Urinary Pathology Flashcards
Define Acute Kidney Injury.
EITHER
- increased serum creatinine >/= 26.5um within 48hrs
OR
- serum creatinine > 1.5 x baseline within the last 7 days
OR
- urine volume 0.5ml/kg/hr for 6hrs
List causes of AKI.
Pre-renal - falling renal blood flow leading to decreased GFR - low cardiac output, hypovolaemia and hypotension due to heart failure Renal - acute tubular necrosis - glomerulonephritis - myeloma - injection of IV contrast - Drug toxicity Post-renal - kidney stones - strictures - fibrosis - prostatic disease - cancer
List the symptoms of AKI.
- anorexia
- nausea
- vomiting
- puritis
- confusion
- drowsiness
- reduced urine output
- hyperkalaemia
- metabolic acidosis
What investigations would you carry out into AKI?
- ultrasound
- urinalysis
- catheterisation
- assess fluid levels
Who would you treat AKI?
- BP control
- IV fluids
- stop precipitating drugs
- treat complications
Define Chronic Kidney Disease.
- presence of kidney damage
OR - GFR <60ml/min/1.73^2 present >3 months
List causes of CKI.
- polycystic kidney disease
- renovascular disease
- multiple myeloma of the kidney
- TB
- urinary tract obstruction
- hypertension
- diabetes
List symptoms of CKI.
- early stages are often asymptomatic
- malaise
- lethargy
- loss of appetite
- weight loss
- insomnia
- nocturia
- nausea
- vomiting
- diarrhoea
- mental slowing
- scratch marks
What investigations would you carry out into CKI?
- urinalysis
- urine microscopy
- U&Es
- ultrasound
- CT
- MRI
How would you treat CKI?
- BP control
- treat underlying cause
Define Minimal Change Disease.
- glomerular disease in which he glomeruli appear to be undamaged on light microscopy, however hey are damaged on electron microscopy
List symptoms of minimal change disease.
- usually affects male children
- very high facial oedema
- proteinuria
- hyperlipidemia
What investigations would you carry out into minimal change disease?
- MSSU
- renal biopsy
- ?culture
Who would you treat minimal change disease?
- high dose corticosteriods
Define IgA Glomerulonephritis.
- IgA present in mesangium causes focal and segmental glomerulonephritis
List symptoms of IgA glomerulonephritis.
- usually affects children and young males
- haematuria
- proteinuria
What investigations would you carry out into IgA glomerulonephritis.
- renal culture
- MSSU
- cystoscopy
- renal biopsy
How would you treat IgA glomerulonephritis?
- ACEinhibitors
- steroids
Define Membranous Nephropathy.
- increased basement membrane of glomerular capillary means IgG becomes stuck, causing holes and allowing albumin through
Give two symptoms of menbranous nephropathy.
- oedema
- anaemia
What investigations would you do into membranous nephropathy?
- renal biopsy
- MSSU
- U&Es
How would you treat membranous nephropathy?
- ACEinhibitors
- cyclophosphamide
- steroids
Define Post-Infective Glomerulonephritis.
- glomerulonephritis 2-3 weeks after sore throat or ear infection