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Gen Med (Renal) > Clinical Essentials > Flashcards

Clinical Essentials Flashcards

1
Q

What defines oliguria?

A

Urine output < 0.5ml/kg/hour

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2
Q

What defines anuria?

A

Passage of < 50ml urine in 24 hours

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3
Q

Healthy adults will pass roughly how much urine in an hour?

A

1ml/kg

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4
Q

Polyuria can be caused by which electrolyte abnormality?

A

Hypercalcaemia

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5
Q

Normal protein excretion is less than how much per day?

A

150mg

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6
Q

Describe the appearance of urine in people with proteinuria?

A

Pink and frothy

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7
Q

Nephrotic range proteinuria always indicates what type of disease?

A

Glomerular disease

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8
Q

What is the triad of nephrotic syndrome?

A

Oedema, hypoalbuminaemia, proteinuria > 3g/day

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9
Q

Passing how much protein in the urine in one day is defined as heavy proteinuria?

A

1-3g

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10
Q

Passing how much protein in the urine in one day is defined as asymptomatic low grade proteinuria?

A

< 1g

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11
Q

Passing how much protein in the urine in one day is defined as nephrotic range proteinuria?

A

> 3g

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12
Q

What is sometimes considered a fourth feature of nephrotic syndrome, which occurs as an attempt to compensate for protein loss?

A

Hyperlipidaemia

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13
Q

What investigation should be used ideally to quantify proteinuria?

A

Spot protein/albumin: creatinine ratio

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14
Q

Haematuria throughout the stream is suggestive of bleeding from where?

A

Glomerulus

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15
Q

Haematuria at the beginning of the stream is suggestive of bleeding from where?

A

Urethra

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16
Q

Haematuria at the end of the stream is suggestive of bleeding from where?

A

Bladder or prostate

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17
Q

What causes myoglobinuria?

A

Rhabdomyolysis

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18
Q

What causes haemoglobinuria?

A

Haemolysis

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19
Q

What is the management for any cases of painless visible haematuria?

A

Urgent referral to urology

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20
Q

CKD is classified according to what?

A

GFR

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21
Q

When is a spot urine test for calculating albumin: creatinine ratio best done?

A

Morning

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22
Q

What is a normal albumin: creatinine ratio in a man?

A

< 2.5mg/mmol

23
Q

What is a normal albumin: creatinine ratio in a woman?

A

< 3.5mg/mmol

24
Q

An albumin: creatinine ratio of what is equal to 0.5g of protein being excreted per day?

A

30mg/mmol

25
Q

An albumin: creatinine ratio of what is equal to 1g of protein being excreted per day?

A

70mg/mmol

26
Q

To calculate the daily protein excretion from a protein: creatinine ratio, what should you do?

A

Multiply the number by 10 and then convert into grams

27
Q

Haematuria is divided into what two types?

A

Visible and non-visible

28
Q

Non-visible haematuria is sub-divided into what two types?

A

Symptomatic and asymptomatic

29
Q

What type of urine sample should be used for urine microscopy?

A

Mid-stream sample

30
Q

On urinalysis, what two indicators are most likely to be raised in someone with a UTI?

A

Leukocytes and nitrites

31
Q

What does specific gravity of urine measure?

A

How concentrated the urine is

32
Q

What is the normal pH range of urine?

A

4.5-8

33
Q

If there is any abnormality detected on dipstick testing, what investigation should be done next?

A

Urine microscopy

34
Q

The presence of dysmorphic red cells on urine microscopy suggests what?

A

Glomerular damage

35
Q

If a urine dipstick is strongly positive for blood but there are no red cells seen on microscopy, what does this suggest?

A

Haemoglobinuria or myoglobinuria

36
Q

What does the presence of red cell casts in the urine indicate?

A

Glomerular damage

37
Q

What does the presence of white cell casts in the urine indicate?

A

Acute infection, usually bacterial

38
Q

What type of urine casts are usually benign?

A

Hyaline

39
Q

What does the presence of granular casts in the urine indicate?

A

Chronic disease

40
Q

What happens to urea and creatinine when renal function is impaired?

A

Increase

41
Q

Neither urea or creatinine tend to rise significantly until GFR falls to around what value?

A

30ml/min

42
Q

What is the normal GFR for an average adult?

A

125ml/min

43
Q

Which individuals tend to have higher values of creatinine?

A

Those with a large muscle bulk

44
Q

Which drug often causes an isolated rise in creatinine?

A

Trimethoprim

45
Q

What is used to calculate a simple estimate of GFR?

A

Creatinine clearance

46
Q

Why does creatinine clearance slightly overestimate GFR?

A

There is a small amount of tubular secretion

47
Q

What is usually the first line imaging investigation for a suspected renal problem?

A

Ultrasound

48
Q

What imaging investigation can be used to assess the patency of renal vessels?

A

Ultrasound with Doppler

49
Q

What is the first line imaging investigation for renal colic?

A

CT-urogram (CT-KUB)

50
Q

Any histological diagnosis of renal disease requires what investigation?

A

Renal biopsy

51
Q

What medications should always be stopped before a renal biopsy?

A

Anticoagulants

52
Q

What investigation should always be done before a renal biopsy to establish the kidney anatomy?

A

Renal ultrasound

53
Q

What is the most common complication of a renal biopsy? This usually occurs within how long?

A

Bleeding - usually within 8 hours of the procedure

Gen Med (Renal) (18 decks)

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