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Urinary > Session 10 > Flashcards

Session 10 Flashcards

1
Q

What can increase the chance of getting Acute kidney injury?

A

Diabetes Mellitus

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2
Q

What is pre-renal failure?

A

Issues with renal perfusion or pump failure eg MI

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3
Q

What are some of the risk factors for Acute Kidney Injury?

A

Diabetes Mellitus
Infection
Drugs (NSAIDS cause vasocontriction of the afferent arteriole)
Chronic kidney disease

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4
Q

What are some of the markers for Acute Kidney Injury?

A

Increased K+
Increased Urea
Increased Creatinine

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5
Q

What is Lupus nephritis?

A

Inflammation of the kidney, especially vasculitis

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6
Q

What do Monomorphic red cells indicate?

A

Damage to the collecting duct or ureters

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7
Q

What do Red cell casts indicate?

A

Damage to the Glomerulus

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8
Q

What do Muddy brown granular casts indicate?

A

Acute nephron necrosis

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9
Q

What are some of the causes of pre renal Acute Kidney Injury?

A

Volume depletion

Effective volume depletion eg Sepsis

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10
Q

What are some of the causes of post renal Acute Kidney Injury?

A

Prostatic
Tumours
Kidney stones

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11
Q

What are some of the Intrinsic renal causes of Acute Kidney Injury?

A

Established acute tubular necrosis due to endogenous toxins
Vascular issues with the small vessels in the Glomerulus
Intrinsic renal interstitial nephritis

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12
Q

How can Acidosis lead to Hyperkalaemia?

A

H+ will enter the cell due to the high concentration and exchanges for a K+. Therefore the ECF concentration of K+ increases

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13
Q

How do you manage a patient with Acute Kidney Injury?

A

Fluid replacement, but remember the composition of the fluid and replace electrolytes too
Correct the metaboliic acidosis
Volume overload
Dialysis as a last resort if symptomatic of uraemia (Effecting CNS/CVS) or the hyperkalaemia is not responding to treatment.

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14
Q

What property do red blood cells have that have passed through the Glomerulus?

A

Dysmorphic red blood cells (Mishaped)

If RBCs are in tact it suggests they are passing into the urine via another route eg malignancy

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15
Q

What are some of the causes of Microscopic haematuria?

A 
Polycystic kidney disease
Renal stones
Renal tumours (Can be carcinoma or transitional)
Glomerular disease
Arteriovenous malformations
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16
Q

What are some of the causes of Microalbuminaemia? (Low levels)

A

Endothelial injury
Glomerular disease
Vascular complications

17
Q

What can you use as a stable marker to compare protein to?

A

Creatinine

18
Q

What are some of the causes of Macroalbuminaemia? (High levels)

A 
Painless = renal cell carcinoma
Myoglobinuria (Haem from muscles due to Rhabdomyolysis due to compartment syndrome)
Haemaglobinuria (Haemaglobin spills into blood due to malaria, very rare)
Glomerular disease (IgA nephropathy. Usually stops when infection is gone)
Consumption of food dyes
19
Q

What are the triad of findings in patients with Nephrotic syndrome?

A

Proteinuria
Hypoalbuminaemia
Oedema (Can be mistaken as cirrhosis or heart failure, but there would not be albumin in the urine for these)

20
Q

What is Nephrotic syndrome?

A

Damage/Loss of the podocytes so the Glomerulus is leaky to proteins

21
Q

What is Anasarca?

A

Oedema spread throughout the whole body

22
Q

How do fat bodies occur in the urine?

A

Casts that are due to hypercholesterolaemia.

Due to Nephrotic syndrome

23
Q

How can Nephrotic syndrome cause an increased risk of DVTs?

A

You lose blood clotting factors that normally prevent excessive coagulation so there is an increased risk

24
Q

What patients are very high risk for bleeding during renal a biopsy?

A

Renal biopsies have a high risk of bleeding, especially worse in patients who are on Aspirin (must stop for 10 days before biopsy) or warfarin

25
Q

What are the some of the main causes of Nephrotic syndrome?

A 
FSGS (Focal segmental glomerulosclerosis - scars in glomerulus)
Minimal change disease
Membranous nephropathy
Infections
Malignancy
26
Q

What are some of the main causes of Nephritic syndrome?

A

Glomerulonephritis
Vasculitis
Lupus

27
Q

What rash doesn’t blanch?

A

A vasculitic rash

28
Q

What can chronic glomerulonephritis cause?

A

The kidneys to shrink. Because it is low grade, it is usually impossible to palpate them

29
Q

What biochemical markers are there for chronic glomerulonephritis?

A

High creatinine
Blood in urine
Protein in urine

30
Q

How do you treat chronic glomerulonephritis?

A

Control blood pressure as this means a slower decline for the kidney
Control the HBA1C in Diabetics
Give ACEi to decrease the proteinuria

31
Q

What are some of the secondary effects of Kidney disease?

A

Hypocalcaemia as the kidneys activate vitamin D

Hyperkalaemia due to acidosis

Urinary (14 decks)

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