renal amk Flashcards
causes of increased serum potassium
MACHINE M- medications such as ACEI and NSAIDS A- acidosis C- cellular destrcution like burns H - haemolysis and hypoaldosteronism I- intake - excessive N - nephrons, renal failure E - excretion - impaired
how do loop diuretics work and some examples
act by inhibiting the NKCC cotransporter in thick ascending limb of henle reducing absorption of NaCl
furosemide and bumetnaide
adverse effects of loop diuretics
hypotension hyponatraemia hypokalaemia hypomagnesamia hypochoraemic alkalosis hypoclacaemia
when do you use a loop diuretic
difference when to use IV or oral
heart failure - if acute IV and if chronic PO
resistant hypertension - particularly in patients with renal impairment
from anterior to posterior, what is the correct order of the structures entering the hilum
vein artery ureter
3 constrictions of ureter
leaving the kidney at the uteropelvic junction L1
bifurcation of the common iliac at L4
entering the bladder at the uterovesical junction
what is urge incontinence
overactivity of detrusor
overreactive bladder
feeling of urge to pass urine with a sudden urge
what is stress incontinence
pelvic floor consists of a sling of muscles that support contents of the pelvic floor - urethral, vaginal and rectal canals
urine leaks as bladd under pressure so leaks when coughing or laughing
overflow incotnience
chronic urinary retention or obstruction - men - unable to fully empty
total icnotnince
unable to store any urine
how to manage urge incontinence
bladder retaining , anticholergenic medication like oxybutynin ( side effect though of memory and dry ) or miabegron ( don't use in hypertension ) as alternative
how to manage stress incontinence
avoid caffeine, pelvic floor exercises , fluoxetine is antidepressant could also have vaginal free tape and coposuspensuoon
what bacteria most commonly causes UTI
Ecoli - gram negative rod
when are UTIs considered recurrent
UTIs are considered recurrent after at least two episodes within 6 months or three or more episodes within 12 months.
what can be caused from a partially treated UTI , chlamydia or appendicitis and renal stones
sterile pyuria
calcium oblate stones what shape
1: Diamond-shaped or rhomboid-shaped crystals are characteristic of stones consisting of uric acid. These are prevalent in individuals with hyperuricemia.
2: Envelope-shaped crystals are typical of calcium oxalate stones. low water-intake. Dehydration predisposes to the precipitation of calcium oxalate into stones.
3: Hexagonal-shaped crystals are found in cystine stones.
4: Coffin-lid crystals are characteristic of ammonium magnesium phosphate stones.
5: Wedge-shaped prism crystals are found in calcium phosphate stones and are the second most common types of calcium stones, after calcium oxalate stones.
pneumonia structures that are retroperitoneal
S: suprarenal (adrenal) gland
A: aorta/IVC
D: duodenum (second and third part)
P: pancreas (except tail)
U: ureters
C: colon (ascending and descending)
K: kidneys
E: oesophagus
R: rectum
Hyperlipidaemia
Hyperlipidaemia is the term used to denote raised serum levels of one or more of total cholesterol (TChol), low-density lipoprotein cholesterol (LDL-C), triglycerides (TGs), or both TChol and TG (combined hyperlipidaemia
what is raised disproportionality in pancreatitis
Amylase is produced in the pancreas and is used to digest carbohydrates. It is released into the blood in large quantities in pancreatic disease
when is ALT high
Alanine aminotransferase (ALT) is a relatively liver-specific cytoplasmic enzyme and is raised in hepatic injury.
when is ALP high
Alkaline phosphatase (ALP) is found predominantly in the biliary tree and hepatic epithelial cells. It is commonly raised significantly in obstructive liver diseases.- bile duct disruption
when GGT high
Gamma-glutamyltransferase (GGT) is commonly raised by alcohol or drugs (for example phenytoin).
causes of acute pancreatitis
Popular mnemonic is GET SMASHED
Gallstones
Ethanol
Trauma
Steroids
Mumps (other viruses include Coxsackie B)
Autoimmune (e.g. polyarteritis nodosa), Ascaris infection
Scorpion venom
Hypertriglyceridaemia, Hyperchylomicronaemia, Hypercalcaemia, Hypothermia
ERCP
Drugs (azathioprine, mesalazine*, didanosine, bendroflumethiazide, furosemide, pentamidine, steroids, sodium valproate)
