Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

MY PHASE 2A MEDICINE > RENAL > Flashcards

RENAL Flashcards

1
Q

Give 3 causes of renal colic.

A
  1. Urinary tract stones.
  2. UTI.
  3. Pyelonephritis.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Give 3 symptoms of renal colic

A
  1. ‘Loin to groin’ pain
  2. nausea/vomiting
  3. Often writhing in pain
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Give 3 common sites where stones get stuck in urinary tract

A
  1. Pelviureteric junction
  2. Pelvic brim
  3. Vesicoureteric junction
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is the most common composition of renal caliculi?

A

Calcium oxalate 75%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What investigations might you do to find out what is causing someone’s renal colic?

A
  1. Bloods - inc. calcium, phosphate and urate.
  2. Urinalysis.
  3. MCS MSU.
  4. NCCT-KUB - gold standard!
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Describe the epidemiology of stones in the urinary tract.

A
  • 10-15% lifetime risk.
  • Males > females - 2:1 ratio.
  • Common among 30-50 y/o.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Give 3 potential causes of stones in the upper urinary tract.

A
  1. Dehydration!!
  2. infection
  3. Hypercalciuria
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Describe the pathophysiology of stone formation in the upper urinary tract.

A

Form from crystals in supersaturated urine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Give 5 ways in which urinary tract stones can be prevented.

A
  1. Stay well hydrated.
  2. Low salt diet.
  3. Healthy protein intake.
  4. Reduced BMI.
  5. Active lifestyle.
  6. Deacidifcation of urine can prevent uric acid stones.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Describe the treatment for renal colic.

A
  1. Analgesia e.g. NSAIDs (diclofenac).
  2. Anti-emetics.
  3. Check for sepsis.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

How would you treat renal stones <5mm diameter?

A

Stones <5mm diameter: 90%+ pass spontaneously

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

How would you treat stones >5mm diameter?

A

Stones >5mm diameter:

  1. Medical therapy (nifedipine or tamulosin)
  2. ESWL - Extracorporeal Shock Wave Lithotripsy
  3. PCNL - Per Cutaneous Nephro Lithotomy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What kind of drug is Tamulosin?

A

Alpha-1-blocker
- relaxes smooth muscle in the bladder neck and prostate and so increases urinary flow. This improves obstructive symptoms.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is the affect of AKI on creatinine and urine output?

A
  • Creatinine is raised.

- Urine output is reduced.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Give 5 risk factors for AKI.

A
  1. Increasing age.
  2. CKD.
  3. HF.
  4. Diabetes mellitus.
  5. Nephrotoxic drugs e.g. NSAIDs and ACEi.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Give a pre-renal cause of AKI.

A
  1. Hypertension.
  2. Heart failure.
  3. Nephrotoxic drugs.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Give 5 renal causes of AKI.

A
  1. Nephrotoxic drugs.
  2. Vasculitis.
  3. Autoimmune.
  4. Acute tubular necrosis.
  5. Glomerulonephritis.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is the major complication someone with AKI might develop?

A

HYPERKALAEMIA!

  • can lead to arrhythmias
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

How can hyperkalaemia be prevented in someone with AKI?

A
  1. Give calcium gluconate to protect the myocardium.
  2. Give insulin and dextrose.

Insulin drives potassium into cells and dextrose is to rebalance the blood sugar.

20
Q

What investigations might you do to determine whether someone has AKI?

A
  1. Check potassium!
  2. Bloods: creatinine, U+E.
  3. Urine output.
  4. Auto-antibodies.
21
Q

Give a primary cause of nephrotic syndrome.

A

Minimal change disease.

This is the most common cause in children.

22
Q

What triad of signs make up nephrotic syndrome?

A
  1. Proteinuria
  2. Hypoalbuminaemia
  3. Oedema
23
Q

What is the pathophysiology behind nephrOtic syndrome?

A
  1. Podocytes or basement membrane aren’t working properly a

2. huge amounts of protein leaks into the bowman’s capsule and is excreted in the urine.

24
Q

What investigations might you do to determine whether someone has nephrotic syndrome?

A
  1. Renal biopsy.
  2. Urine dipstick - +++ protein.
  3. Bloods: low serum albumin.
  4. Look for auto-antibodies.
25
Q

Give 2 potential complications of nephrotic syndrome.

A
  1. Sepsis

2. Venous thromboembolism

26
Q

Why is someone with nephrotic syndrome at risk of sepsis?

A

Because you lose immunoglobulins in the urine.

27
Q

What can nephrotic syndrome be secondary to?

A
  1. Diabetes.
  2. Amyloid.
  3. Infections.
  4. SLE.
  5. Drugs.
28
Q

Describe the treatment for nephrotic syndrome.

A
  1. Treat complications e.g. diuretics for oedema; ACEi for proteinuria.
  2. Treat the underlying cause.
  3. Statins and anti-coagluation e.g. warfarin.
  4. In children give steroids as minimal change disease is the most likely cause.
29
Q

Is focal segmental glomerulosclerosis a cause of nephritic or nephrotic syndrome?

A

Nephrotic syndrome.

30
Q

Give 4 causes of acute nephrItic syndrome.

A
  1. ANCA.
  2. Goodpastures.
  3. SLE.
  4. Post streptococcal glomerulonephritis
  5. IgA nephropathy.
31
Q

Give 5 signs of acute nephritic syndrome.

A
  1. Inflammation of glomeruli.
  2. HAEMATURIA and PROTEINURIA.
  3. Hypertension.
  4. Fluid overload.
  5. Oliguria.
  6. Red cell casts.
32
Q

Describe the pathophysiology behind nephritic syndrome.

A
  1. Immune complex deposition in glomerular capillary
  2. Neutrophil recruitment -> inflammation and damage to glomerular capillary membrane
  3. RBC, WBC, protein etc leaks into bowman’s capsule and is excreted in the urine.
33
Q

A patient presents complaining that they are hardly passing any urine and in the small amount of urine they do pass there is blood in it. On further questioning they tell you they have recently finished a course of antibiotics (amoxicillin) for a chest infection they had 2 weeks ago. Their BP is high. What is the likely cause?

A

Nephritic syndrome

34
Q

What would often precede a nephritic syndrome?

A

URTI!!! (days/weeks after)

35
Q

What is ADPKD?

A
  1. An autosomal dominant condition characterised by progressive cyst development.
  2. Cysts increase in size -> renal enlargement and loss of function
  3. kidney failure.
36
Q

A mutation in which genes can cause ADPKD?

A
  1. PKD1 (associated with more severe disease). (85%)

2. PKD2.

37
Q

Give 3 signs of ADPKD.

A
  1. Hypertension.
  2. Haematuria.
  3. Polyuria.
  4. Abdominal/loin pain.
  5. (renal enlargement!) Palpable bilateral costo-vertebral masses.
38
Q

Give 2 extra-renal manifestations of ADPKD.

A
  1. Polycystic liver disease.

2. INTRACRANIAL ANEURYSMS e.g. SAH.

39
Q

How can ADPKD be diagnosed?

A
  • Symptoms.
  • Family history.
  • High BP.
  • Urinalysis.
  • USS.
40
Q

How is ADPKD managed?

A
  1. monitor U&E
  2. treat high BP
  3. treat infections
  4. treat End Stage Renal Failure
41
Q

Why might someone with advanced CKD also have hyperparathyroidism?

A
  1. Advanced CKD = calcitriol deficiency.

2. Calcitriol suppresses PTH therefore deficiency -> hyperparathyroidism.

42
Q

Name 5 groups of people who are at risk of hypervolaemia.

A
  1. Acute kidney injury patients.
  2. CKD patients.
  3. Heart failure patients.
  4. Liver failure patients.
43
Q

Give 5 causes of CKD.

A
  1. Diabetes mellitus.
  2. Hypertension.
  3. Atherosclerotic renal vascular disease.
  4. Congenital e.g. PKD.
  5. Urinary tract obstruction.
44
Q

Give 5 signs of CKD.

A
  1. Proteinuria.
  2. Haematuria.
  3. Impaired eGFR <60ml/min.
  4. Rise in serum urea/creatinine.
  5. Anaemia (reduced EPO).
  6. Bone disease.
  7. Polyneuropathy.
  8. CV disease.
  9. Erectile dysfunction.
  10. Raised PTH.
45
Q

Describe the management for CKD.

A
  1. Treat the underlying cause.
  2. Slow deterioration of kidney function e.g. maintain BP.
  3. Reduce CV risk e.g. statins, smoking cessation.
  4. Treat complications e.g. anaemia.
  5. ESRF -> dialysis or transplant.

MY PHASE 2A MEDICINE (14 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions