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Medicine, Year 2, Block 10 (Kidney Function & Failure) > The Approach to the Patient with Kidney Disease > Flashcards

The Approach to the Patient with Kidney Disease Flashcards

1
Q

Give examples of symptoms which may suggest an Upper Urinary Tract pathology (affecting kidneys)

A

Severe colicky pain which may radiate to groin or testicle, or haematuria

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2
Q

Lower urinary tract symptoms (affecting bladder and urethra) can be divided into two different pathologies - what are they?

A
  • Obstructive voiding

- Storage related

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3
Q

Give six examples of Obstructive Voiding Lower urinary tract symptoms (affecting bladder and urethra)?

A
  1. Hesitancy
  2. Delay in initiating urination
  3. Weak urinary stream
  4. Straining to void
  5. Incomplete emptying
  6. Terminal dribbling
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4
Q

Give six examples of Storage related Lower urinary tract symptoms (affecting bladder and urethra)?

A
  1. Polyuria
  2. Nocturia
  3. Urgency
  4. Incontinence
  5. Bladder pain
  6. Dysuria
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5
Q

What are the three symptoms which describe urine volume abnormalities?

A

Polyuria (high), oligouria (low), anuria (absent)

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6
Q

Give three differentials for polyuria

A

Early chronic kidney disease
Osmotic diuretic use
Post renal obstruction

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7
Q

Give one cause for oligouria

A

Acute kidney injury

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8
Q

Give two differentials for anuria

A

Severe acute kidney injury

Post renal obstruction

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9
Q

Why might urine appear dark yellow?

A

Urine may be concentrated or have presence of bile pigments

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10
Q

Why may urine appear pink?

A

Haematuria or beeturia

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11
Q

Why may urine appear red?

A

Haematuria

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12
Q

Why may urine appear browny red?

A

Muscle breakdown; rhabdomyolysis

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13
Q

Why may urine appear cloudy?

A

Excess white cells due to infection

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14
Q

Why may urine appear frothy?

A

Proteinuria

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15
Q

Why may urine show presence of debris?

A

Infection
Vesico-colic fistula
Renal papillary necrosis

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16
Q

Why may urine show presence of air?

A

Vesico-colic fistula

17
Q

In Urine testing via a Multistix, what enzyme is detected for presence of Leukocytes?

A

Leukocyte esterase

18
Q

In Urine testing via a Multistix, what is detected for presence of bacteria?

A

Nitrites

19
Q

In Urine testing via a Multistix, what is detected for suggestion of Haemolysis?

A

Urobillinogen

20
Q

In Urine testing via a Multistix, detection of protein suggests?

A

Glomerular injury

21
Q

In Urine testing via a Multistix, detection of a high pH suggests what two differentials?

A

Bacterial infection

Renal tubular acidosis

22
Q

In Urine testing via a Multistix, detection of blood suggests what two differentials?

A

Uroepithelial damage

Glomerular damage

23
Q

In Urine testing via a Multistix, detection of ketones suggests?

A

Ketoacidosis

24
Q

In Urine testing via a Multistix, detection of bilirubin suggests?

A

Obstructive jaundice

25
Q

In Urine testing via a Multistix, detection of glucose suggests?

A

Diabetes mellitus

26
Q

In a biochemical profile of urine, creatinine levels can be used as an estimate for?

A

Glomerular filtration rate (GFR)

27
Q

What imaging technique is most appropriate for kidneys? Why?

A

Ultrasound: cheap, non-invasive, no radiation, no risk, can be used to assess renal size and anatomical features

28
Q

Sodium / water retention can lead to what symptoms?

A

Periperal oedema - swellings on feet

Pulmonary oedema - breathlessness

29
Q

What is more common, primary or secondary hypertension?

A

Primary

30
Q

How might secondary hypertension occur by renal artery stenosis?

A

Renal artery stenosis means BP in kidneys will be low due to reduced perfusion, causing an increase in renin release which causes renin mediated hypertension an a systemic rise in BP

31
Q

How might glomerular damage manifest in urine?

A

Proteinuria

Visible / non-visible haematuria

32
Q

Describe why PCKD has a bimodal age distribution

A

Two genes are involved: APKD1, which presents symptoms in pts aged 30-40 and APKD2, which presents symptoms in pts aged 70

33
Q

What is inheritance pattern for PCKD?

A

Autosomal dominant

34
Q

What are the disadvantages of dialysis use?

A
  1. Patients have complex medical problems
  2. Frequent hospital admissions
  3. Depression / psychological issues
  4. Heavy burden on time
  5. Fluid / diet restriction
  6. Employment difficulties
  7. Impact of home treatments on home
  8. Cost to health provider

Medicine, Year 2, Block 10 (Kidney Function & Failure) (11 decks)

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