Urology Flashcards
Nephritic syndrome CF
Proteinuria
Haemuaturia
HTN
Urinary Cast
(Less damage)
Nephrotic syndrome CF
Proteinuria >3.5g/24hr
Hypoalbuminaemia <30g/L
Oedema
Thrombosis
(More damage)
Common cause of Nephrotic
1) primary
a) children
b) adults
2) secondary
a) Minimal change disease
b) Membrane glomerlunophritis
2: DM SLE
Nephritic syndrome
Post-Strep GN → after step infection (beta-haemolytic )
Focal glomerulonephritis
IgA nephropathy - associated with autoimmune conditions IgA
Tx of minimal change disease
Steroids +- cyclophosphamide
What does minimal change disease look like on light microscopy
normal
Membrane glomerlunophritis damaged by what?
Causes
IgG deposits - thickens the BM (can be seen on light microscopy)
1) Idiopathic
2) infection, malignancy,
Focal segmental glomerulonsclerosis
a) what seen on light microscopy
b) causes
Light microscopy - some effect
causes - reflux nephropathy, idiopathic HIV
Amlyoidosis can damage the BM and cause renal disease. - how to detect?
monoclonal bands on serum electrophoresis
Investigations for the syndromes - what is the definitive diagnosis
Urine dipstick - protein blood MC+S - protein:creatinine ration Bloods Renall USS Renal biopsy → definitive diagnosis
Mgmt algorithm
Oedema - diuretics (furosemide) + salt restriction, daily weighs + U+E
ACEi/ARB↓ protein excretion by ↓ glomerular filtration pressure
Anticoagulation
Station
Tx underlying cause
Minimal change disease: steroid +- cyclophosphamide - if unsure Tx before Inv
Infection, malignancy, systemic disease
Renal calinoma - what cell type
clear cell carcinoma 80%
CF
Often incidental
abdo mass, haematuria, pain
Mgmt for renal cancer
RCC very resistant to chemotherapy and radiotherapy.
Localised
Surgical resection
> Stages - targeted therapy
Immunomodulation - sensitive to immune system
a-interferon + interleukin-2
tyrosine kinase inhibitors (sorafenib, sunitinib)
RF for renal cancer
Smoking
Obesity
Cystic disease
Von Hippel-Lindau syndrome (Chromosome 3 → mutations in tumour suppressor gene)
