RENAL AND GU Flashcards
What defines a UTI?
> 10^5 organisms/mL or less if with pyuria(pus in the urine)
What can a bladder UTI lead to?
cystitis
What is a prostate UTI?
Prostatitis
What is a urethra UTI?
Urethritis
What is the most common cause of UTIs?
E.coli then staph saprophyticus, proteus and klebisella
What are risk factors for UTIs?
Diabetes, pregnancy, impaired voiding, sex, stones, intact male foreskin
What organism makes a UTI complicated?
S.aureus
What are symptoms of acute pyelonephritis?
High fever, rigors, vomiting, loin pain, tenderness
What are symptoms of cystitis?
Frequency, dysuria (painful or difficult urnination), urgency, haematuria and suprapubic pain
What are the symptoms of prostatitis?
Flu-like, low backache, few urinary symptoms and swollen tender prostate on DRE
What appears on a UTI urine dipstick?
Leucocytes and nitrates
Which antibiotics are used for UTIs?
Trimethoprim or nitrofurantoin(is eGFR <30)
Where are renal calculi most common?
Pelviureteric junction
Pelvic brim
Vesicoureteric junction
Are renal stones more common in males or females?
Males
What is the pain like for renal colic?
Loin to groin with nausea and vomitting, haem and proteinuria, anuria, sterile pyuria
What foods are linked to kidney stones?
Spinach, tea, rhubarb, strawberries, nuts, chocolate
What blood tests do you do for renal stones?
Full blood count, U+E, PO4, Glucose, bicarbonate, urate
Imaging- young- xr
Old- non-contrast CT
What is the treatment for renal colic?
Pain relief, anti emetics, ccb and extracorporeal shockwave lithotripsy to remove the stone
What type of cancer is bladder cancer?
Transitional cell cancinoma
What are signs other than painless haematuria for bladder cancer?
Frequency, urgency, dysuria and urinary tract obstruction
What does TURBT stand for?
Transurethral resection of bladder tumour
What is the treatment for t2/3 stage bladder cancer?
Radical cystectomy or post op chemo
What is treatment foe stage Tis, Ta and T1 bladder cancer?
Transurethral Resection of Bladder Tumur and cisplatin
What are symptoms of renal cancer?
Haematuria, loin pain, abdominal mass, anorexia, high BP from renin
What issues are there with treating renal cancer?
It is very radio/chemo resisitant but for T1= surgically whilst the rest are treated with biological therapies
What is nephritic syndrome causes?
IgA nephropathy, post streptococcal glomerulonephritis, goodpasture’s, vascular disease
With Nephritic syndrome do you get hypo or hypertension?
Hypertension
What does post-streptococci glomerulonephritis present with?
Group A beta-haemolytic streptococcus
What are the causes of nephrotic syndrome?
Minimal change disease, membranous
glomerulonephritis- 1st
Diabetes melitus, malignancy, HIV, SLR- 2ndry
What are signs other than proteinuria for nephrotic syndrome?
Odeama, Hyperlidaemia and hypoalbuminaemia
What is minimal change disease?
Where cytokines damage the glomeruli so the podocyte foot processes flatten
What is urine retention?
producing urine but not being able to void
What are causes of urine retention?
Benign prostate enlargement, prostate cancer, MS or prolapsed disc, drugs blocked catheter
What hormone causes prostate hyperplasia?
Dihydrotestosterone
What are the treatments for BPH?
Medical= alpha blockers or 5 aplha reductase inhibitors
Surgical: Transurethral resection of the prostate
retropubic prostatectomy
What type of cancer is prostate cancer?
Adenocarcinoma
What scoring system is used for prostate cancer and how does it work?
The Gleason’s score and it looks at how much the cancer cells look uniform
What are treatments for prostate cancer?
Radical prostatectomy, radical radiotherapy, hormone therapy (anti-androgen and LHRH agonists), chemo
What investigation shows testicular torsion?
Doppler ultrasound
What is epididymo-orchitis?
Sudden onset testicular pain due to STI
What are signs of testicular cancer?
A painless lump, haematospermia, abdominal mass
What are the 2 types of testicular cancer?
Seminoma or non seminoma
What are the 3 tumour markers for testicular cancer?
Alpha fetoprotein
Beta human chorionic gonadotrophin
Lactate dehydrogenase
How do you treat seminomas?
radical orchiectomy and radio
How do you treat non-seminomas?
Chemo
What genes are asociated with polycystic kidney disease?
PKD1 and PKD 2
Causes of renal AKI?
Glomerulonephritis, acute tubular necrosis, drugs, vasculitis
What autoantibodies are seen in AKI?
ANCA and anti-GBM
What are causes of CKD?
Diabetes, PKD, hypertension, reflux nephropathy, obstructive uropathy
What is the eGFR in stage 4 CKD?
15-30
Where in the testes is testicular cancer most commonly found?
In the body
What is the most common compostition of renal stones?
Calcium oxalate?
What is an investigation for renal cancer?
Intravenous urogram
What is the most common type of bladder cancer?
Transitional
What age group does testicular cancer effect?
20-40
What is a hydroceles?
Fluid in the tunica vaginalis that can recover spontanoeously
What is a varocele?
A dilated pampiniform plexus which feels like a bag of worms
