Nephrotic Syndrome in children, IL-13, good treatment with oral steroids, T cell and cytokine mediated damage to GBM

A

Minimal Change Nephropathy

74
Q

Most common cause of Nephrotic Syndrome in adults, HIV/heroin/obesity/reflux

A

Focal Segmental Glomerulonephritis

75
Q

2nd most common cause of Nephrotic Syndrome in adults, Anti-PLA2r antibody, “spike and dome” appearance, 1/3rd spontaneous remission, 1/3rd proteinuria, 1/3rd ESRF

A

Membranous Glomerulonephritis

76
Q

Nephritic Syndrome, haematuria, Sore throat 1-2days after URTI, Henoch-Schoelin purpura, IgA deposits in mesangial cells

A

IgA Nephropathy

77
Q

Develops 1-2weeks after URTI, proteinuria, low complement, lumpy immune complexes on electron microscopy

A

Post Streptococcal Glomerulonephritis

78
Q

What is autosomal recessive kidney disease associated with?

A

Congenital hepatic fibrosis

79
Q

What is a renal Angioyolipoma associated with?

A

Benign tumour, associated with Tuberose Sclerosis

80
Q

Cancer which affects the renal pelvis?

A

Transitional cell carcinoma

81
Q

Cancer which affect the parenchyma?

A

Renal cell carcinoma

82
Q

Benign tumour which can mimic RCC, has a central scar

Summary of Stuff (14 decks)

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