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2MB: disease summaries > Renal > Flashcards

Renal Flashcards

1
Q

What is AKI + how to treat

A 
Reduced GFR in 24 hrs
Reduced output (<0.5/ 6hrs)
Increased creatinine (>50%)

Management:
Give saline
Ca gluconate, insulin and dextrose to protect heart

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2
Q

CKD: define and treat

A 
Decrease in GFR over 90 days
I: >90 w damage
II: 60-90 w damage
III: 30-60
IV: 15-30
Manage:
Lifestyle (salt and fluid restriction)
ACEis/ARBs
NaHCO3
Phosphate binders
ferrocarboxylase
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3
Q

Indications for dialysis

A

K+ >7 or 6.5 w treatment
Pericardial rub/effusion
pH < 7.15

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4
Q

Whats the risk with peritoneal dialysis?

A

Peritonitis

Treat with vancomycin and gentamicin

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5
Q

Why is haemodialysis considered safer?

A

Avoids dysequilibrium syndrome

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6
Q

Acute loin to groin pain
Colicky pain
Sweating

A

Renal stones
Investigate:
CT-KUB

Management:
-Diclofenac
small: Tamsulosin
Large: Percutaneous nephrostomy

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7
Q

Whats the most common form of renal stone?

A

Caclium oxalate

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8
Q

What does a ‘staghorn’ calculi indicate?

A

UTI

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9
Q

Proteinuria (1-3g)
Oedema
albumin <30

A

Nephrotic syndrome

Investigate:
Lipid in urine

Management:

  • Fluid and salt restriction
  • Diuretics
  • Albumin if decreased volume
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10
Q

Hamaturia

A

Nephritic syndrome

Treat cause

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11
Q

Kids

EM shows podocytes

A

Minimal change

Steroids and cyclophosphamides

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12
Q

Adults
C3 on immunofluorescence
loss of loops and sclerotic membrane

A

Focal segmental

Steroids

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13
Q

Infections
PLAR2
Thickened GBM
Basement membrane complexes

A

Membranous
6 months ACEis
Steroids and cyclophosphamide

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14
Q

IgA deposits
Macroscopic haematuria
Increasesd cells and matrix
Incrased BP

A

IgA nephropathy

Steroids and cyclophosphamide

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15
Q

ANCA +ve/-ve

nephritic

A 
Rapidly progressive: 
c-ANCA: Steroids and cyclophosphamide
p-ANCA: MPA
anti-GBM + linear immuno: GPS
Steroids and cyclophosphamide
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16
Q

Haematuria following strep infection
Smoky urine
oedema
lumpy bumpy complex

A

Post strep

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17
Q

Massive bilateral enlargement

Renal symptoms and polycythemia

A

AD polycystic kidney disease
PKD1 gene

Investigate: US then CT/MRI

Management:
tolvaptan
lithotripsy for stones

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18
Q

Children
Bilateral enlargement
Slow decline in eGFR

A

AR kidney disease
PK1HD
US at pregnancy @ 20 weeks
Transplant

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19
Q

Renal symptoms
Sensorineural deafness
anterior lens dislocation

A

Allports syndrome
X-linked 4 collagen
Biopsy shows thickened membrane
Manage symptoms

20
Q

Angiokeratomas

Cardio and neuro problems

A

Anderson-Fabrys
X-lined a galactosidase
Fabryzyme

21
Q

Fibrosis of tubules of imaging

family history

A

Medullary cystic kidney

Transplant

22
Q

Sponge appearance on imaging

A

Medullary sponge kidney

Excretion nephropathy

23
Q

Tumour
Fluffy
Stellate central scar

A

Oncocytoma

24
Q

Tumour

Bright echo on USS

A

Angiomyolipoma

Embolise/partial nephrectomy

25
Q

Bright yellow surface
Heterogenous
VHL loss
Renal vein and PNPS association

A

Clear cel

26
Q

Finger like

multifocal

A

Papillary

27
Q

Raisinoid nuclei

Perinuclear halo

A

Chromophobe

28
Q

Desmoplastic stroma

A

Collecting duct

29
Q

Young

Sickle cell

A

Medullary

30
Q

Gross haematuria following abdo trauma

A

Bladder injury

Investigation: CT cystography
If blood at meatus/no catheter (retrograde urethrogram)

31
Q

How to investigate urethral injury

A

retrograde urethrogram

32
Q

Loin pain
haematuria
mass

A

Suspect cancer
Small: watch/ablate
>3cm: Nephrectomy
Bloods and imaging as follow up

33
Q

Suprapubic pain
Increased urine frequency
Haematuria
Been on honeymoon/cathetr in

A

UTI
Tends to be coliforms (E.Coli)
‘staghorn/foul smell: proteus

Investigate:
Dipstick shows WBCs and nitrites
Midstream culture
kAss > 105 in childbearing

Treament: 
Uncomplicated; Nitrofuratoin/trimethoprim 
Complicated llower/ pyelo: 
GP/catheter: Co trimox/co-amox
Hospital; Amox + gent
34
Q

Peeing on sneezing coughing

A

Stress incontinence (increased pressure)

Investigations: Urodynamic

Management:
Exercises and lifestyle

35
Q

Always needing to go
Incompleteness
Fullness

A

Urge incontinence
Pelvic floor
Oxybutin
Mirabegnon

36
Q

Pain
Hard to urinate
History of BPH

A 
Acute retention
Investigation: urogram and cystoscopy
Management: 
Catheterise
Tamsulosin
If clots: 3 way catheter
37
Q

Man who worked in dye industry and smoked a lot
Suprapubic pain
painless haematuria
recurrent UTIs

A

Bladder cancer
(Usually transitional cell but can be squamous)

Investigations: CT halo sign

Management:
lower: cystectomy
Upper: intravesical chemo

38
Q

Bell clapper deformity
Adolescent
Pain at night

A

Testicular torsion
-ve cremasteric reflex
D-US
2/3 point fixation

39
Q

Undescended testes, HIV

Slow growing mass in balls

A 
Testicular cancer
Seminoma: potato
non-seminomatous: More aggressive
Increased PLAP
a feto if yolk sac
Bhcg if trophoblast

Treatment: Orchidectomy
Radio if semino, chemo if not

40
Q

Hard painless lump on dick

SCC/BCC appearance

A

Penile cancer
Imaging of lower abdomen
circumcise/resurface/glansectomy/penilectomy lymphadenectomy

41
Q

Swelled foreskin following catherisation

A

Paraphimosis
Iced glove
Granulated sugar
puncture skin

42
Q

Erection > 48 hrs

A

Priaprism
Isch: Compartment syndrome
NI: trauma

Investigations:
Aspirate blood and colour duplex

Management:
aspirate
Phenylephrine (NI)

43
Q

‘Bag of worms’ in balls

Valsalva makes it pulsate

A

Variocoele

US to check further up as could be malignancy sign

44
Q

Incomplete dribbling
weak stream
Straining

A

BPH (hormonal imbalances increases central and peripheral zones)

Investigate:
PR
PSA

Rx:
Tamsolusin
finasteride
TURP

45
Q

Asymptomatic
Raised PSA
Craggy mass on PR

A

Prostate cancer
(adenocarcinoma thats mutlifocal and affects peripheries)
TRUS biopsy

Management:
Conservative
5 a reductase
Cancer treatment

2MB: disease summaries (10 decks)

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