Renal and urology Flashcards
pre renal causes of AKI
hypovolemia- dehydration, haemorrhage, diarrhoea, sepsis
renal artery stenosis- NSAIDs, ACEi/ARB
what drugs cause renal artery stenosis
ACEi/ARBs
NSAID
renal causes of AKI
acute tubular necrosis
acute glomerulonephritis
nephrotoxic drugs eg contrast
vascular
post renal causes of AKI
BPH
tumor
strictures
kidney stones
complications of AKI
electrolyte imbalance
CKD
uraemia
fluid overload
AKI symptoms
oedema
SOB
fatigue
reduced urine output
hyperkalemia mx
10ml 10% calcium gluconate
10 units insulin and 25g IV glucose over 5-30 mins
consider adjuncts of salbutamol, calcium resonium etc
if refractory, dialysis
amount of glucose/time it is given in for hyperkalemia
25g IV glucose over 5-30 mins
conc and time depends on weight and glucose levels (can be 10/20/50%)
where is most potassium reabsorbed in kidneys
proximal tubules
what type of kidney stone causes staghorn calculi
struvite
mx kidney stones
<5mm watchful waiting
>20mm in kidney= percutaneous nephrolithotomy
10-20mm in ureter= ureteroscopy
if hydronephrosis or infection= nephrostomy w abx cover
BPH mx
lifestyle= no caffeine, stop drinking fluids 2 hrs before bed
medications= tamsulosin, then finasteride if it doesnt work
surgery= TURP
tamsulosin moa
alpha blocker
relaxes neck of bladder muscles
finasteride moa
5 alpha reductase blocker
acute urinary retention mx
catheterise
replace volume loss w IV fluids
urine dip, MC&S
prhens sign interpretation
if lifting the testicle relieves pain this suggests epididymitis
what does end of stream vs whole stream haematuria indicate
end of stream= bladder irritation
whole stream= upper tract source
gold standard imaging for ix cause of haematuria
flexible
bladder clot retention mx
3 way catheter
bladder washout and irrigation
