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Diseases > Renal > Flashcards

Renal Flashcards

1
Q

Definition of UTI

A

presence of a pure growth of >10^5 organisms per mL of fresh MSU, 1/3 women with symptoms of UTI have -ve MSU

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2
Q

List Lower UTI

A

Urethra (Urethritis)
Bladder (cystitis)
Prostate (Porstatitis)

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3
Q

List Upper UTI

A

Renal pelvis - Pyelonephritis

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4
Q

List the causative organisms of UTI

A

E.coli
Staph Saprophyticus
kelbsiella
Pseudomonas aeruginosa

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5
Q

List the risk factors for UTI

A

Increased bacterial inoculation chance - Sexual activity, incontinence
Binding of uropathogenic bacteria - increased spermicide use, decreased oestrogen, menopause
Decreased urine flow - Dehydration, tract obstruction
Bacterial growth - DM, immunosuppression, stones, catheter, tract malformation, pregnancy

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6
Q

Summarise epidemiology for UTI

A

Common

Majority in women

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7
Q

What are the presenting symptoms of UTI?

A

Cystitis: Frequency, Urgency, dysuria, haematuria, suprapubic pain

Prostatitis: Flu-like symptoms, Low backache, Few urinary symptoms, Swollen or tender prostate on PR

Acute Pyelonephritis: High fever, Rigors, Vomiting, Loin pain + tenderness, Oliguria

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8
Q

What are the signs of UTI

A 
Fever
Abdo/loin tenderness
Foul smelling urine
Distended bladder
enlarged prostate
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9
Q

What investigations would you carry out for UTI?

A

Urine dipstick - leucocyte esterase + nitrites
Urine microscopy - leucocytes (infection)
MSU Culture - exclude diagnosis (pt no respond to abx)
Ultrasound - rule out obstruction
Bloods - FBC, U&E, CRP, Blood cultures (urosepsis)

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10
Q

Management plan for UTI

A

Uncomplicated Tx - Trimethoprin // Nitrofurantoin
Treat for 3-6 days, men may require longer course
Alternative treatments - Coamoxiclav//Cefalexin

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11
Q

Complications of UTI

A 
Ascending infection leads to:
pyelonephritis
perinephric and intrarenal abscess
Hydronephrosis // pyenophrosis
AKI
Sepsis
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12
Q

Summarise prognosis for UTI

A

GREAT prognosis with appropriate treatment

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13
Q

Define AKI

A

Abrupt loss of kidney function resulting in the retention of urea and other nitrogenous waste products and the dysregulation of extracellular volume and electrolytes

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14
Q

How is AKI classified

A

Pre-renal
Intrinsic renal
Post renal

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15
Q

List pre-renal causes of AKI

A

Hypovolaemia (haemorrhage, sever vomiting)
Heart Failure
Cirrhosis
Nephrotic Syndrome
Hypotension (Shock, sepsis, anaphylaxis)
Renal hypoperfusion (NSAIDs, ACEi, ARBs, RAS)

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16
Q

List intrinsic causes of AKI

A 
glumerulonephritis, haemolytic uraemic syndrome
Acute tubular necrosis
Acute interstitial nephritis
Vasculitides
Eclampsia
17
Q

List post-renal causes of AKI

A 
(Obstruction)
Calculi
Urethral stricture
Prostatic hypertrophy/malignancy
bladder tumour
18
Q

What are the risk factors for AKI

A 
Age
CKD
comorbidities
Sepsis
Hypovolaemia
Nephrotoxic medications
Emergency SUrgery
Diabetes mellitus
19
Q

Summarise the epidemiology of AKI

A

15% of adults admitted to hospital develop AKI

Common in elderly

20
Q

What are the presenting symptoms of AKI

A

oliguria/anuria
nausea/vomiting
dehydration
confusion

21
Q

What are the signs of AKI

A 
Hypertension
distended bladder
dehydration
fluid overload
Raised JVP
pulmonary and peripheral oedema
Pallor/rash/bruising (vascular disease)
22
Q

Appropriate investigations for AKI

A

urinalysis (blood, leuc/nitrites -UTI, glucose, protein, osm)
Bloods (FBC, Blood film, U&Es, Clotting, CRP)
Immunology - immunoglobulins, ANA, complement
Ultrasound - post renal cause/hydronephrosis
Imaging - CXR(pulmonary oedema)/AXR(renal stones)

23
Q

Management plan for AKI

A

Protect from hyperkalaemia
optimise fluid balance
stop nephrotoxic drugs
Consider for dialysis

refer to nephrology if intrinsic renal disease is suspected
Renal Replacement Therapy: Hyperkalaemia, Pulmonary Oedema, severe metabolic acidaemia, uraemic

24
Q

List complications of AKI

A 
pulmonary oedema
Acidaemia
Uraemia
Hyperkalaemia
Bleeding
25
Q

Summarise the prognosis for AKI

A 
Poor prognosis
Age
multiple organ failure
Oliguria
Hypotension CKD

AKI has an increased risk of developing CKD

Diseases (2 decks)

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