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ICM/FCM > Renal & Urinary FCM > Flashcards

Renal & Urinary FCM Flashcards

1
Q

What symptoms suggest BPH? (3 marks)

A

Nocturia,
Urinary hesitancy
Reduced flow

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2
Q

What is BPH?

A

Benign Prostatic Hyperplasia

Enlargement of prostate due to natural growth with age

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3
Q

How would you investigate for BPH? (3 marks)

A

Urinalysis - rule out UTI

PSA & DRE

US - urinary retention

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4
Q

What is the medical management for BPH and when would you review this medication?

A

Tamsulosin

Review at 4 weeks

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5
Q

Aside Tamsulosin, what other medication would you give if there is a high risk of BPH progression?

A

Finasteride

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6
Q

What is the difference between a moving renal colic and renal obstruction?

A

Kidney stone - constant, dull

Obstruction - episodic, sharp

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7
Q

What imaging would you request if someone is presenting with symptoms depicting renal colic?

A

CT-KUB

Non-contrast CT scan of kidneys, ureters and bladder

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8
Q

What imaging would you request for a pregnant patient presenting with symptoms suggestive of renal colic?

A

US kidneys, ureters and bladder

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9
Q

Name 4 causes of acute urinary retention in men

A 
BPH 
Prostate cancer
Paraphimosis
Penile trauma 
(constipation)
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10
Q

Name 4 causes of acute urinary retention in females

A

Prolapse
Ovarian cyst
Uterine Fibroid
Constipation

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11
Q

What medication is contraindicated in the first trimester of pregnancy for a UTI?

A

Trimethoprim

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12
Q

What is the first line treatment for a UTI and can be given to pregnant women?

A

Nitrofurantoin

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13
Q

What other investigation should you send if a patient presents with a UTI and why?

A

Mid-stream urine for MC&S to detect bacteria to know which antibiotics

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14
Q

What should you check in a patients blood when prescribing nitrofurantoin and in what 2 cases should you avoid it?

A

Renal function - eGFR

Avoid:
Last term of pregnancy
eGFR <45

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15
Q

What investigations would you do to investigate hyperkalaemia? (3 marks)

A

ABG/VBG - look for raised potassium and metabolic acidosis

Serial U&Es

12 Lead ECG - Tall tented t waves and flat p waves

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16
Q

Why would you give a patient with hyperkalemia calcium gluconate

A

Protect the cardiac membrane has high potassium can lead to arrhythmias

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17
Q

Why would you give a patient with hyperkalamia insulin-glucose IV infusion?

A

Insulin acts as a potassium binder and shifts potassium into cells to lower serum levels

18
Q

Why would you give a hyperkalaemic patient salbutamol nebs?

A

Shifts potassium into cells

19
Q

What medications should be stopped in AKI?

D.A.M.N

A

D - Diuretics
A - ACEi, ARB,
M - Metformin
N - NSAIDS

20
Q

Why is metformin stopped in AKI?

A

It is normally excreted from the kidneys - can cause build-up

21
Q

What 4 things should you consider in a patient with an AKI?

A

Hyperkalaemia

Optimise fluid balance

Stop nephrotoxic drugs

Consider for dialysis

22
Q

What is Epididymitis and what is the most common cause?

A

Pain, swelling and inflammation of the epididymis and posterior scrotum

STI <35

23
Q

What causes epididymitis in men over 35? (2 marks)

A

BPH

E.coli

24
Q

What is prostatitis?

A

Infection/inflammation of the prostate gland

25
Q

Name 3 causes of prostatitis

A

UTI
Phimosis (unable to retract foreskin)
Urethral stricture

26
Q

How does prostatitis present? (4 marks)

A

Dysuria, urgency and hesitancy
Pain at base of penis
Tender, boggy prostate
Systemic features

27
Q

How would you investigate for prostatitis? (4 marks)

A

Bloods - inflammatory markers

Urine

  • Urinalysis to check for infection
  • Urine culture to assess cause

STI screen

28
Q

When would you refer a man to hospital for prostatitis in regards to their PMHx?

A

Immunocompromised

DM

29
Q

What is the first line medical management for prostatitis?

A

Ciprofloxacin 500mg BD for 14 days

30
Q

How does testicular torsion present? ( 4 marks)

A

Presents <6 hours from symptom onset

History of trauma

Previous attacks of pain

Vomiting

31
Q

What is the management of suspected testicular torsion?

A

Urgent surgery

32
Q

Does testicular torsion cause pain to the whole scrotum?

A

Yes

33
Q

How does epididymitis-orchitis present? (3 marks)

A

Dull pain
Pain and swelling of posterior scrotum
Patient sexually active

34
Q

Is the pain and tenderness relieved by elevating the scrotum in testicular torsion or epididymo-orchitis? (positive phren’s sign)

A

Epididymo-orchitis

35
Q

Name 3 instances where you would also send off a urine culture in a patient presenting with a LUTI?

A

Pregnant
Recurrent UTI
Haematuria

36
Q

What is rhabdomyolysis?

A

Results from skeletal muscle breakdown releasing urate, potassium and creatine kinase into the blood

37
Q

What scenarios would rhabdomyolysis present? (3 marks)

A

Long duration on the floor (elderly, fall)

Trauma to site for long duration

Long distance running

38
Q

Name two important complications of rhabdomyolysis

A

Hyperkalaemia

AKI

39
Q

Name 3 investigations you should do in a patient presenting with rhabdomyolysis

A

ECG
Potassium levels
Urinalysis

40
Q

What condition is Nitrofurantoin contra-indicated in and why?

A

Glucose-6-phosphate deficiency (G6PD) as it can cause haemolytic anaemia

41
Q

What is Balanitis?

A

Inflammation of the glans penis

42
Q

Name 4 signs and symptoms of balanitis

A

Penile ulcerations
Dysuria
Non-retractable foreskin
Lymphadenopathy

Discharge?

ICM/FCM (16 decks)

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