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

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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
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3
Q

List the symptoms of AKI.

A
  • anorexia
  • nausea
  • vomiting
  • puritis
  • confusion
  • drowsiness
  • reduced urine output
  • hyperkalaemia
  • metabolic acidosis
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4
Q

What investigations would you carry out into AKI?

A
  • ultrasound
  • urinalysis
  • catheterisation
  • assess fluid levels
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5
Q

Who would you treat AKI?

A
  • BP control
  • IV fluids
  • stop precipitating drugs
  • treat complications
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6
Q

Define Chronic Kidney Disease.

A
  • presence of kidney damage
    OR
  • GFR <60ml/min/1.73^2 present >3 months
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7
Q

List causes of CKI.

A
  • polycystic kidney disease
  • renovascular disease
  • multiple myeloma of the kidney
  • TB
  • urinary tract obstruction
  • hypertension
  • diabetes
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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
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9
Q

What investigations would you carry out into CKI?

A
  • urinalysis
  • urine microscopy
  • U&Es
  • ultrasound
  • CT
  • MRI
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10
Q

How would you treat CKI?

A
  • BP control

- treat underlying cause

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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
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12
Q

List symptoms of minimal change disease.

A
  • usually affects male children
  • very high facial oedema
  • proteinuria
  • hyperlipidemia
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13
Q

What investigations would you carry out into minimal change disease?

A
  • MSSU
  • renal biopsy
  • ?culture
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14
Q

Who would you treat minimal change disease?

A
  • high dose corticosteriods
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15
Q

Define IgA Glomerulonephritis.

A
  • IgA present in mesangium causes focal and segmental glomerulonephritis
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16
Q

List symptoms of IgA glomerulonephritis.

A
  • usually affects children and young males
  • haematuria
  • proteinuria
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17
Q

What investigations would you carry out into IgA glomerulonephritis.

A
  • renal culture
  • MSSU
  • cystoscopy
  • renal biopsy
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18
Q

How would you treat IgA glomerulonephritis?

A
  • ACEinhibitors

- steroids

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19
Q

Define Membranous Nephropathy.

A
  • increased basement membrane of glomerular capillary means IgG becomes stuck, causing holes and allowing albumin through
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20
Q

Give two symptoms of menbranous nephropathy.

A
  • oedema

- anaemia

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21
Q

What investigations would you do into membranous nephropathy?

A
  • renal biopsy
  • MSSU
  • U&Es
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22
Q

How would you treat membranous nephropathy?

A
  • ACEinhibitors
  • cyclophosphamide
  • steroids
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23
Q

Define Post-Infective Glomerulonephritis.

A
  • glomerulonephritis 2-3 weeks after sore throat or ear infection
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24
Q

Give symptoms of post-infective glomerulonephritis.

A
  • oedema
  • anaemia
  • proteinuria
  • haematuria
25
Q

What investigations would you carry out into post-infective glomerulonephritis?

A
  • renal biposy
  • MSSU
  • U&Es
  • FBC
  • renal culture
26
Q

How would you treat post-infective glomerulonephritis?

A
  • BP control
  • diuretics
  • salt restriction
  • corticosteroids
  • dialysis
27
Q

Define Goodpasture’s Syndrome.

A
  • anti-GBM antibodies are directed against the collegen of the basement membrane, causing problems with filtration
28
Q

Lists symptoms of Goodpasture’s syndrome.

A
  • proteinuria
  • malaise
  • weight loss
  • chills
  • joint pain
  • haematuria
  • oedema
29
Q

What investigations would you carry out into Goodpasture’s syndrome?

A
  • MSSU
  • renal biopsy
  • U&Es
30
Q

How would you treat Goodpasture’s syndrome?

A
  • plasma exchange to remove circulating anti-GBM antibodies

- steroids

31
Q

Define Benign Prostatic Enlargement.

A
  • increased prostate size without any malignancy
32
Q

List symptoms of Benign Prostatic Enlargement.

A
  • increased frequency of urination
  • nocturia
  • difficulties initiating stream
  • urinary retention
  • incontinence
33
Q

What investigations would you carry out into benign prostatic enlargement.

A
  • digital rectal examination
  • urine culture
  • prostate-specific antigen
  • renal function test
  • ultrasound
34
Q

How would you treat benign prostatic enlargement?

A
  • alpha-blockers
  • 5-alpha reductase inhibitors
  • surgery
35
Q

Define Acute Urinary Retention.

A
  • painful inability to void with a palpable and precussable bladder
36
Q

List causes of acute urinary retention.

A
  • benign prostatic hyperplasia

- pelvic nerve damage

37
Q

Define Chronic Urinary Retention.

A
  • painless, palpable and precussable bladder after voiding
38
Q

How would you treat chronic urinary retention?

A
  • catherterisation
39
Q

Define Diabetic Nephropathy.

A
  • glomerulonephritis as a result of the complications of diabetes
40
Q

List symptoms of diabetic nephropathy.

A
  • nocturia
  • lethargy
  • headaches
  • malaise
  • polyuria
  • oedema
41
Q

What investigations would you carry out into diabetic nephropathy?

A
  • glycaemic control
  • BP control
  • ACE inhibitors
42
Q

Define Transitional Cell Carcinoma.

A
  • carcinoma of the urothelium that lines the bladder walls and lumen wall
43
Q

List symptoms of transitional cell carcinoma.

A
  • painless, visible haematuria
  • recurrent UTI
  • dysuria
  • change in frequency
  • nocturia
  • increased urgency
  • bladder pain
44
Q

What investigations would you carry out into transition cell carcinoma?

A
  • urine culture, cystoscopy, biopsy, CT urogram, ultrasound, U&Es, urine dipstick
45
Q

How would you treat transitional cell carcinoma?

A
  • resection
  • chemotherapy
  • radiotherapy
46
Q

List symptoms of renal cell carcinoma.

A
  • haematuria
  • loin/flank pain
  • mass in flank
  • malaise
  • anorexia
  • weight loss
47
Q

What investigations would you carry out into renal cell carcinoma?

A
  • ultrasounds
  • CT
  • MRI
  • DO NOT biopsy as kidney is highly vascular
48
Q

How would you treat renal cell carcinoma?

A
  • surgery

- chemotherapy

49
Q

Define nephrolithasis.

A
  • formation of kidney stones that obstruct the ureters and prevent the flow of urine into the bladder
50
Q

List causes of nephrolithasis.

A
  • hypercalcaemia
  • dehydration
  • hypercaluria
  • infection
51
Q

List symptoms of nephrolithasis.

A
  • flank pain, radiating down gonads
  • constant or intermittant
  • haematuria
  • UTI
52
Q

What investigations would you carry out into nephrolithasis?

A
  • urine dipstick
  • eGFR
  • calcium levels
  • CT
53
Q

How would you treat nephrolithasis?

A
  • extracoporeal shockwave therapy

- surgery

54
Q

List symptoms of prostate cancer.

A
  • patients only symptomatic if local invasion
  • haematuria
  • terminal dribbling
  • increased frequency
  • increased time to void
  • increased time to initiate voiding
55
Q

What investigations would you carry out into prostate cancer?

A
  • opportunistic PSA testing
  • digital rectal examination
  • ultrasound
  • biopsy
56
Q

How would you treat prostate cancer?

A
  • surgery
  • chemotherapy
  • androgen-receptor blockers
57
Q

List symptoms of testicular cancer.

A
  • most commonly men 15-35
  • painful testicular mass
  • metastasis to para-aortic lymph nodes
  • gynacomastia
58
Q

What investigations would you carry out into testicular cancer?

A
  • ultrasound
  • MRI
  • assay of serum tumour markers
  • CT
59
Q

How would you treat testicular cancer?

A
  • rapid surgery
  • chemotherapy
  • lymph node dissection