Renal Pt 2

Question 1

UTIs types and causes?

Answer 1

lower UTI and upper (pyelonephritis)

ECOLI
Staph. saprophyticus
Proteus mirabilis
Enterococci

Atypical (immunocompromised) = klebsiella, candida, pseudomonas

Question 2

RFs for UTIs?

Answer 2

Female, sex, spermicide exposure, pregnancy, menopause, immunosuppression, UT obstruction or malformation, catherisation

Question 3

Cystitis symptoms?

Answer 3

Frequency, urgency, dysuria, haematuria

Question 4

Prostatitis symptoms?

Answer 4

Suprapubic pain, flu like symptoms, low backache, few urinary symptoms
enlarged prostate

Question 5

Acute pyelonephritis symptoms?

Answer 5

High fever, rigors, vomiting, loin pain ad tenderness, oliguria (if AKI)

General = fever, abdo pain, distended bladded

Question 6

Ix and management for UTIs?

Answer 6

Urine dipstick (nitrites)
MSU for urine MCS
Bloods: FBC, U&Es, CRP

Uncomplicated: Nitrofurantoin or cefalexin (pregnant)

Male: Fefalexin or ciprofloxacin

Pyelonephritis/urospsis = co-amoxiclav

Question 7

Polycystic Kidney Disease features?

Answer 7

Can be auto dom (85%PKD1 Ch16, 15 PKD2 Ch4)

Clinically silent for years, renal failure sx, FHX of SAH (berry aneurysms)

Question 8

Presentation of PCKD?

Answer 8

HTN, renal enlargement, abdo pain +-haematuria

Question 9

Ix for PCKD?

Answer 9

Haematuria, raised Hb, deranged U&Es, abdo USS

Question 10

Triad for renal cell Carcinoma?

Answer 10

Haematuria, loin pain and abdo mass

Also PUO, night sweats and maybe polycythaemia

Question 11

RFs for RCC?

Answer 11

Age, smoking, obesity, HTN, dialysis, certain syndromes inherited e.g. von hippel lindau, tuberous sclerosis,

50% incidental finding

Question 12

Ix for RCC?

Answer 12

Increased BP (renin), polycythaemia or IDA, ALP, RBCs in urine, cannon ball mets so CT or MRI

Question 13

Renal Artery stenosis Causes?

Answer 13

Athersclerosis 80%, fibromuscular dysplasia 10%, young females)

Question 14

Clues for renal artery stenosis?

Answer 14

Increased bp refractory to treatment
Worsening renal function after ACEiARB in bilateral RAS
Flash pulmonary oedema
Abdo +-carotid or femroal bruits and weak leg pulse

Question 15

Ix for renal artery stenosis?

Answer 15

USS for kidney size, CT angiogram

GOLD = digital dubtraction renal angiography

Question 16

Acute tubular necrosis Buzzwords?

Answer 16

Muddy brow cast + high creatinine
High urine sodium, 
low urine osmolality
Low urine:serum urea ratio
Low urine:plasma osmlarity ration

Question 17

Acute interstitial nephritis buzzwords?

Answer 17

Eosinphilic cast, urine dip = protein + blood
Old man, CAP
penicillin Tx, dysuria
Back apain

Question 18

HUS buzzwords?

Answer 18

D&V + high urea + creatinine + K+
Normocytic anaemia + fractionate RBC (film)
ECOLI O157:H7 stool

Question 19

TTP Buzzwords?

Answer 19

HUS + fever + neurological manifestations

Question 20

Funny rash and nephritic picture Wegeners?

Answer 20

Young, high platelet, high C3/4 and positive ANCA,

Nosebleeds, sinusitis, lung, kidney

Question 21

Funny rash, nephritic picture for lupus?

Answer 21

Young, low Hb, low platelet, low C3/4 and -ve ANCA, wire-loop capillary

Question 22

Cryoglobulins with funny rash and nephritic picture?

Answer 22

Old, high platelets, high C3/4 and -ve ANCA

High ESR, arthralgia, + Raynauds
Associated with MM, waldenstrom

Question 23

CKD Amyloid A amyloidosis buzzwords?

Answer 23

Crohns, poor renal function, proteinuria, +ve congo red stain

Question 24

CKD amyloidosis buzzwords?

Answer 24

24 Y of Rheumatoid + peripheral oedemia

Proteiunrea 3+ ?cause

Question 25

CKD MM buzzowrds?

Answer 25

Bone pain, lethargym monoclonal band on serum electrophoresis, monocloal globulin protein in urine (bence-jones)

Question 26

CKD diabetic microalbuminuria buzzwords?

Answer 26

T1DM albuminuria, previous dipstick normal

Question 27

CKD diabetic nephropathy buzzword?

Answer 27

Kimmelstiel wilson nodules

Question 28

CKD rhabdomyolysis buzzwords?

Answer 28

Collapse following stroke, high urea + creatinine, K+, high CK urine dark red