The Approach to the Patient with Kidney Disease Flashcards
Give examples of symptoms which may suggest an Upper Urinary Tract pathology (affecting kidneys)
Severe colicky pain which may radiate to groin or testicle, or haematuria
Lower urinary tract symptoms (affecting bladder and urethra) can be divided into two different pathologies - what are they?
- Obstructive voiding
- Storage related
Give six examples of Obstructive Voiding Lower urinary tract symptoms (affecting bladder and urethra)?
- Hesitancy
- Delay in initiating urination
- Weak urinary stream
- Straining to void
- Incomplete emptying
- Terminal dribbling
Give six examples of Storage related Lower urinary tract symptoms (affecting bladder and urethra)?
- Polyuria
- Nocturia
- Urgency
- Incontinence
- Bladder pain
- Dysuria
What are the three symptoms which describe urine volume abnormalities?
Polyuria (high), oligouria (low), anuria (absent)
Give three differentials for polyuria
Early chronic kidney disease
Osmotic diuretic use
Post renal obstruction
Give one cause for oligouria
Acute kidney injury
Give two differentials for anuria
Severe acute kidney injury
Post renal obstruction
Why might urine appear dark yellow?
Urine may be concentrated or have presence of bile pigments
Why may urine appear pink?
Haematuria or beeturia
Why may urine appear red?
Haematuria
Why may urine appear browny red?
Muscle breakdown; rhabdomyolysis
Why may urine appear cloudy?
Excess white cells due to infection
Why may urine appear frothy?
Proteinuria
Why may urine show presence of debris?
Infection
Vesico-colic fistula
Renal papillary necrosis
Why may urine show presence of air?
Vesico-colic fistula
In Urine testing via a Multistix, what enzyme is detected for presence of Leukocytes?
Leukocyte esterase
In Urine testing via a Multistix, what is detected for presence of bacteria?
Nitrites
In Urine testing via a Multistix, what is detected for suggestion of Haemolysis?
Urobillinogen
In Urine testing via a Multistix, detection of protein suggests?
Glomerular injury
In Urine testing via a Multistix, detection of a high pH suggests what two differentials?
Bacterial infection
Renal tubular acidosis
In Urine testing via a Multistix, detection of blood suggests what two differentials?
Uroepithelial damage
Glomerular damage
In Urine testing via a Multistix, detection of ketones suggests?
Ketoacidosis
In Urine testing via a Multistix, detection of bilirubin suggests?
Obstructive jaundice
