7. BAMS Nephrology Flashcards Preview

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Flashcards in 7. BAMS Nephrology Deck (8):
1

Renal Failure and Acute Renal Failure

List 4 features of renal failure

List 3 types of causes of renal failure with examples of each

Features of acute renal failure

Main cause of acute renal failure

Treatment of acute renal failure

Loss of excretory function, loss of acid bace balance, loss of renal endocrine replacement, loss of water/electrolyte balance

Pre-renal (kidney hypo perfusion - shock), intra-renal (drug damage, trauma, chronic disease, rhabdolysis), post-renal (outflow obstruction)

Rapid loss of function (creatinine >200umol/l), anuric with volume overload (ankle/sacral oedema, increase JVP, weight gain, SoB, pulmonary oedema), gradual progression to polyuria, hyperkalaemia, uraemia, acidosis development

Usually pre-renal cause, usually reversible

Support (nutrition, dialysis) until recovery

2

Chronic Renal Failure

List 2 causes of primary chronic renal failure

List 5 causes of secondary chronic renal failure

Management of chronic renal failure

List 5 symptoms of chronic renal disease

PKD, glomerulonephritis

Diabetes, HTN, renal artery disease, drug therapy, vasculitis

Control underlying causes, correct fluid balance and deficiencies, remove outflow obstruction

Anaemia, HTN, tired, weak, nausea, polyuria, nocturia

3

Renal Vascular Disease and Malignancies

What 2 things does renal vascular disease cause

When can ESRD be diagnosed

Name 2 types of renal malignancies

Reduced blood flow to kidneys and microangiopathy

When eGFR <15ml/min and creatinine 800-1000umol/l

Renal cell carcinoma, transitional cell carcinoma

4

Dialysis

What is dialysis

Name 2 types of dialysis and the difference between them

Intermittent correction of changes in plasma concentration of small molecules

Haemodialysis (actively altered, 8hr sessions) and peritoneal dialysis (continuous, daily at home)

5

Renal Endocrine Replacement and Urinary Tract Diseases

Name 3 ways to improve renal endocrine function

Name optimal ESRD treatment and what it does

List 4 complications of optimal ESRD treatment

What, in urine, suggests infection and why

EPO injection, vitamin D supplement (bone mass maintenance), HTN control (ACE inhibitors)

Transplant - normal energy/fertility, no dietary restrictions, restores renal function

Rejection, immunosuppression, osteoporosis risk, high CV mortality

Urine is usually sterile, so WBCs/microscopic blood suggests infection

6

Urinary Tract Infections

Affected population

What is the main bacteria associated with UTIs

Name 2 predisposing factors to UTIs

List 4 symptoms of UTI

How is a UTI treated

Females > males (due to urethra length)

E. coli

Poor bladder emptying, low urinary flow rates

Dysuria, offensive smelling urine, cloudy urine, frequency, suprapubic pain

Increase fluid intake, antibiotic (trimethoprim, amoxicillin)

7

Urinary Tract Obstructions

List 4 symptoms of UOO

What is renal calculi

How is a renal calculi treated

Slow stream, hesitancy, frequency, urgency, nocturia, incomplete voiding

Stones in bladder/kidney

Lithotripsy - ultrasonic sound energy

8

Prostate Disease

What is BPH

How is it treated

Is prostate adenocarcinoma common

Explain the advantages and disadvantages of PSA in relation to prostate adenocarcinoma

How is it treated

Name the primary site of metastasis from a prostate malignancy

Benign prostate hyperplasia - enlargement of the prostate gland

Surgery - open prostatectomy, TURP and a-adrenergic blockers

Yes - 90% men 90yrs+ have it

PSA - useful for monitoring disease activity in those known to have disease. Problems with specificity/sensitivity exclude PSA use for screening

Surgery, radiotherapy, hormone treatment (block hormone-dependent tumour growth)

Bone