Renal/ GUM Flashcards
Renal tubular acidosis (RTA) associated with abnormal H+ secretion and nephrolithiasis
Type I (distal) RTA
RTA associated with abnormal HCO3- re absorption and rickets
Type II (proximal) RTA
RTA associated with low aldosterone state
Type IV (distal) RTA
Treatment of hyperNa
Unstable vital signs –> normal saline; D5W or half NS to replace free water loss
DDx of hypotonic hypervolaemic hypoNa
Cirrhosis, CHF, nephrotic syndrome, AKI, CKD
Chvostek & Trousseau signs
HypoCa
Two most common cause of hyperCa
Malignancy & hyperparathroidism
T-wave flattening & U waves
HypoK
Peaked T waves & widened QRS
HyperK
Treatment of HyperK
C BIG K - calcium gluconate 10ml 10% - bicarb (not UK) - insulin - glucose - kayexalate Or salbutamol to drive K in
First line treatment of hyperCa
IV fluids
Type of AKI with FeNa <1%
Pre renal
49 yr old man presents with acute onset flank pain and haematuria
Nephrolithiasis
Most common type of nephrolithiasis
Calcium oxalate
Test of choice for nephrolithiasis
Non-contrast CTKUB
USS shows bilateral enlarged kidney cysts. Associated brain anomaly?
Cerebral berry aneurysms (autosomal dominant poly cystic kidney disease)
Haematuria, hypertension, oliguria
Nephritic syndrome
Proteinuria, hypoalbuminaemia, hypelipidaemia, hyperlipiduria & oedema
Nephrotic syndrome
The most common form of nephrotic syndrome in adults
Focal segmental glomerulosclerosis
Nephritic syndrome presenting 3 days after UTI, normal C3
IgA nephropathy (Berger disease)
Palpable purpura, arthralgia, abdominal pain
Henoch- Schönlein purpura
Glomerulonephritis with deafness
Alport syndrome
Glomerulonephritis with haemoptysis
Granulomatosis with polyangiitis (Wegeners) & Goodpastures syndrome
Presence of red cell casts in urine sediment
Glomerulonephritis or nephritic syndrome
Eosinophils in urine sediment
Allergic interstitial nephritis
Waxy casts in urine sediment and Maltese crosses (seen with lipiduria)
Nephrotic syndrome
Muddy brown casts
Acute tubular necrosis
Drowsiness, asterixes, nausea, pericardial friction rub
Uraemia syndrome seen in patients with renal failure
55 year old man is diagnosed with prostate cancer. Treatment options?
Wait, surgical resection, radiation therapy and/or androgen suppression
Haematuria in a 50yo smoker
Bladder cancer
Haematuria, flank pain, palpable flank mass
Renal cell carcinoma
Testicular cancer associated with beta-hCG
Choriocarcinoma
Most common type of testicular cancer?
Seminoma - type of germ cell tumour
Most common histology of bladder cancer
Transitional cell carcinoma
Complication of overly rapid correction of hypoNa?
Central pontine myelinolysis
Salicylate ingestion occurs in what type of acid base disorder?
Anion gap acidosis & primary respiratory alkalosis due to central respiratory stimulation
Acid-base disturbance commonly seen in pregnant women
Respiratory alkalosis
55 year old man presents with irritating and obstructive urinary symptoms. Treatment options?
BPH
No treatment, terazosin, finasteride or TURP
