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Medicine Year 3 - Core Conditions > Renal Tract > Flashcards

Renal Tract Flashcards

1
Q

Who is most likely to get a UTI?

A

Women, 16-35yrs

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2
Q

What is an upper UTI called?

A

Pyelonephritis

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3
Q

Most common cause of UTI Infection

A

Escherichia Coli (80%)

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4
Q

UTI Risk Factors

A

Female Anatomy, Sex, Diabetes, Obesity, Family Hx, Catheters

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5
Q

UTI Male Risk Factors

A

Large Prostate, Uncircumcised

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6
Q

UTI Presentation

A

Dysuria, Frequency, Incomplete emptying, Pain in lower back, Haematuria

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7
Q

UTI Presentation in Children

A

Fever, Incontinence, Vomit, Jaundice

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8
Q

UTI Presentation in Elderly

A

Incontinence, Confusion, Fatigue

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9
Q

What shows up on Urinalysis if a UTI is present?

A

Nitrites, Leukocyte esterase, Bacteria

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10
Q

Uncomplicated UTI Treatment

A

Short course (3-7 days)

Trimethoprim/Nirofurantoin

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11
Q

Most common cause of Pyelonephritis?

A

Escherichia Coli

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12
Q

Pyelonephritis Risk Factors

A

Sex, Prior UTI, Diabetes, Structural problems of tract, Spermicides, Kidney stones

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13
Q

Pyelonephritis Presentation

A

Fever, Flank tenderness, Nausea, Dysuria, Haematuria, Frequency, Vomiting

Rapid onset

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14
Q

Pyelonephritis Investigations

A

Urinalysis, FBC, Urine + Blood culture, Antibiotic sensitivity tests

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15
Q

Pyelonephritis Treatment

A

Ciprofloxacin or Ceftriaxone

Complicated = IV Fluids and IV Antibiotics

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16
Q

What makes a Pyelonephritis complicated?

A

Fever, Leucocytosis

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17
Q

Who is Hydronephrosis more common in?

A

Men and Children

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18
Q

What is Hydronephrosis?

A

Build up of urine/water in the kidneys as a result of obstruction

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19
Q

Causes of Hydronephrosis?

A

Anything that can cause obstruction

Stones, Clots, Fibrosis, Dysfunction, Tumours, UTI

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20
Q

Hydronephrosis Presentation

A

Intense pain in flank, Nausea/Vomiting

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21
Q

Hydronephrosis Signs

A

Elevated Urea and Creatinine, Elevated pH, Palpable mass

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22
Q

Hydronephrosis Investigations

A

Urinalysis, IV Urogram, USS, CT/MRI

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23
Q

Acute Hydronephrosis Treatment

A

Insert Nephrostomy Tube

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24
Q

Chronic Hydronephrosis Treatment

A

Insert Ureteric Stent / Pyeloplasty

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25
Q

Causes of Chronic Kidney Disease?

A

Diabetes, High BP, Glomerulonephritis, Obstruction, Stenosis

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26
Q

Chronic Kidney Disease Presentation

A

Leg swelling, Fatigue, Vomiting, Loss of Appetite, Confusion, High Potassium Symptoms, Trouble with Sex

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27
Q

What must the GFR be to diagnose Chronic Kidney Disease?

A

GFR = <60 for 3 months

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28
Q

Chronic Kidney Disease Investigations

A

GFR, Albumin (low), Creatinine, USS, Biopsy

29
Q

Chronic Kidney Disease Treatment

A

Manage BP/Cholesterol/Sugar, Avoid Toxins (NSAIDs)

Severe = Dialysis, Transplant

30
Q

Definition of Acute Kidney Injury

A

Urine output = <0.5ml/kg/hour for 6 hours

Rise of Creatinine of 26umol/L in 48 hours/>50% in last 7 days

31
Q

Most common cause of Acute Kidney Injury?

A

Pre-renal = 90% (Low BP, Fluid depletion)

32
Q

Acute Kidney Injury Risk Factors

A

Dehydration, Sever infection, Diabetes, Old age, CKD

33
Q

Acute Kidney Injury Symptoms

A

Fatigue, Headache, Nausea/Vomiting, Pain in flanks, Thirst

34
Q

Acute Kidney Injury Signs

A

Low urine output, High BP, Large bladder, Uraemia, Metabolic acidosis

35
Q

What type of Kidney disease do you get a rash with?

A

Interstitial Nephritis

36
Q

Acute Kidney Injury Investigations

A

Urinalysis, USS

Bloods, Catheter, Biopsy, CT/MRI

37
Q

The 3 causes of Acute Kidney Injury

A

Pre-Renal (low BP)

Intrinsic (glomerular, nephritis, toxins)

Post-renal (obstruction)

38
Q

Acute Kidney Injury Treatment

A

STOP

+ Remove blockage, Diuretics, Steroids, Dialysis, Catheter (depending)

39
Q

Chronic Kidney Disease Risk Factors

A

Old age, Diabetes, Hypertension, Obesity, CVD

40
Q

What type of cancer is Prostate Carcinoma?

A

Adenocarcinoma (glandular)

41
Q

Where in the prostate is Prostate Carcinoma most common?

A

Peripheral zone

42
Q

Where does Prostate Carcinoma most commonly invade?

A

Rectum, Bladder, Ureters

43
Q

Prostate Carcinoma Risk Factors

A

> 50, Family Hx, African-American, Red meat, Milk, BRCA, Obesity

44
Q

Prostate Carcinoma Presentation

A

Dysuria, Haematuria, Nocturia, Poor stream

Pain in pelvis, Fatigue, Sexual dysfunction (Bone pain)

45
Q

What Scoring System is used for Prostate Carcinoma?

A

Gleason Score (2-10)

46
Q

Prostate Carcinoma Investigations

A

PR, Imaging, Biopsy, Tumour markers (PSA)

47
Q

Prostate Carcinoma Treatment

A

Surveillance, Surgery, Radiation/Hormone/Chemo

48
Q

How many males over 80 are affected by Benign Prostatic Hypertrophy?

A

90%

49
Q

What enzymes increase in activity as men age to cause Benign Prostatic Hypertrophy?

A

Aromatase, 5-Alpha Reductase

= more oestrogen and DHT

50
Q

Where is Benign Prostatic Hypertrophy most common in the prostate?

A

Transition Zone

Median and Lateral lobes

51
Q

Benign Prostatic Hypertrophy Risk Factors

A

Family Hx, Obesity, Diabetes, Erectile dysfunction

52
Q

Benign Prostatic Hypertrophy Presentation

A

Frequency, Hesitancy, Nocturia, Weak stream, Anuria, Loss of bladder control, Urgency, Incomplete emptying, Dysuria

53
Q

Benign Prostatic Hypertrophy Investigations

A

PR, Urinalysis, Bloods

54
Q

Benign Prostatic Hypertrophy Treatment

A

Lifestyle, Alpha blockers, 5a-reductase inhibitors, Self-catheterization, Surgery

55
Q

Most common type of Bladder Carcinoma?

A

Transitional Cell Carcinoma (90%)

56
Q

Bladder Carcinoma Presentation

A

Haematuria, Frequency, Dysuria, Lower back pain, Mass, Peripheral Oedema

57
Q

Bladder Carcinoma Risk Factors

A

Smoking, Family Hx, Radiation treatment, Frequent Cystitis

58
Q

Bladder Carcinoma Investigations

A

Cystoscopy with Biopsy, CT, Bone scan

59
Q

What percentage of Kidney Cancer is Renal Cell Carcinoma?

A

95%

60
Q

Where does Renal Cell Carcinoma Originate?

A

Lining of the proximal convoluted tubule

61
Q

Renal Cell Carcinoma Presentation

A

(hidden at first), Haematuria, Flank pain, Mass, Weight loss, Fever, Night sweats

62
Q

What are the Paraneoplastic syndromes that are associated with Renal Cell Carcinoma?

A

High blood calcium, High RBCs, High Platelets, Secondary amyloidosis

63
Q

Renal Cell Carcinoma Investigations

A

BLoods, USS, CT/MRI, Renal angiography, IV Pyelogram

64
Q

What Treatment is not good for Renal Cell Carcinoma?

A

Chemo/Radiotherapy

65
Q

What is the most common type of Urinary Tract Stone?

A

Calcium (85%)

Also: Uric acid, Cystine, Struvite

66
Q

Urinary Tract Stone Causes

A

Hyperparathyroidism, Dehydration, Diet, Family Hx, Medication (indinavir)

67
Q

Urinary Tract Stone Presentation

A

Colic Pain, Nausea, Sweating, Haematuria, Frequency, Fever, Dysuria, Cloudy urine

68
Q

Urinary Tract Stone Investigations

A

CT, USS (misses small stone), X-Ray (for calcium stones), Urinalysis

69
Q

Urinary Tract Stone Treatment

A

Fluid, Analgesia, Alpha blockers, Stent, Lithotripsy/Endoscopy

Medicine Year 3 - Core Conditions (12 decks)

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