Urinary Pathology Flashcards
1
Q
Define Acute Kidney Injury.
A
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
2
Q
List causes of AKI.
A
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
3
Q
List the symptoms of AKI.
A
- anorexia
- nausea
- vomiting
- puritis
- confusion
- drowsiness
- reduced urine output
- hyperkalaemia
- metabolic acidosis
4
Q
What investigations would you carry out into AKI?
A
- ultrasound
- urinalysis
- catheterisation
- assess fluid levels
5
Q
Who would you treat AKI?
A
- BP control
- IV fluids
- stop precipitating drugs
- treat complications
6
Q
Define Chronic Kidney Disease.
A
- presence of kidney damage
OR - GFR <60ml/min/1.73^2 present >3 months
7
Q
List causes of CKI.
A
- polycystic kidney disease
- renovascular disease
- multiple myeloma of the kidney
- TB
- urinary tract obstruction
- hypertension
- diabetes
8
Q
List symptoms of CKI.
A
- early stages are often asymptomatic
- malaise
- lethargy
- loss of appetite
- weight loss
- insomnia
- nocturia
- nausea
- vomiting
- diarrhoea
- mental slowing
- scratch marks
9
Q
What investigations would you carry out into CKI?
A
- urinalysis
- urine microscopy
- U&Es
- ultrasound
- CT
- MRI
10
Q
How would you treat CKI?
A
- BP control
- treat underlying cause
11
Q
Define Minimal Change Disease.
A
- glomerular disease in which he glomeruli appear to be undamaged on light microscopy, however hey are damaged on electron microscopy
12
Q
List symptoms of minimal change disease.
A
- usually affects male children
- very high facial oedema
- proteinuria
- hyperlipidemia
13
Q
What investigations would you carry out into minimal change disease?
A
- MSSU
- renal biopsy
- ?culture
14
Q
Who would you treat minimal change disease?
A
- high dose corticosteriods
15
Q
Define IgA Glomerulonephritis.
A
- IgA present in mesangium causes focal and segmental glomerulonephritis
16
Q
List symptoms of IgA glomerulonephritis.
A
- usually affects children and young males
- haematuria
- proteinuria
17
Q
What investigations would you carry out into IgA glomerulonephritis.
A
- renal culture
- MSSU
- cystoscopy
- renal biopsy
18
Q
How would you treat IgA glomerulonephritis?
A
- ACEinhibitors
- steroids
19
Q
Define Membranous Nephropathy.
A
- increased basement membrane of glomerular capillary means IgG becomes stuck, causing holes and allowing albumin through
20
Q
Give two symptoms of menbranous nephropathy.
A
- oedema
- anaemia
21
Q
What investigations would you do into membranous nephropathy?
A
- renal biopsy
- MSSU
- U&Es
22
Q
How would you treat membranous nephropathy?
A
- ACEinhibitors
- cyclophosphamide
- steroids
23
Q
Define Post-Infective Glomerulonephritis.
A
- glomerulonephritis 2-3 weeks after sore throat or ear infection
24
Q
Give symptoms of post-infective glomerulonephritis.
A
- oedema
- anaemia
- proteinuria
- haematuria
25
What investigations would you carry out into post-infective glomerulonephritis?
- renal biposy
- MSSU
- U&Es
- FBC
- renal culture
26
How would you treat post-infective glomerulonephritis?
- BP control
- diuretics
- salt restriction
- corticosteroids
- dialysis
27
Define Goodpasture's Syndrome.
- anti-GBM antibodies are directed against the collegen of the basement membrane, causing problems with filtration
28
Lists symptoms of Goodpasture's syndrome.
- proteinuria
- malaise
- weight loss
- chills
- joint pain
- haematuria
- oedema
29
What investigations would you carry out into Goodpasture's syndrome?
- MSSU
- renal biopsy
- U&Es
30
How would you treat Goodpasture's syndrome?
- plasma exchange to remove circulating anti-GBM antibodies
| - steroids
31
Define Benign Prostatic Enlargement.
- increased prostate size without any malignancy
32
List symptoms of Benign Prostatic Enlargement.
- increased frequency of urination
- nocturia
- difficulties initiating stream
- urinary retention
- incontinence
33
What investigations would you carry out into benign prostatic enlargement.
- digital rectal examination
- urine culture
- prostate-specific antigen
- renal function test
- ultrasound
34
How would you treat benign prostatic enlargement?
- alpha-blockers
- 5-alpha reductase inhibitors
- surgery
35
Define Acute Urinary Retention.
- painful inability to void with a palpable and precussable bladder
36
List causes of acute urinary retention.
- benign prostatic hyperplasia
| - pelvic nerve damage
37
Define Chronic Urinary Retention.
- painless, palpable and precussable bladder after voiding
38
How would you treat chronic urinary retention?
- catherterisation
39
Define Diabetic Nephropathy.
- glomerulonephritis as a result of the complications of diabetes
40
List symptoms of diabetic nephropathy.
- nocturia
- lethargy
- headaches
- malaise
- polyuria
- oedema
41
What investigations would you carry out into diabetic nephropathy?
- glycaemic control
- BP control
- ACE inhibitors
42
Define Transitional Cell Carcinoma.
- carcinoma of the urothelium that lines the bladder walls and lumen wall
43
List symptoms of transitional cell carcinoma.
- painless, visible haematuria
- recurrent UTI
- dysuria
- change in frequency
- nocturia
- increased urgency
- bladder pain
44
What investigations would you carry out into transition cell carcinoma?
- urine culture, cystoscopy, biopsy, CT urogram, ultrasound, U&Es, urine dipstick
45
How would you treat transitional cell carcinoma?
- resection
- chemotherapy
- radiotherapy
46
List symptoms of renal cell carcinoma.
- haematuria
- loin/flank pain
- mass in flank
- malaise
- anorexia
- weight loss
47
What investigations would you carry out into renal cell carcinoma?
- ultrasounds
- CT
- MRI
- DO NOT biopsy as kidney is highly vascular
48
How would you treat renal cell carcinoma?
- surgery
| - chemotherapy
49
Define nephrolithasis.
- formation of kidney stones that obstruct the ureters and prevent the flow of urine into the bladder
50
List causes of nephrolithasis.
- hypercalcaemia
- dehydration
- hypercaluria
- infection
51
List symptoms of nephrolithasis.
- flank pain, radiating down gonads
- constant or intermittant
- haematuria
- UTI
52
What investigations would you carry out into nephrolithasis?
- urine dipstick
- eGFR
- calcium levels
- CT
53
How would you treat nephrolithasis?
- extracoporeal shockwave therapy
| - surgery
54
List symptoms of prostate cancer.
- patients only symptomatic if local invasion
- haematuria
- terminal dribbling
- increased frequency
- increased time to void
- increased time to initiate voiding
55
What investigations would you carry out into prostate cancer?
- opportunistic PSA testing
- digital rectal examination
- ultrasound
- biopsy
56
How would you treat prostate cancer?
- surgery
- chemotherapy
- androgen-receptor blockers
57
List symptoms of testicular cancer.
- most commonly men 15-35
- painful testicular mass
- metastasis to para-aortic lymph nodes
- gynacomastia
58
What investigations would you carry out into testicular cancer?
- ultrasound
- MRI
- assay of serum tumour markers
- CT
59
How would you treat testicular cancer?
- rapid surgery
- chemotherapy
- lymph node dissection
