Renal Lecture

Question 1

Common Presenting Complaints for Renal Disorders

Answer 1

Disorders of micturition
Disorders of urine volume
Alterations in urine composition
Loin/flank pain
Oedema
Hypertension (due to impairment of the renin-angiotensin system)

Question 2

What is the difference between polyuria and diuresis?

Answer 2

Polyuria: production of abnormally large volumes of dilute urine.
Diuresis: increased or excessive production of urine.

Question 3

Having to pee more often and producing lots of urine (polyuria) could be due to:

Answer 3

• Increased fluid intake (polydipsia)
• Decreased ADH and/or ADH sensitivity
• Solute diuresis (eg: glucose in DM or urea in chronic renal failure)

Question 4

Having to pee more often but still producing normal amounts of urine could be due to:

Answer 4

Inflammation (UTI)
Tumour (prostate/bladder cancer or benign prostatic hyperplasia)
Urinary calculi
Reduced bladder capacity

Question 5

What are some characteristics of poor flow of urination?

Answer 5

Poor flow with weak stream

Difficulty stopping and starting

Question 6

What could be the likely cause of poor flow of urine?

Answer 6

Prostate enlargement (in men) or urethral/
 detrusor muscle constricture

Question 7

What is Dysuria?

Answer 7

Pain during urination

Question 8

Having to Pee lots with pain could be…

Answer 8

cystitis or urethritis

Question 9

Having to pee with alot of pain and rectal and perineal pain could be….

Answer 9

prostatitis

Question 10

Dysuria Red Flags

Answer 10

Fever
 Flank pain or tenderness
 Immunocompromised patient
 Recurrent episodes (including frequent childhood infections)
 Known urinary tract abnormality
 Male

Question 11

What is the difference between olig,poly and an-uria?

Answer 11

Polyuria = production of abnormally large volumes of dilute urine (>3L of urine per day)
Oliguria  = production of abnormally small amounts of urine (<500mL/day)
Anuria = failure of the kidneys to produce urine. (100mL/day)

Question 12

What could abnormally small amounts of urine (oliguria) lead to?

Answer 12

• Lead to increased concentrations of urea and creatinine

- Indicates development of acute kidney injury

Question 13

What could cause a person to not produce any urine? (Anuria)

Answer 13

Renal tract obstruction
Renal artery occlusion
Cortical necrosis
Inflammatory glomerular disease

Question 14

What are the most common causes of haematuria?

Answer 14

UTIs, prostatitis or urinary calculi (in adults)

Question 15

Haematuria at the end of urination suggests…

Answer 15

bladder or prostate bleeding

Question 16

What is Haematuria

Answer 16

the presence of blood in urine.

Question 17

Visible haematuria at the start of urination suggests..

Answer 17

Urethral bleeding

Question 18

Haematuria Red Flags

Answer 18

Significant amounts of blood
Persistent microscopic haematuria, especially in older patients
Age > 50
Hypertension and oedema
Fever
Night sweats 
Weight loss

Question 19

Sudden, severe and colicky, often radiating to the groin, scrotum or labia suggests….

Answer 19

Acute renal obstruction

Question 20

Localised renal angle pain suggests…..

Answer 20

Acute pyelonephritis

Question 21

Diaphragm or psoas muscle irritation could suggest….

Answer 21

Peri-renal abscess

Question 22

Uraemia Red Flags

Answer 22

Anorexia, vomiting, nausea, weight-loss
Restless limbs
Fatigue/weakness
Reduced mental acuity
Loss of concentration
Pruritus
Abnormal sense of touch
HA
Sleep disturbance
Abnormal taste
Sexual dysfunction

Question 23

What is Uraemia ?

Answer 23

Raised level of urea and other nitrogenous components in the blood which should have been excreted by the kidneys