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1st/2nd Year Revision > Urinary Conditions > Flashcards

Urinary Conditions Flashcards

1
Q

Acute kidney injury (AKI) - crucial features

A

Increased creatinine
Decreased urine output
Duration - hours/days

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2
Q

What are the risk factors for AKI?

A

Any acute illness
Infection
Diabetes

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3
Q

What are the causes of AKI?

A

Pre-renal (most common, due to inadequate blood supply) - dehydration, hypotension, heart failure
Renal (intrinsic disease) - glomerulonephritis, interstitial nephritis, acute tubular acidosis
Post-renal (obstruction to the outflow of urine) - kidney stones, ureter/urethral strictures, enlarged prostate

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4
Q

What investigations would be done if AKI was suspected?

A

Bloods - FBC, U&Es, creatinine, CRP, LFTs
Urinalysis
Ultrasound

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5
Q

How is AKI managed?

A

Rehydration
Stop nephrotoxic medications
Relieve obstruction

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6
Q

What are the complications of AKI?

A 
AEIOU:
Acidosis (metabolic)
Electrolyte imbalance - hyperkalaemia
Intoxications
Fluid overload
Uraemic complications
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7
Q

Chronic kidney disease

A

3 months

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8
Q

What are the causes of CKD?

A 
Diabetes
Hypertension
Age-related decline
Glomerulonephritis
Polycystic kidney disease
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9
Q

What are the symptoms of CKD?

A 
Asymptomatic
Pruritus
Loss of appetite
Nausea
Oedema
Pallor
Hypertension
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10
Q

What are the stages of CKD?

A

1-5 (3 has a and b)
Stage 1 - GFR normal (90)
Stage 5 - GFR <15
Increases by 15 each time

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11
Q

How is CKD managed?

A

Aim to slow disease progression
Optimise control of condition
ACE inhibitor
Renal replacement therapy (if CKD stage 5) - dialysis (haemodialysis, peritoneal), transplantation

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12
Q

What are the complications of CKD?

A

Anaemia
Bone disease
CVS disease
Peripheral neuropathy

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13
Q

What is the pathology of polycystic kidney disease?

A

Fluid filled cysts in the kidney

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14
Q

What is the cause of polycystic kidney disease?

A

Autosomal dominant
Presents in early adult life
PKD-1 on chromosome 16
(is a recessive one too on different chromosome)

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15
Q

What are the symptoms of polycystic kidney disease?

A 
Dysuria
Loin pain
Haematuria
Polyuria
Increased BP
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16
Q

How is polycystic kidney disease treated?

A

Symptomatic

Transplant

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17
Q

What are the complications with polycystic kidney disease?

A

Liver/pancreatic cysts

Cerebral artery berry aneurysm

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18
Q

What are predisposing factors for a urinary tract infection?

A 
Sex - female
Stones
Foreign bodies
Congenital abnormalities
Bladder outflow obstruction
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19
Q

Why are UTIs more common in females?

A

Shorter urethra
Moist environment
Close proximity to anus

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20
Q

What are common pathogens in UTIs?

A

E.coli

Pseudomonas

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21
Q

What are the symptoms of a UTI?

A

Cystitis - frequency, urgency, dysuria, suprapubic pain

Pyelonephritis - loin pain, nausea, fever, rigors

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22
Q

When do you investigate a UTI further?

A 
Male
Recurrent infections
Children
Pregnancy
Urinalysis (nitrates and leukocytes show infection), MSU, USS, KUB
23
Q

How are UTIs treated?

A

Trimethroprim

Pyelonephritis - amoxicillin

24
Q

What causes urinary stones?

A 
Idiopathic
Infection
Obstruction
Hot climate
Hyperparathyroidism
25
Q

What are most stones made of?

A

Calcium oxalate

26
Q

What are the symptoms of stones?

A

Severe loin pain (10/10)
Bladder/urethra - maybe haematuria
Ureter - radiates to groin

27
Q

What investigations would be done if stones were suspected?

A

Urinalysis - microscopic haematuria
CT KUB - diagnostic
IV urogram

28
Q

How are urinary stones treated?

A

Analgesia
Small stones normally pass on their own
Extracorporeal shock wave lithotripsy
Percutaneous nephrolithotomy

29
Q

What are the complications of urinary stones?

A

Recurrence

30
Q

What is the pathology of renal cell carcinoma?

A

Adenocarcinoma - clear cell

31
Q

What are the symptoms of renal cell carcinoma?

A 
Average age 70
Haematuria
Loin pain
Palpable mass
Weight loss
32
Q

Where does renal cell carcinoma commonly spread to?

A

Renal vein

IVC

33
Q

How is renal cell carcinoma treated?

A

Nephrectomy

34
Q

What are the risk factors for bladder cancer?

A

Smoking

Exposure to aromatic amines

35
Q

What is the pathology of bladder cancer?

A

90% transitional cell carcinoma

The rest are squamous

36
Q

What are the symptoms of bladder cancer?

A

Haematuria

Recurrent UTIs

37
Q

What investigations would be done if bladder cancer was suspected?

A

Flexible cystography

CT

38
Q

How is bladder cancer managed?

A

Superficial - endoscopic resection

Invasive - radical cystectomy

39
Q

Benign prostatic hyperplasia

A

Affects men over 50

40
Q

What are the symptoms of benign prostatic hyperplasia?

A 
Hesitancy
Poor stream
Terminal dribbling
Incomplete emptying
Frequency
Nocturia
Urgency
41
Q

How is benign prostatic hyperplasia investigated?

A 
Digital rectal examination - enlarged prostate
MSU
Urinary flow rate
Post-void residual volume
PSA
42
Q

How is benign prostatic hyperplasia treated?

A

Conservative - avoid caffeine, evening fluids
Alpha blocker - tamsulon
Surgery - transurethral removal of the prostate

43
Q

What are the complications of benign prostatic hyperplasia?

A

Acute urinary retention
Overflow incontinence
ALI
Bladder stones

44
Q

What are the risk factors for prostate cancer?

A

Ageing

Family history - prostate, BRCA1, BRCA2

45
Q

What are the symptoms of prostate cancer?

A

Storage and voiding problems
Haematuria
Hard nodular prostate on examination
Can present with advanced disease - AKI, bone pain, spinal cord compression

46
Q

What investigations would be done if prostate cancer was suspected?

A

PSA
Trans-rectal ultrasound guided prostatic biopsy
MRI

47
Q

How is prostate cancer treated?

A

Active surveillance
Radiotherapy
If advanced - hormone manipulation (eg GnRH agonist goserelin)

48
Q

What are the risk factors for testicular cancer?

A

Testicular maldescent
Infertility
Atrophic testes
Previous cancer in contralateral testes

49
Q

What is the pathology of testicular cancer?

A

Germ cell tumour

50
Q

What are the symptoms of testicular cancer?

A

Painless lump

Potential tenderness, inflammation

51
Q

What investigations would be done if testicular cancer was suspected?

A

MSU

Testicular ultrasound

52
Q

How is testicular cancer managed?

A

Radical orchidectomy

53
Q

Where does testicular cancer commonly metastasise to?

A

Lung
Bone
Liver

1st/2nd Year Revision (15 decks)

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