Disease of the kidneys & urinary tract

Question 1

What structures are present in the upper urinary tract?

Answer 1

Kidneys

Ureters

Question 2

What are the 3 constrictions of the ureter?

Answer 2

Pelviureteric junction
Brim of the pelvis
Vesicoureteric junction

Question 3

What structures are found in the lower urinary tract?

Answer 3

Bladder

Urethra

Question 4

What sphincter contracts under sympathetic innervation during ejaculation? What does this prevent?

Answer 4

Internal urethral sphincter

Retrograde ejaculation

Question 5

What is another name of the urethral opening?

Answer 5

External urethral meatus

Question 6

When there is tightening of the foreskin on a penis, what condition can occur?

Answer 6

Phimosis

Question 7

When the foreskin of a penis is retracted and gets stuck, what is this condition called?

Answer 7

Para-phimosis

Question 8

What is the definition of proteinuria?

Answer 8

Urinary protein excretion >150mg/day

Question 9

How many types of haemturia are there?

Answer 9

3
Macroscopic
Microscopic (microscopic or dipstick positive)

Question 10

What is the definition of microscopic haemturia?

Answer 10

> 3 RBCs/ high power field

Question 11

What is the deinfition of oligouria?

Answer 11

Urine output <0.5ml/kg/hr

Question 12

What is the definition of anuria?

Answer 12

No urine production

Question 13

What is the definition of polyuria?

Answer 13

> 3L/day

Question 14

What is the definition of nocturia?

Answer 14

Waking up at night >1 to micturate

Question 15

What is the definition of nocturnal polyuria?

Answer 15

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

Question 16

What are the 6 different functions of the kidneys?

Answer 16

Body volume (ECF) 
Endocrine function 
Electrolyte balance
Acid/Base balance 
Excretion of waste products 
Regulation of vascular tone

Question 17

What is the mnemonic used to define AKI staging

Answer 17

R  - risk
I - injury
F - failure
L - loss
E - endstage kidney disease

Question 18

What are some of presenting symptoms of CKD?

Answer 18

Anaemia
Oedema
Hypetension
Tiredness

Question 19

What type of cancer is common in the ureters & bladder?

Answer 19

Transitional cell carcinoma

Question 20

What are the different types of obstruction?

Answer 20

Intra-luminal
Intra-mural
Extra-luminal

Question 21

What are some of the presenting signs of ureteric disease?

Answer 21

Pain 
Pyrexia
Haemturia
Palpable mass
Renal failure

Question 22

What are some storage lower urinary tract symptoms?

Answer 22

Frequency
Nocturia
Urgency
Urge incontinence

Question 23

What are some voiding lower urinary tract symptoms?

Answer 23

Poor flow
Intermittency
Terminal dribbling

Question 24

What types of incontinence can occur?

Answer 24

Urge 
Stress
Mixed 
Overflow 
Neurogenic

Question 25

What is pneumaturia? What is it a sign of?

Answer 25

Bubbles in urine | Fistula present

Question 26

What is the risk of bladder cancer in patient with frank haemturia?

Answer 26

25-30%

Question 27

What is the risk of renal cancer in patient with frank haematuria?

Answer 27

0.5-1%

Question 28

The micturition cycle is composed of what 2 phases?

Answer 28

Storage (or filling) phase | Voiding phase

Question 29

Where is the micturition centre in the brain found?

Answer 29

Pons

Question 30

What is the most common cause go bladder outflow obstruction?

Answer 30

Benign prostatic enlargment

Question 31

What are the signs & symptoms of acute urinary retention?

Answer 31

Painful Inability to void urine Percussable bladder

Question 32

What can cause acute urinary retention?

Answer 32

``` Benign prostatic obstruction UTI urethral stricture Alcohol excess post-operative event ```

Question 33

What is the immediate treatment for acute urinary retention?

Answer 33

Catheterisation

Question 34

What is the residual volume usually found in cases of acute urinary retention?

Answer 34

500-1000mls

Question 35

What is the definition of chronic urinary retention?

Answer 35

Painless, palpable & permissible badder after voiding

Question 36

What is the residual volumes associated with chronic urinary retention?

Answer 36

400 up to 2L

Question 37

What are some of the causes of chronic urinary retention?

Answer 37

Detrusor muscle under activity (primary or secondary to BOO)

Question 38

What are the 2 types of chronic urinary retention? Which is more urgent?

Answer 38

``` High pressure (emergency) Low pressure ```

Question 39

What is the immediate treatment for chronic urinary retention?

Answer 39

Catheterisation

Question 40

What are the 2 types of catheter?

Answer 40

Urethral | Suprapubic

Question 41

What can occur following chronic urinary retention treatment?

Answer 41

Pathological diuresis (>200ml/hr)

Question 42

What is required in order to diagnose UTI?

Answer 42

Microbiological culture from MSSU | Symptoms (at least 1)

Question 43

What are some symptoms associated with UTI?

Answer 43

Dysuria Urinary frequency & urgency Fever Flank pain

Question 44

What are the 2 types of UTIs?

Answer 44

Complicated | Uncomplicated

Question 45

What is classed as uncomplicated UTI?

Answer 45

Young sexually active female

Question 46

What is classed as complicated UTI?

Answer 46

Older women Men Children

Question 47

What types of organism cause UTIs?

Answer 47

``` E.coli Staph, saprophyticus Klebsiella Proteus Pseudomonas Staph aureus ```

Question 48

What treatment would you use for UTI?

Answer 48

ABIs