Renal/urology Flashcards
Amyloidosis - diagnosis?
Congo red staining of biopsy–> bright green fluorescence
Other manifestations of AD polycystic kidney disease?
Cysts - liver/spleen/pancreas
Berry aneurysms
MV prolpase
Risk of RCC
most common type of kidney stone
calcium oxalate
management of a neonate with a hydrocele?
watch and wait for 1 year - most resolve
what is prehn’s sign?
elevation of the testis - improves the pain in epidiymitis. no relief of pain in torsion
causative organisms of epididymoorchitis in >35yo
E coli
Pseudomonas
Wegeners vs Churg Strauss vs Goodpastures
- what are their more widely used names?
- Wegeners = GPA (granulomatosis with polyangiitis)
- Churg Strauss = EGPA (eosinophilic granulomatosis with polyangiitis)
- Goodpastures = anti-GBM
Wegeners (GPA) vs Churg STrauss (EGPA) vs Goodpastures (anti GBM)
- how do their presentations differ?
All cause nephritic syndrome - low level proteinuria + haematuria + oliguria + hypertension
- Wegeners = TRIAD of URTI + LRTI + glomerulonephritis
- Churg strauss = Eosinophilia + asthma + cardiac involvement
- Anti GBM = pulmonary haemorrhage BUT no URTI sx
Etiology of post streptococcal glomerulonephritis
Immune complexes containing streptococcal antigen –> damages GBM –> glomerulonephritis 2/52 later
What is interstitial cystitis aka?
How does it present?
AKA bladder pain syndrome, is within the umbrella of chronic pelvic pain
- ongoing for years - often have tx for UTI with negative urine cultures
- urinary incontinence and lower pelvic pain that often varies with bladder filling
Importance of varicoceles?
Cause of male infertility
What findings may be on clinical exam in urethral injury?
- blood at tip of urethral meatus
- perineal bruising
- abnormal high riding/unable to palpate prostate on PR exam
RCC on which side can cause a varicocele? why?
Left sided RCC can cause a varicocele. The Left testicular vein drains into the left renal vein first.
Phaechromocytoma - where does it arise from? 2 examples of hereditary cuases?
catecholamine producing chromaffin cells
- von Hippel Landau
- MEN 2
Most common type of testicular tumour? -2 subtypes of this?
Germ cell tumour (90%!)
- seminomas
- non seminomas ie teratoma
Which bloods may be raised in testiular tumour?
bhcg
Alpha fetoprotein
Lab diagnosis of CKD?
eGFR<60 on 2 separate occasions >90 days apart
INdication for SGLT2 inhibitor for CKD?
If coexisting T2DM and ongoing proteinuria despite ACEi/ARB
Contraindications for sildenafil?
Recent MI/CVA
Taking nitrates already
Unstable angina
Hypotension
Triad of HUS
- low platelets
- renal failure
- haemolytic anaemia
AKI
- with high urinary sodium
- with low urinary sodium
–> what are the causes in each?
high urinary sodium - ie kidney unable to retain sodium
- acute tubular necrosis –> ischemic or direct toxin
low urinary sodium - prerenal causes
at what age would you refer undescended testis? unilateral and bilateral
3 months old, with a view to be seen by surgeons at <6months old
Phimosis
- what is it?
- causes?
unable to retract i.e. pull the foreskin away from the tip
causes - congenital OR from scarring
secondary to balanitis or traumatic retraction of the foreskin
1st choice abx for pyelonephritis
Cefalexin
contraindications to nitrofurantoin
late pregnancy
renal impairment
G6PD
acute porphyria
contraindications to trimethoprim
Pregnancy
Folate deficiency
hallmark feature of genitourinary TB
sterile pyuria
glomerulonephritis
hearing loss
visual problems
-diagnosis?
Alport syndrome
defect of type IV collagen
causes of nephrogenic diabetes insipidus
lithium
CKD
low K
In which pt groups would you treat a UTI with 7 days of abx?
Men
Pregnancy
Renal tract anatomical abnormality
Renal failure
Catheterised
smooth lump separate to testes containing milky fluid
spermatocoele
brown urine from abx - which ones? name 2
nitrofurantoin
metronidazole
man sustains pelvic fracture
ct shows mild extraperitoneal bladder leak
management?
urethral catheterisation - usually heals in 7-10 days
causes of pneumaturia - name 3
- diverticulitis
- malignancy
- crohns
