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Finals > Renal & Urology > Flashcards

Renal & Urology Flashcards

1
Q

How is CKD classified?

A 
Stage 1: >90 eGFR
Stage 2: 60-89
Stage 3a (moderately impaired): 45-59
-Stage 3b (moderately impaired): 30-44
-Stage 4 (severely impaired): 15-29
-Stage 5 (advanced/on dialysis): <15
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2
Q

How is kidney disease investigated?

A
  • FBC, U&Es, LFTs, CK and coag
  • eGFR
  • Urinalysis (blood or protein)
  • Urine PCR/ACR
  • Histology
  • Imaging (USS
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3
Q

Name some of the causes of CKD

A
  • Diabetes
  • Glomerulonephritis
  • Hypertension
  • Renovascular disease
  • Polycystic kidney disease
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4
Q

How can CKD present?

A
  • Anaemia
  • Hypertension
  • SOB (fluid overload, cardiomyopathies etc.)
  • Cognitive impairment
  • Anorexia
  • Nausea and vomiting
  • Oliguria
  • Nocturia
  • Haematuria/proteinuria
  • Peripheral oedema
  • Itches and cramps
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5
Q

How can CKD be managed?

A
  • Treatment of underlying disease
  • Slowing the rate of renal decline
  • Prevention and treatment of complications
  • Preparation for renal replacement therapy
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6
Q

Name some of the complications of CKD

A
  • Acidosis
  • Anaemia
  • Bone disease
  • CV risk
  • Electrolytes
  • Fluid overload
  • Gout
  • Hypertension
  • Iatrogenic issues
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7
Q

Name the risk factors for prostate cancer

A
  • Age
  • Race/ethnicity (Afro-Caribbean
  • Family history
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8
Q

How does prostate cancer present?

A
  • Mostly asymptomatic (diagnosed through opportunistic PSA testing)
  • Urinary symptoms: weak stream, hesitancy, incomplete emptying, frequency, urgency, urge incontinence, UTI, haematuria
  • Perineal/suprapubic/loin pain
  • Renal failure
  • Haemospermia
  • Tenesmus
  • Impotence
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9
Q

How is prostate cancer diagnosed?

A
  • PSA
  • PR exam
  • TRUS guided prostate biopsies
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10
Q

How can localised prostate cancer be managed?

A
  • Watchful waiting
  • Radiotherapy
  • Radical prostatectomy
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11
Q

How can locally advance prostate cancer be managed?

A

Hormone therapy +/- surgery or radiotherapy

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12
Q

Name the types of hormonal therapy for prostate cancer

A
  • Surgical castration
  • Chemical castration
  • Anti-androgens
  • Oestrogens
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13
Q

How does testicular present?

A
  • Painless lump
  • Tender inflammed swelling
  • History of trauma
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14
Q

Name the tumour markers used for testicular cancer

A
  • AFP (teratoma)
  • HCG (seminoma)
  • LDH (tumour burden)
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15
Q

How can testicular cancer be diagnosed?

A
  • MSSU
  • USS
  • CXR
  • Tumour markers
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16
Q

How can testicular cancer be managed?

A

-Radical orchidectomy

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17
Q

What is the most common type of testicular cancer?

A

Germ cell tumour

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18
Q

Name the antibiotics of choice for lower UTIs in women

A
  • Trimethroprim 3 days

- Nitrofurantoin

19
Q

Name the antibiotics of choice for lower UTIs in men

A
  • 7 days of trimethroprim or nitrifurantoin

- 14 days of a quinolone (e.g. ciprofloxacin) if possible prostatitis

20
Q

Which antibiotics can be used for UTIs in pregnancy?

A
  • Nitrofurantoin (not at term)

- Cephalexin

21
Q

Describe the stages of AKI

A

Stage 1: 1.5-2x baseline creatinine

  • Stage 2: 2-3x baseline creatinine
  • Stage 3: 3x baseline
22
Q

How should AKIs be managed?

A
  • S: suspect sepsis
  • H: hypovolaemia
  • O: obstruction (bladder scan)
  • U: urinalysis
  • T: toxins (med review and avoid nephrotoxics)
23
Q

How can hyperkalaemia be managed?

A
  • Calcium gluconate
  • Salbutamol or insulin-dextrose
  • Dialysis or diuresis
24
Q

Describe the presentation of a nephritic state

A
  • Urine sediment
  • Haematuria
  • Dysmorphic RBCs
  • Cellular casts
  • Hypertension
  • Renal impairment
25
Q

How does nephrotic syndrome present?

A
  • Oedema
  • Proteinuria
  • Hypoalbuminaemia
  • Hyperlipidaemia
26
Q

Name the nephrotic type glomerulonephritis

A
  • Minimal change disease

- Membranous nephropathy

27
Q

Name the nephritic type glomerulonephritis

A
  • Diffuse proliferative
  • Post-infective
  • Crescentic GN
28
Q

How can post-infective GN be managed?

A
  • Loop diuretis

- Vasodilators (amlodipine)

29
Q

How can crescentic GN be managed?

A
  • Steroids
  • Plasma exchange
  • Cytotoxics
  • B cell therapy
  • Complement inhibitors
30
Q

How can nephrotic syndrome be managed?

A
  • Salt and fluid restriction
  • Loop diuretics
  • ACEIs
  • Heparin or warfarin
  • Statins
31
Q

How can minimal change disease be managed?

A
  • Prednisolone

- Relapses: cyclosporin, tacrolimus etc.

32
Q

How can acute urinary retention be managed?

A
  • Catheterisation

- Alpha blocker e.g. alfuzosin

33
Q

How do urinary tract stones present?

A
  • Renal pain
  • Ureteric colic (radiates to the groin)
  • Dysuria
  • Haematuria
  • Testicular or vulval pain
  • UTI
  • Loin tenderness
  • Pyrexia
34
Q

How can urinary tract stones be managed?

A
  • NSAIDs
  • Paracetamol or opiods
  • Alpha blockers
35
Q

How can benign prostatic obstruction be managed?

A
  • Watchful waiting
  • Alpha blockers
  • 5 alpha reductase inhibitors
  • TURP or other resective surgery
36
Q

What is the most common type of bladder cancer?

A

Transitional cell carcinoma

37
Q

How does bladder cancer present?

A
  • Painless visible haematuria
  • Recurrent UTI
  • Dysuria, frequency, nocturia, urgency and urge incontinence
  • Bladder pain
38
Q

How can bladder cancer be investigated?

A
  • Urine culture
  • Cystourethroscopy
  • CT urogram or USS
  • Cytology
  • BP and U&Es
39
Q

How can bladder cancers be managed?

A
  • Endoscopic or radical resection
  • Chemotherapy
  • BCG therapy
  • Radiotherapy
40
Q

How do upper tract urothelial cancers present?

A
  • Frank haematuria
  • Unilateral ureteric obstruction
  • Flank or loin pain
41
Q

How can upper tract urothelial cancers be managed?

A
  • Nephro-ureterectomy
  • Endoscopic treatment
  • Surveillance cystoscopy
42
Q

How do renal adenocarcinoma present?

A
  • Asymptomatic
  • Flank pain, mass and haematuria
  • Paraneoplastic syndrome (anorexia cachexia, pyrexia, hypertension, hypercalcaemia, abnormal LFTs, anaemia, polycythaemia and raised ESR
  • Metastatic disease
43
Q

How can renal adenocarcinoma be managed?

A
  • Radical nephrectomy
  • RCC is radioresistant and chemoresistant
  • Tyrosine kinase inhibitors
  • Immunotherapy

Finals (18 decks)

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