Renal Pt 2 Flashcards
UTIs types and causes?
lower UTI and upper (pyelonephritis)
ECOLI
Staph. saprophyticus
Proteus mirabilis
Enterococci
Atypical (immunocompromised) = klebsiella, candida, pseudomonas
RFs for UTIs?
Female, sex, spermicide exposure, pregnancy, menopause, immunosuppression, UT obstruction or malformation, catherisation
Cystitis symptoms?
Frequency, urgency, dysuria, haematuria
Prostatitis symptoms?
Suprapubic pain, flu like symptoms, low backache, few urinary symptoms
enlarged prostate
Acute pyelonephritis symptoms?
High fever, rigors, vomiting, loin pain ad tenderness, oliguria (if AKI)
General = fever, abdo pain, distended bladded
Ix and management for UTIs?
Urine dipstick (nitrites)
MSU for urine MCS
Bloods: FBC, U&Es, CRP
Uncomplicated: Nitrofurantoin or cefalexin (pregnant)
Male: Fefalexin or ciprofloxacin
Pyelonephritis/urospsis = co-amoxiclav
Polycystic Kidney Disease features?
Can be auto dom (85%PKD1 Ch16, 15 PKD2 Ch4)
Clinically silent for years, renal failure sx, FHX of SAH (berry aneurysms)
Presentation of PCKD?
HTN, renal enlargement, abdo pain +-haematuria
Ix for PCKD?
Haematuria, raised Hb, deranged U&Es, abdo USS
Triad for renal cell Carcinoma?
Haematuria, loin pain and abdo mass
Also PUO, night sweats and maybe polycythaemia
RFs for RCC?
Age, smoking, obesity, HTN, dialysis, certain syndromes inherited e.g. von hippel lindau, tuberous sclerosis,
50% incidental finding
Ix for RCC?
Increased BP (renin), polycythaemia or IDA, ALP, RBCs in urine, cannon ball mets so CT or MRI
Renal Artery stenosis Causes?
Athersclerosis 80%, fibromuscular dysplasia 10%, young females)
Clues for renal artery stenosis?
Increased bp refractory to treatment
Worsening renal function after ACEiARB in bilateral RAS
Flash pulmonary oedema
Abdo +-carotid or femroal bruits and weak leg pulse
Ix for renal artery stenosis?
USS for kidney size, CT angiogram
GOLD = digital dubtraction renal angiography