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Year 2 Systems > Urinary Formative > Flashcards

Urinary Formative Flashcards

1
Q

What are the causes of a high creatinine?

A

Kidneys not functioning properly so creatinine not cleared

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2
Q

Effect on GFR of efferent arteriolar constriction

A

Increase

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3
Q

How would drinking a large amount of water affect osmolarity and volume of the ECF?

A

Decreased osmolarity and increased volume

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4
Q

Where is ADH produced?

A

Hypothalamus

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5
Q

What triggers the release of ADH?

A

High osmolarity
Too much Na+
Dehydration

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6
Q

If Drug A’s clearance is greater than inulin clearance, then what would be true of Drug A?

A

Net secretion

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7
Q

What is the result of impaired renal function? (metabolic/respiratory acid/alkalosis)

A

Metabolic acidosis (loss of HCO3)

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8
Q

Why are ammonium ions excreted in respiratory acidosis?

A

Formation of “new” bicarbonate ions results in ammonium secretion

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9
Q

A patient with lung cancer develops the syndrome of inappropriate ADH secretion. What changes in Na+ concentration might be expected to be seen?

A

Reduced

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10
Q

Name a loop diuretic

A

Furosemide

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11
Q

Thiazide type diuretic examples

A

Indapamide

Metolazone

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12
Q

A 6 year old child presents with swelling of his face and legs. His serum albumin concentration is 18g/l (normal 37-42) and his mother notices that his urine is frothy. What is the most likely diagnosis?

A

Minimal change disease

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13
Q

What is minimal change disease?

A

Most common cause of nephrotic syndrome (protein lost in urine) without visible changes in the glomerulus on microscopy

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14
Q

Nephrotic syndrome

A 
>3 g proteinuria
Hypoalbuminemia
Peripheral oedema
Hyperlipidemia
Hypercoagulability
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15
Q

Nephrotic syndrome treatment

A

Prednisone (oral steroids)

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16
Q

Nephritic syndrome

A

Classified by blood in the urine

Normally proliferative

17
Q

IgA nephropathy symptoms

A 
Severe flank/abdominal pain
High blood pressure
Hematuria (gross, frank, microscopic)
Compromised immune system
Oedema in hands and feet
18
Q

Focal and segmental glomerulonephritis

A

Sclerosis of segments of some glomerules

Likely to present as a nephrotic syndrome

19
Q

Membranous nephropathy

A

Characterized by a thickened glomerular basement membrane without a hyperproliferation of the glomerular cells

20
Q

Proliferative glomerulonephritis (types)

A

IgA nephropathy
Post-infectious
Membranoproliferative
Crescentic glomerulonephritis

21
Q

A 23 year old woman complains of flank pain, dysuria and frequency of micturition. She has taken ibuprofen for the pain. Her urinalysis shows protein, nitrites and blood. What is the likely diagnosis?

A

Acute pyelonephritis

22
Q

A 40 year old man was found to have asymptomatic proteinuria and microscopic haematuria during routine employment-related examination. His BP was found to be 160/100mmHg and serum creatinine 170micromol/l (normal 86-116). He has no urinary symptoms. What is the next most important investigation?

A

Urinary tract US

23
Q

A 60 year old man has stage 5 CKD with a serum creatinine of 500 micromol/l, (normal 88-116). What are the likely levels of serum calcium and phosphate?

A

Calcium - low

Phosphate - high

24
Q

Patients with renal failure are often anaemic. What is the best treatment for their anaemia?

A

Erythropoietin

25
Q

Effect of high phosphate

A

Can pull calcium out of bones, weakening them

26
Q

Why do people with CKD have a high phosphate?

A

Unable to remove excess

27
Q

Why do people with CKD have a low calcium?

A

Secondary to high phosphate

28
Q

Which organism is most likely to cause an uncomplicated UTI?

A

E. coli

29
Q

A 70 year old man complains of poor stream of urine, nocturia and post-micturition dribbling.
Which of the following is the most likely cause?

A

Prostatic hypertrophy

30
Q

A 60 year old man presents with tiredness and malaise. Routine investigations reveal a raised serum creatinine and an estimated GFR of 35ml/min. Which of the following stages of CKD is he in?

A

Stage 3

31
Q

What does rifle stand for in AKI?

A 
Risk
Injury
Failure
Loss of function
End-stage kidney failure
32
Q

What is the commonest urological malignancy in patients with painless frank haematuria?

A

Bladder cancer

33
Q

What is the commonest type of renal tract stones in adults?

A

Calcium oxalate

34
Q

What is the commonest mode of presentation for patients with a renal or ureteric stone?

A

Loin pain radiating to the flank and/or groin

35
Q

What are the features of acute urinary retention?

A

Painful inability to void with a palpable or percussible bladder

36
Q

Are UTI bacteria mainly gram positive or negative?

A

Negative - treat with cephalosporins, fluoroquinolones, and aminoglycosides

Year 2 Systems (9 decks)

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