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2a RRS > UTIs/nephrotic/nephritic syndrome > Flashcards

UTIs/nephrotic/nephritic syndrome Flashcards

1
Q

what is a complicated and uncomplicated UTI

A 
complicated = men, pregnancy, immunocompromised 
uncomplicated = non pregnant women
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2
Q

Presentation of UTI

A 
dysuria 
frequency and urgency 
Haematuria 
smelly urine 
Suprapubic pain and tenderness 
back and flank pain 
elderly confusion 
Fever (indicates pyelonephritis)
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3
Q

causative agent of UTI

and their effects

A

E Coli, commonest 50%
kelbestia - more likely to occur during hospital stay
proteus- stones
S. Aureus - risk of infective endocarditis
Pseudomonas chlamydia - immunocompromised

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4
Q

Investigations for a UTI

A

Urinalysis
dipstick - proteinuria, nitrites, pyuria (wbc)
MSU MC and S increased wcc and bacteria (MIDSTREAM)

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5
Q

dipstick for a UTI

A

proteinuria, nitrites, leukocytes

haematuria, pyuria (WBCs in urine)

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6
Q

what is a lower and upper UTI

A 
Lower= cystitis (Bladder), urethritis (urethra) or prostatitis 
Upper= pyelonephritis, ureteritis
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7
Q

what is pyelonephritis

A

Infection of the renal pelvis by UTI

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8
Q

presentation of pyelonephritis

A

Same as lower UTI ( dysuria, haematuria, Frequency, suprapubic pain and tenderness)

TRIAD = LOIN PAIN
FEVER
RENAL TENDERNESS
plus N+V, rigors

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9
Q

Treatment of UTI: cystic UTI complicated or uncomplicated

A

Oral TRIMETHOPRIM
or IV gentamicin if in patient care
or amoxicillin

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10
Q

Treatment of UTI: pyelonephritis

A

ciprofloxacin

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11
Q

what is defined as recurrent UTI

A

more than 2 in 6 months

more than 3 in a year (same bacteria)

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12
Q

what is a uti usually associated with

A

bacteriuria and pyuria (WBC in urine)

bacteriuria = pure growth of more than 10^5 organisms per ml collected from fresh CLEAN CATCH urine sample

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13
Q

whats a uti in bladder called (Upper or Lower)

A

cystitis

lower

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14
Q

what uti in prstate called (Upper or Lower)

A

prostatitis

lower

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15
Q

whats a uti in uterthra called (Upper or Lower)

A

urethitis

lower

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16
Q

UTI in uereter caller

A

ureteritis

upper

17
Q

UTI in renal pelvis

A

pyelonephritis

upper

18
Q

what are RF of pyelonephritis

A

increased compicated
- age -= infants, elderly
anatomical abnormaloty - PKD horsehoe kindey
forgein body (stone or catheter)
immunocomp (DM, transplant, chemo HIV/aids)
pregenant

19
Q

Mx of pyelonephritis

A

ciprofloxacin ABX IV
fluids
drain obstructed kidney
analgesia

20
Q

what does nephritic sydnrome show on microscopy of urine

and dipstick

A

RED CELLS CASTS

dipstick = haemturia

21
Q

diference between nephrItic and nephrOtic syndrome basic

A 
nephrItic = heamaturia and proteinuria
nephrOtic = proteinuria ONLY. NO BLOOD
22
Q

triad of presentation for nephrItic syndrome vs nephrOtic

A

nephrItic = heamaturia, oliguria and HTN
nephrOtic = proteinuria, hypoalbuminemia and
oedema

23
Q

what causes nephritic syndrome

A

Commonest cause is IgA nephropathy (primary cause)
Secondary causes=
SLE,
Goodpasture’s (ANti GBM disease, cresecnt shaped pulm haemorrhage glomeruli)
POST STREP URTI INFECTION

24
Q

what is malfunctioning in nephrotic sydnrome

A

struct chagnes and functional abnormalilities of the pPODOCYTES
= foot processes fuse = MINIMAL CHANGE DIEASE (children)
=or podocyte LOSS == inadeq filtration barrier = PROTEINURIA

25
Q

what is minimal change disease

A

primary cause of nephrotic syndrome
in children
podocyte foot processes fuse togeter = no longer filtration barrier = protien loss

26
Q

why is there albumin loss in nephrotic sydnrome

A

foot processs damaged - no longer neg charge so dont repel albumin
albumin lsot to glomerular filtrate = lowers oncotic p in blood= low osmotic p = water moves OUT into tissues = OEDEMA
(hence triad = hypoalbuminaeima, proteinaeimia, oedema)

27
Q

causes of nephrotic syndorme

A

primary = minimal change
membranous nephropathy - thick GBM

secondary = hep C or B 
DIABETIC NEPHROPATHY
SLE
Malignacny
Drugs (NSAIDs)
28
Q

complications of nephrotic syndrome

A 
thromboembolism as liver in overdrive to replace protieins lost (?) i.e increased clotting factors == (LMW Heparin, warfarin)
DVT 
renal v thrombosis
INfections - give vaccine - pneumococcal
hyperlipidaemia - statins
29
Q

Treatment of Nephrotic syndrome

A 
primary - min change disease = steroids
Oedema=  Loop diuretic furosemide 
Proteinuria: ACEi or ARB 
Prevent atheromas by statins and anticoagulation 
Treat underlying cause
30
Q

what see on dipstick of nephrotic syndrome

A

high proteins

NO BLOOD

31
Q

what see in blood of nephrotic syndrome

A

LOW albumin (can now pass through barrier as faulty)

32
Q

management of nephritic sydnrome

A

Antihypertensives = salt restriction - loop dieruetics (furosemide), CCBs (amlodipine)
Treat cause

33
Q

what infection is main cause of nephrItic synsrome

A

streptococcus URTI infection

2a RRS (26 decks)

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