1. Renal Medicine Flashcards Preview

BDS2 BAMS Urology/Nephrology (Renal) > 1. Renal Medicine > Flashcards

Flashcards in 1. Renal Medicine Deck (42):
1

Where does filtration occur

Glomerus

2

What is filtration dependent upon

Glomerular pressure

3

What does the juxta-glomerular apparatus contain

RAAS

4

Function of prostaglandins

Control glomerular functions

5

Definition of polyuria

Excess urine

6

Definition of dysuria

Pain when passing urine

7

Definition of haematuria

Blood in urine

8

Definition of proteinuria

Protein in urine

9

Definition of uraemia

Excess urea in blood

10

Renal function is measured by (3)

Serum urea
Serum creatinine
24hr urine collection (creatinine clearance)

11

Renal failure involves (4)

Loss of renal excretory function
Loss of water and electrolyte balance
Loss of acid base balance
Loss of renal endocrine function (EPO, calcium metabolism, renin secretion)

12

Renal failure can be (2)

Acute (usually reversible)
Chronic

13

Features of acute renal failure

Rapid loss of renal function, usually over hours/days

14

Features of chronic renal failure

Gradual loss of renal function, usually over many years

15

Causes of renal failure (3)

Pre-renal
Renal
Post-renal

16

Definition of pre-renal failure and examples (3)

Hypo-perfusion of kidney
Shock
Renal artery disease
Aorta disease

17

Examples of renal failure (4)

Chronic disease
Drug damage
Trauma
Rhabdolysis

18

Definition of rhabdolysis

Breakdown of skeletal muscle

19

Examples of post-renal failure

Renal outflow obstruction

20

Acute renal failure involves (5)

Rapid loss of renal function
Anuric initially with volume overload
Gradual progression to polyuria
Development of hyperkalaemia
Development of uraemia and acidosis

21

Creatinine level in acute renal failure

>200umol/l

22

Symptoms of acute renal failure (5)

Ankle oedema (ambulatory) or sacral oedema (sedentary)
Pulmonary oedema
Breathlessness
Raised JVP
Weight gain

23

Effects of acidosis (3)

Low bicarbonate
Increased respiratory excretion of CO2
Raised respiratory rate

24

Main cause of acute renal failure

Pre-renal cause

25

Specific cause and example of acute renal failure (2)

Trauma/drug-induced
Crush injury --> muscle breakdown --> uraemia --> kidneys blocked --> acute failure

26

Types of chronic renal failure (2)

Primary
Secondary

27

Causes of primary renal failure (2)

Glomerulonephritis
Polycystic kidney disease

28

Causes of secondary renal failure (6)

Diabetes (30%)
HTN (20%)
Drug therapy
Vasculitis
Renal artery disease
Aorta disease

29

Presentation of glomerulonephritis (4)

Haematuria
Proteinuria
In an otherwise healthy individual
Gradual progression to HTN and chronic renal failure

30

Complications of glomerulonephritis

Nephrotic syndrome

31

Nephrotic syndrome involves (4)

Excessive loss of protein in urine (leads to hypoalbuminaemia)
Loss of plasma oncotic pressure
Tissue swelling (oedema)
Hypercoagulable state (loss of clotting factors)

32

Why should NSAIDs be avoided in renal failure (2)

Inhibit glomerular blood flow
Causes interstitial nephritis

33

Nephrotoxic drugs include

Cyclosporin

34

Renal vascular disease involves (2)

Reduced blood flow to kidney (atheroma, HTN)
Microangiopathy

35

Immune-mediated renal damage can be (3)

Multiple myeloma (plasma cell tumour/tubular nephritis)
Goodpasture's syndrome
Vasculitis (lupus)

36

Polycystic kidney disease causes (2)

Gene mutation (PKD 1, 2, 3)
Multiple cysts in renal parenchyma (enlarged kidney, progressive destruction, gradual renal failure)

37

When does end stage renal disease (ESRD) occur (2)

When eGFR <15ml/min
Creatinine is 800-1000umol/l

38

Chronic renal failure management involves (5)

Reduce rate of decline (control underlying cause)
Correct fluid balance
Correct deficiencies
Remove outflow obstruction
Treat infection

39

Signs of chronic renal failure (3)

Anaemia
HTN
Renal bone disease (low Ca, high PO4, hyperparathyroidism, osteomalacia)

40

Symptoms of chronic renal failure (6)

Insidious (may be few)
Polyuria
Nocturia
Tired
Weak
Nausea

41

Renal malignancies include (2)

Renal cell carcinoma (HTN, polycythaemia)
Transitional cell carcinoma (haematuria, asymptomatic)

42

Secondary oral effects of anaemia include (2)

Oral ulceration
Dysaesthesia