non-renal diseases

Question 1

what is cystitis

Answer 1

persistent inflammation which results in squamous metaplasia

Question 2

what are the causes of cystitis

Answer 2

parasites and mycotic infection
aseptic
in-dwelling catheters

Question 3

what is the type of cystitis that is aseptic

Answer 3

interstitial cystitis

Question 4

what are the symptoms of cystitis

Answer 4

UTI symptoms

pain

Question 5

what is cystitis cystica

Answer 5

infolding of the bladder mucosa, it is a non-specific sign of inflammation

Question 6

what does diverticulae in the bladder result in

Answer 6

stagnant urine

Question 7

what are the symptoms of diverticulae in the bladder

Answer 7

infections
stones
cancer

Question 8

list some causes of obstruction in the urinary system

Answer 8

prostatism
stones
tumours
strictures

Question 9

what are the symptoms of obstruction

Answer 9

persistent back pressure
dilation of the collecting ducts = hydronephrosis
trabeculated bladder muscle

Question 10

what is the investigation of obstruction

Answer 10

CT cystography

Question 11

what are the causes of bladder outflow obstruction

Answer 11

BPH
urethral stricture
prostate cancer
bladder stones 
drugs

Question 12

what drugs would cause bladder outflow obstruction

Answer 12

anti-cholingerics

nasal decongestants

Question 13

what are the symptoms that would make you suspect cancer in bladder outflow obstruction

Answer 13

haemturia
subprapubic pain
recurrent UTIs
weight loss

Question 14

what are the symptoms of bladder outflow obstruction

Answer 14

frequency/urgency 
nocturia 
bed-wetting
hesitancy 
poor/intermittent flow/dribbling
enlarged bladder/kidney/prostate

Question 15

what are the investigations of bladder outflow obstruction

Answer 15

IPSS or LUTS questionaire
PR/abdo exam
frequency-volume chart 
urinalysis
PSA

Question 16

what investigation would you do if the PSA was elevated and the ado exam was abnormal

Answer 16

transrectal US

Question 17

what symptom would make you suspect high pressure chronic retention

Answer 17

bedwetting

Question 18

what is the treatment for a bladder causing bladder outflow obstruction

Answer 18

muscle relaxants: beta agonist = morabegron or betmiga

or anti-cholinergics

Question 19

what is the treatment for a prostate causing bladder outflow obstruction

Answer 19

alpha blocker = tamsulosin
5-alpha reductase inhibitor
transurethral resection

Question 20

what is urinary incontinence

Answer 20

involuntary leakage of urine

Question 21

what are the types of urinary incontinence

Answer 21

stress
urge
mixed

Question 22

what is stress urinary incontinence

Answer 22

leakage on exertion or effort

Question 23

what causes stress urinary incontinence

Answer 23

bladder neck or urethral hypermobility

AND/OR

neuromuscluar defect resulting in sphincter deficiency

Question 24

what is urge urinary incontinence

Answer 24

leakage accompanied by or immediately preceded by urgency

Question 25

what causes urge urinary incontinence

Answer 25

bladder overactivity or pathology irritating the bladder

Question 26

what causes a constant leakage of urine

Answer 26

fistula between bladder and vagina | presence of ectopic ureter draining into vagina

Question 27

what causes a post-micturition dribble

Answer 27

urine pooling the the bladder urethra

Question 28

what are the symptoms of urinary incontinence

Answer 28

``` pain haematuria recurrent UTI significant voiding/obstruction symptoms history of pelvic surgery/radiotherapy mass ```

Question 29

what are the investigations of urinary incontinence

Answer 29

``` abdo/PR/pelvic exam urinalysis ± culture flow rate and post-voiding residue pad testing imaging/cystoscopy ```

Question 30

what are the conservative treatments of urinary incontinence

Answer 30

pelvic floor exercises biofeedback lifestyle: weight, fluid intake

Question 31

what medication can be given to treat STRESS urinary incontinence

Answer 31

duloxetine

Question 32

what is the surgical treatment of urinary incontinence

Answer 32

``` injections retropubic suspension = female stress suburethral tapes and slings artifical urinary sphincter ileal conduit urinary diversion ```

Question 33

what is an overactive bladder

Answer 33

collection of symptoms usually affecting >40s

Question 34

what are the symptoms of an overactive bladder

Answer 34

urgency ± urge incontinence frequency nocturia

Question 35

what medication is given to treat an overactive bladder

Answer 35

anti-cholingerics | beta agonists = mirabegron/betmiga

Question 36

what is diabetic nephropathy

Answer 36

microvascular complication that develops over time due to metabolic and vascular effects

Question 37

what are the symptoms of diabetic nephropathy

Answer 37

``` renal hypertrophy inflammation proteinuria tubule-intestital fibrosis microalbuminuria ```

Question 38

what causes the renal hypertrophy in diabetic nephropathy, what does it result in

Answer 38

plasma glucose stimulates growth factors resulting in mesangial expansion and nodule formation/diffuse glomerulosclerosis

Question 39

what causes proteinuria in diabetic nephropathy

Answer 39

basement membrane thickening | podocyte dysfunction

Question 40

what investigation must you do if haematuria is present in diabetic nephropathy

Answer 40

biopsy

Question 41

how does ischaemic neuropathy affect the kidneys

Answer 41

caused reduced GFR due to reduced renal blood flow beyond the level of auto regulatory compensation

Question 42

what is hypertensive neuropathy

Answer 42

reduction in renal perfusion pressure activates a series of hormonal and neuronal responses that raise systemic BP

Question 43

who is usually affected by renal artery stenosis

Answer 43

males >50 unilaterally

Question 44

what are the symptoms of renal artery stenosis

Answer 44

``` hypertension AKI after treatment of high BP flash pulmonary oedema abdominal bruit discrepancy in kidney size ```

Question 45

what are the investigations of renal artery stenosis

Answer 45

US | CT or MRI angiography

Question 46

what is the treatment of renal artery stenosis

Answer 46

statin ACEI (unless bilateral) anti-platelet angioplasty ± stenting

Question 47

what is fibromuscular dysplasia

Answer 47

non-inflammatory disease of the blood vessels that causes abnormal growth within the artery walls

Question 48

who is affected by fibromuscular dysplasia

Answer 48

females 15-50

Question 49

what vessels are affected by fibromuscular dysplasia

Answer 49

both renal arteries | occasionally cerebral arteries

Question 50

what is dysproteinaemia

Answer 50

overproduction of Ig by clonal expansion of cells from B-cell lineage

Question 51

what is myeloma

Answer 51

cancer of the plasma cells responsible for producing antibodies

Question 52

how does myeloma affect the kidneys

Answer 52

abnormal plasma cells accumulate in the bone marrow impairing the production of normal blood cells. paraproteins (abnormal antibodies) are the produced which causes renal dysfunction

Question 53

what is the classic presentation of myeloma

Answer 53

back pain and renal failure

Question 54

what are the symptoms of myeloma

Answer 54

``` anaemia hypercalcaemia renal failure bone pain weakness/fatigue weight loss ```

Question 55

what are the renal symptoms of myeloma

Answer 55

monoclonal Ig deposition in glomeruli dehydration hypercalcaemia

Question 56

what investigation are done for myeloma, what would you expect to find

Answer 56

bllods = free light chains urine = bence jones proteins bone marrow & renal biopsy skeletal survey

Question 57

what is the treatment of myeloma

Answer 57

chemo stem cell transplant plasma exchange

Question 58

what is small vessel vasculitis, who does it affect

Answer 58

inflammation of small blood vessels 50-70yrs

Question 59

what are the types of small vessel vasculitis

Answer 59

GPA microscopic polyangiitis Churg-strauss

Question 60

what are the systemic symptoms of small vessel vasculitis

Answer 60

fever weight loss anorexia malaise

Question 61

what are the systems involved in small vessel vasculitis caused by GPA

Answer 61

resp renal systemic

Question 62

what are the immunological marker for small vessel vasculitis

Answer 62

ANCA Anti-MPO = microscopic polyangiitis anti-PR3 = GPA

Question 63

what is lupus/SLE, who'd does it usually affect

Answer 63

chronic inflammatory disease of unknown origin women 20-30

Question 64

what are the symptoms of SLE

Answer 64

malar rash photosensitivity renal disease systemic

Question 65

what are the renal symptoms of SLE

Answer 65

lupus nephritis proteinuria granular casts

Question 66

what are the immunological markers for SLE

Answer 66

anti-DNA antibody | anti-SM antibody

Question 67

how would you treat the renal issues of SLE

Answer 67

hydroxycholorquine steroids add cyclophosphamide or MFF add azathioprine