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Finals - Systems Paper > Renal/Urology > Flashcards

Renal/Urology Flashcards

1
Q

Prerenal AKI causes

A

Hypovlaemia

Renal artery stenosis

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2
Q

Renal AKI causes

A 
Glomerulonephritis
Acute tubular necorosis
Acute interstitial nephritis
Rhabdomylosis
Tumour lysis syndrome
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3
Q

Post renal AKI causes

A

Kidney stones

BPH

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4
Q

Diagnosis AKI

A

Renal US if no identifiable cause

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5
Q

AKI treatment

A

Assess drugs
Loop diuretics for oedema
Treat hyperkalaemia

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6
Q

Renal replacement therapy indications

A

Hyperkalaemia
Pulmonary oedema
Uraemia

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7
Q

Drugs to stop in AKI

A 
NSAID except aspirin
ACEI
ARB
Diuretic
Aminoglycoside
Metformin
Digoxin
Lithium
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8
Q

AKI diagnostic criteria

A

Increase creatinine 26 in 48h
or increase >50% in 7d
or oligurea

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9
Q

Staging criteria AKI

A

1) Creatinine 1.5-1.9x or oliguria >6h
2) Creatinine 2-2.9x or oliguria >12h
3) Creatinine 3x or oliguria >24h

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10
Q

CKD classification

A

1) GFR > 90 and abnormal U and E/proteinuria
2) 60-90
3) 30-59
4) 15-29
5) <15

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11
Q

Treatment anaemia in CKD

A

Optimise iron then erythropoitin stimulating agents

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12
Q

Kind of anaemia in CKD

A

Normochromatic normocytic anaemia

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13
Q

Bone profile in CKD

A

Decreased calcium
Increased PTH
Increased phosphate
Decreased vit D

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14
Q

Treatment bone disease in CKD

A

1) Decrease dietary phosphate
2) Phosphate binders and vit D
3) Parathyroidectomy

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15
Q

Treatment CKD hypertension

A

1) ACEI - rise in creatinine 25% acceptable

2) Furesemide

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16
Q

Treatment proteinuria CKD

A

1) ACEI if ACR>30

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17
Q

Identify nephrotic syndrome

A

Triad:

  • proteinuria
  • hypoalbuminaemia
  • oedema
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18
Q

Diseases causing nephrotic syndrome

A

Minimal change disease
Membranous glomerulonephritis
Focal segmental glomerulonephritis

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19
Q

Diseases cause nephritic syndrome

A

Rapidly progressive glomerulonephritis
IgA nephropathy
Alport syndrome

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20
Q

Diseases causing mix of nephrotic and nephritic syndrome

A

Diffuse proliferative glomerulonephritis
Membranoproliferative glomerulonephritis
Post-strep glomerulonephritis

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21
Q

Most common nephrotic syndrome

A

Children - minimal change

Adults - focal segmental glomerulosclerosis

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22
Q

Identify hyperacute rejection

A

Minutes to hours

Needs removed

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23
Q

Identify acute failure

A

<6m
Asymptomatic worsening renal function
Maybe reversible with steroids

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24
Q

Identify chronic graft failure

A

> 6m

Recurrence original disease

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25
Q

Identify acute interstitial nephritis

A

Caused by drugs - antibiotics, NSAID
Allergic type picture
Sterile pyuria and white cell casts on urinalysis

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26
Q

Identify ADPKD

A 
Hypertension
Stones
CKD
Liver cyst
Berry aneurysm
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27
Q

Diagnosis ADPKD

A

Abdominal US

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28
Q

Treatment ADPKD

A

Tolvaptin

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29
Q

Identify alport syndrome

A

X linked, childhood presentation
Renal failure
Microscopic haematuria
Bilateral sensorineural deafness

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30
Q

Identify anti-glomerular basement membrane disease (goodpasture)

A

Pulmonary haemorrhage

Rapidly progressive glomerulonephritis - proteinuria and haematuria

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31
Q

Diagnosis goodpasture

A

Renal biopsy

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32
Q

Treatment goodpasture

A

Steroids

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33
Q

Identify focal segmental glomerlunephritis

A

Linked HIV

Young males

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34
Q

Identify haemolytic uraemic syndrome

A

Young children classic triad:

  • AKI
  • haemolytic anaemia
  • thrombocytopenia
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35
Q

Treatment haemolytic uraemic syndrome

A

Suportive, no role antibiotics

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36
Q

Identify henoch schlein purpula

A 
Children
Rash on buttocks and extensors
Arthritis
Abdominal pain
Maybe IgA nephropathy
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37
Q

Treatment henoch schlein purpula

A

Supportive

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38
Q

Identify IgA nephropathy

A

Within days of infection

Blood in urine

39
Q

Identify post-strep glomurulonephritis

A

1 to 2 weeks after infection

Blood in urine

40
Q

Identify membranous glomerulonephritis

A

Most common
Associated malignancy
Nephrotic syndrome
Biopsy - thickened basement membrane and dense deposites

41
Q

Treatment membranous glomerulonephritis

A

ACEI

Immunosuppresion

42
Q

Identify minimal change disease

A

Nephrotic syndrome in children

43
Q

Treatment minimal change disease

A

1) Steroids

2) Cychlophosphamide

44
Q

Identify rapidly progressive glomerulonephritis

A

Associated goodpasture and wegeners
Nephritic syndrome
Biopsy - epithelial cresents

45
Q

Identify rhabdomyolysis

A

Often eldery fall

Huge rise CK

46
Q

Treatment rhabdomyolysis

A

IV fluids maintain urinary output

47
Q

Identify pre-renal uraemia instead of acute tubular necrosis

A

Prerenal - urine Na <20, urine osmolaty > 500 and response to fluid challenge is good, Urea to creatine serum is raised

Acute tubular necrosis - urine Na >40, urine osmolarity <350, response to fluid challenge poor

48
Q

Anion gap calculate

A

(Na + k) - (bicarbonate + Cl)

49
Q

Normal anion gap

50
Q

Daily fluid needs

A

25-30ml/kg/day water
1mmol/kg/day K, Na, Cl
50-100g/day glucose

51
Q

Identify renal artery stenosis

A

Hypertension
CKD
Flash pulmonary oedema
Increased renin

52
Q

Calculate paeds fluid needs

A

100ml/24h first 10kg
50ml/24h next 10kg
20ml/24h/kg after

53
Q

“Brown granular casts”

A

Acute tubular necrosis

54
Q

“Red cell casts”

A

Nephritic syndrome

55
Q

“Hyaline casts”

A

Normal, after exercise, fever

56
Q

Acute urinary retention diagnosis

57
Q

Prostate cancer histology

A

Adenocarcinoma

58
Q

Prostate cancer diagnosis

A

Multiparametric MRI

59
Q

Grading system for prostate cancer

60
Q

Treatment prostate cancer

A

Radical prosectomy and radiotherapy

Androgen receptor blockers and GnRH agonists

61
Q

Complications prosectomy

A

Erectile dysfunction

Urinary incontinence

62
Q

Most common renal stone

A

Calcium oxalate

63
Q

Radio lucent renal stone

64
Q

“ground glass” appearance renal stone

65
Q

Stag horn renal stone

66
Q

Renal stones diagnosis

67
Q

Pain treatment in renal stones

A

IM diclofenac

68
Q

Treatment renal stones

A

<5mm - expectant
<2cm - shockwave lithotripsy
<2cm and pregnant - ureteroscopy
complex and staghorn - percutaneous nephrolithiostomy

69
Q

“Whirlpool sign”

A

Testicular torsion

70
Q

Diagnosis testicular torsion

71
Q

Treatment BPH

A

1) Watchful waiting
2) Alpha1-antagonist - eg tamsulosin
3) 5a-reductase inhibitors - eg finasteride
4) Surgery

72
Q

Mechanism tamsulosin

A

Decreases smooth muscle tone

73
Q

Mechanism finasteride

A

Blocks conversion testosterone to dihydrotestosterone

74
Q

Bladder cancer histology

A

Transitional cell carcinoma most common

Squamous cell carcinoma in schistosomiasis

75
Q

Identify bladder cancer

A

Painless macroscopic haematuria

76
Q

Diagnosis bladder cancer

A

Cystoscopy to visualise

MRI and CT to stage

77
Q

Treatment bladder cancer

A

Low stage - TURP
T2 - surgery
High grade - chemo and radiotherapy

78
Q

Renal carcinoma histology

A

Adenocarcinoma

79
Q

Pareaneoplastic features of renal cancer

A

Polycythaemia
Hypercalcaemia
Hypertension
Stauffers syndrome (abnormal LFTs without mets)

80
Q

Diagnose renal cancer

81
Q

Treatment renal cancer

A

T1 - partial nephrectomy
T2 - radical nephrectomy

Chemo and radiotherapy sometimes

82
Q

Treatment bacterial prostatitis

A

Quinolone - ciprofloxacin

83
Q

Most common cause prostatitis

84
Q

Identify chronic urinary retention

A

High pressure - impaired renal function and bilateral hydronephrosis

Low pressure - normal renal function and no hydronephrosis

85
Q

Treatment epidymo-orchitis

A

Ceftriaxone IM followed by deoxycycline oral 14d

86
Q

Diagnose erectile dysfunction

A

Testosterone 9-11am

87
Q

Treatment erectile dysfunction

A

Sildenofil (viagra)

88
Q

Treatment hydrocele

A

Refer for US to exclude tumour

89
Q

Investigating hydronephrosis

A

US first

CT if suspect cancer

90
Q

Treatment hydronephrosis

A

Acute - nephrostomy

Chronic - stent

91
Q

Investigating genitourinary trauma

A

Urogram/cystogram

92
Q

Testicular cancer most common

A

Germ cell tumours:

  • seminomas
  • non seminomas - yolk sac, teratoma, chariocarcinoma
93
Q

What kind of testicualar cancer causes gynaemocastia

A

Germ cell - secretion hCG and AFP

94
Q

AFP tumour marker for

A

Non seminomas testicular cancer

Finals - Systems Paper (20 decks)

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