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Year 2 - Renal > Presentation of diseases of kidneys + urinary tract > Flashcards

Presentation of diseases of kidneys + urinary tract Flashcards

1
Q

Upper urinary tract is everything above the

A

bladder

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2
Q

How does prostate serve as a barrier to UTIs

A

secretes bacteriostatic substances like zinc, females obviously lack this

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3
Q

Nephrotoxic drugs

A

Antibiotics

NSAIDs

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4
Q

Define oliguria

A

Decreased urine output to <0.5ml/kg/hour

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5
Q

Define anuria

A

No urine output

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6
Q

Define polyuria

A

Increased urine output >3l/24 hrs

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7
Q

Define nocturia

A

Waking up at night once or more to pee

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8
Q

Define nocturnal polyuria

A

Nocturnal urine output >1/3 of total urine output in 24 hours

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9
Q

Presentation of renal diseases (6)

A 
Pain
Pyrexia
Haematuria
Proteinuria
Pyuria
Mass on palpation
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10
Q

Define proteinuria

A

urinary protein excretion >150mg/day

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11
Q

Functions of the kidney (7)

A 
Filtration + excretion
Acid base balance
Electrolyte balance
Blood pressure regulation
Body fluid balance
Produce erythropoietin (hormone that stimulates RBC production)
Convert vitamin D into active form
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12
Q

Presentation of chronic renal failure/chronic kidney disease

A

ASYMPTOMATIC (majority) -

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13
Q

BIG risk factors of chronic kidney disease/renal failure

A

DM - biggest

Hypertension

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14
Q

Symptoms (3) /signs (2) of chronic kidney disease

A 
Majority asymptomatic - 
Symptoms
-Fatigue
-Nausea +/- vomiting (in advanced renal failure)
-Pruritus (in advanced renal failure)

Signs

  • Oedema - periorbital and peripheral
  • hypertension
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15
Q

Presentation of ureteric diseases

A 
Pain, e.g. renal colic
Pyrexia
Haematuria
Palpable kidney
Renal failure
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16
Q

Presentation of bladder diseases (7)

A 
Suprapubic pain
Pyrexia
Haematuria
Lower urinary tract symptoms (see other flashcard)
Recurrent UTIs
Urinary retention
Urinary leak from vagina
17
Q

What are the ‘lower urinary tract symptoms’ (5)

A

Voiding LUTS - frequency, nocturia, urgency

Storage LUTS - poor flow, dribbling

Incontinence - stress, urge etc

18
Q

Types of urinary incontinence

A

Stress - weak urethral sphincter
Urge - due to overactive bladder
Overflow - poor bladder contraction

19
Q

Someone presenting with frank haematuria is more likely to be presenting with bladder or renal cancer (could be neither but just for comparison between these 2 cancers)

A

bladder

20
Q

Define acute urinary retention

A

painful inability to void with a palpable and percussible bladder

21
Q

In acute urinary retention, how much residual volume is in bladder

A

500ml - 1000ml but usually <1000

22
Q

Main risk factor of acute urinary retention

A

Benign prostatic obstruction - obstructs urethra due to enlargement of prostate

23
Q

Immediate treatment of acute urinary retention

A

Catheterisation

24
Q

Define chronic urinary retention

A

painless, palpable and percussible bladder after voiding

25
Q

In chronic urinary retention, what is the residual volume in the bladder

A

400ml - 2000+ ml

26
Q

Main cause of chronic urinary retention

A

Detrusor underactivity/weakness primary to bladder failure or secondary to BPO

27
Q

Chronic urinary retention presents with what symptoms

A

LUTS - frequency, urgency, nocturia, poor flow, dribbling incontinence

28
Q

Chronic urinary retention may present with what complications

A

UTI
Bladder stones
Overflow incontinence - if retention severe
Renal failure - if retention severe

29
Q

Immediate treatment of symptomatic chronic urinary retention

+ subsequent treatment

A

Catheterisation

long term catheter or TURP (transurethral resection of prostate)

30
Q

Diagnosis of a UTI requires microbiological evidence AND symptoms/signs - describe the specifics of this

A

Microbiological evidence - bacterial count of 10^4/ml from MSSU with no more than 2 species

Symptoms/signs - at least one of fever, flank pain, suprapubic pain, frequency, urgency, dysuria

31
Q

2 types of UTI

A

Uncomplicated UTIs (young sexually active females only with clear relation to sexual activity)

Complicated UTIs (everyone else)

32
Q

What are the 3 endocrine functions of the kidney

A

Produce erythropoietin - stimulates RBC production

Convert vitamin D into active form

Produce renin (JG cells)

33
Q

Acute urinary retention should be treated immediately with catheterisation, what medical treatment should be started immediately if no renal failure

A

alpha blocker - to relax bladder muscle tone

Year 2 - Renal (21 decks)

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