Renal - Genetic Conditions + Infections Flashcards
how is PKD inherited?
aut dom
features of PKD?
HT abdo/flank pain haematuria palpable kidneys UTI cardiac murmurs
pathology features of PKD?
renal cysts
interstitial fibrosis
tubular atrophy
renal failure
Ix for PKD?
US
urinalysis
U+Es, creatinine, eGFR
Tx for PKD?
HT control
drain infected cysts
treat UTIs
transplant/dialysis
what are those with PKD at higher risk of? how to prevent?
SAH
baseline head CTs taken
what does TTP stand for?
thrombotic throbocytopenic purpura
what happens in TTP?
microangiopathic haemolytic anaemia and thrombocytopenic purpura
what is TTP associated with? what differentiates it?
HUS
worse neurological abnormalities
pathology of TTP?
deficiency of vWF
platelet aggregation occurs
fibrin deposits
microthombi in small vessels occur
features of TTP?
fever renal failure neurological changes vomiting diarrhoea purpura bruises menorrhagia
where do microthrombi often occur in TTP?
bowel
causes of TTP?
AI cancer pregnancy HIV clopidogrel GI infections
Ix and results for TTP?
FBC (platelets decreased) Hb (decreased) blood smear (thrombocytopenic) urinalysis U+Es, creatinine (raised)
Tx for TTP?
plasma exchange
steroids
aspirin
complications of TTP?
stroke
MI
renal failure
what makes a UTI complicated?
kidney involvement
pregnancy
risk factors for UTI?
Abx use DM structural abnormalities pregnancy female
features of a lower UTI?
frequency
urgency
dysuria
suprapubic pain
features of an upper UTI?
flank pain fever rigors vomiting haemturia dysuria frequency urgency
most common cause of UTI?
E coli
who usually gets pseudomonas UTIs?
catheters
who usually gets proteus UTIs?
stones
who usually gets staph UTIs?
women of child bearing age
what bacteria are associated with rectal contamination UTIs?
klebsiella
enterococci faecalis
Ix for UTI?
dipstick
MSSU
CT urogram/US (if recurrent cause)
Tx for uncomplicated lower UTI?
nitrofurantoin (not in late preg)
trimethoprim (not in early preg)
when should UTI be referred for recurrent?
2≥ in last 6 months
3≥ in last 12
why should trimethoprim be avoided in CKD?
if using ACE/ARB/spironolactone
risk of hyperkalaemia
what can be done surgically for a recurrent UTI?
widen urethra
