Macleod's

Question 1

which nerve roots innervate the renal capsule and ureter

Answer 1

T10-12/L1

Question 2

what is dysuria

Answer 2

pain

feature of UTI, cystitis, urethritis, acute prostatitis

Question 3

questions to ask for dysuria

Answer 3

• systemic upset with fever, suprapubic discomfort = pyelonephritis
• symptoms of urine outflow obstruction
• sexual history

Question 4

questions to ask for loin pain

Answer 4

• location (if radiates to testicles maybe lower ureter obstruction)
• fever, rigors and dysuria = infection
• previous episodes

Question 5

questions to ask about haematuria

Answer 5

• loin pain = ureteric obstruction
• fever, dysuria, suprapubic pain = infection
• family hisotry of renal disease

Question 6

definiton of proteinuria

Answer 6

> 150mg per day

Question 7

questions to ask about prerenal AKI

Answer 7

• fluid losses eg vomiting, diarrhoea or bleeding
• recent operations
• features of infection
• underlying conditions eg heart failure / liver failure
• drug prescriptions eg NSAIDs

Question 8

questions to ask about intrinsic renal AKI

Answer 8

• recent illness or operations
• drug history eg antibiotics, NSAIDS and PPIs
• systemic symptoms

Question 9

most common causes of intrinsic renal AKI

Answer 9

• acute tubular necrois in hospital setting

- rhabdomyoysis (prolonged immobolisation following a fall)

Question 10

most common cause of postrenal AKI

Answer 10

badder outflow obstruction (in men its BPH)

Question 11

questions to ask about postrenal AKI

Answer 11

• urinary urgency
• stream
• suprapubic pain
• leg weakness

Question 12

questions to ask for someone with a renal transplant

Answer 12

• date of transplant (organ rejection most common in first few weeks)
• immunosuppression
• fever, weight loss, cough, breathlessness, dysuria + tenderness over graft

Question 13

specific things to ask about in past medical history

Answer 13

• hypertension / vascular disease
• DM
• inflammatory diseases eg RA
• IBD
• urinary tract stones
• surgery
• dilaysis / renal transplantation

Question 14

specific questions to ask about family history

Answer 14

• renal diseases eg ADPKD
• subarachnoid haemorrhages
• deafness

Question 15

hand examination

Answer 15

• pallor of palmar creases (anaemia)
• muehrcke’s lines on nails (hypoalbuminaemia for nephrotic syndrome)
• half and half nails (lidsay’s nails for CDK)

Question 16

arm examination

Answer 16

• fistula access

- functioning fistula will have a readily palpable thrill (buzzing feel)

Question 17

face examination

Answer 17

• rashes (CTD)

- conjunctival pallor (anaemia)

Question 18

skin examination

Answer 18

• vasculitic rash on legs (HSP)

- drug rash (allergic intestinal nephritis)