Urology Flashcards
what is the threshold for diagnosis of a UTI
> 10^5 colony forming units per millilitre of urine
what are the common causative organisms of UTIs
E. coli - 68% proteus mirabilis staph saprophyticus Klebsiella Enterococcus faecalis
what dipstick findings suggest UTI?
+ve for nitrites and/or leukocytes
microscopic haematuria
treatment for UTI is?
Trimethroprim
Nitrofurantoin
short course, 3-5 days
for resistant cause, co-amoxiclav, ciprofloxacin
what is acute pyelonephritis?
infection within renal pelvis/parenchyma
fever, loin pain, tenderness, significant bacteriuria
what medication can be used to treat pyelonephritis in pregnancy
tetracycline, trimethoprim, sulphonamides, quinolones must be avoided
amoxicillin, nitrofurantoin and cephalosporins ok
common causes of hydronephrosis
urinary tract obstruction
BPH, cancer, stones
presentation of hypdronephrosis
dull ache/pain in back, flanks, worse after drinking alot
microscopic haematuria
urinating less often, weak stream
how is AKI defined
increase in creatinine:
>0.3ml within 48hrs
>1.5x baseline within 7 days
urine volume <0.5ml/kg/hr for 6 hours
pre-renal causes of AKI
hypoperfusion, due to:
hypovolaemia, hypotension, sepsis, CCF, cirrhosis, renal artery stenosis
Intrinsic renal causes of AKI
tubular- acute tubular necrosis, nephrotoxins
Glomerular - glomerulonephritis
Interstitial - acute interstitial nephritis
Vascular - vasculitis, thrombus
post-renal causes of AKI
Obstruction
stones, clots, malignancy, BPH
why is it important to do an urgent ABG and ECG in AKI?
check for hyperkalaemia, which can lead to arrhythmias
management of AKI
treat the underlying cause
replenish fluid, remove obstruction
dialysis if necessary
how is chronic kidney disease (CKD) classified
presence of kidney damage (proteinuria, haematuria etc) or decreased kidney function (eGFR <60) for 3 months or more
causes of chronic kidney disease
PCKD, glomerulonephritis, hypertension, tubointerstitial nephritis, pelvic tumours, diabetes
symptoms of severe CKD
anorexia, N+V, fatigue, oedema, dyspnoea, polyuria, anuria/oliguria
management of CKD
stop nephrotoxic drugs, treat underlying cause, treat oedema, anaemia
diet - Na, K+, protein restriction
if necessary, prepare for dialysis or transplant
how long does it take to recover renal function after an AKI
2-3 weeks
at what point do symptoms tend to become apparent in CKD
when urea >40mmol/L
when eGFR drops suddenly or below 15
what is the presentation of BPH
incomplete emptying, frequency, urgency, weak stream, straining, nocturia, intermittency
how is BPH diagnosed
PR exam
MSU, U+Es, PSA (carry out before PR)
USS, biopsy if suspected malignancy
Name some alpha blockers used in BPH
Doxazocin, tamsulosin, alfuzosin, terazosin
what treatment options are there for BPH
lifestyle indwelling catheter alpha blockers finasteride Surgery - transurethral resection of the prostate (TURP), prostatectomy
