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1
Q

NICE criteria diagnosing AKI

A
  • rise in creatinine >25mmol/L in 48 hours
  • rise in creatinine >50% in 7 days
  • urine output <0.5ml/kg/hour for >6 hours = stage 1
  • urine output <0.5ml/kg/hour for 12 hours = stage 2
  • urine urine output <0.3 ml/kg/hour for 24 hours = stage 3
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2
Q

indications for dialysis

A

A - acidosis
E - electrolyte imbalance (persistent hyperkalaemia >6.9)
I - intoxication/poisoning
O - oedema
U - uraemia (pericarditis or encephalopathy)

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3
Q

moa tamsulosin for BPH

A

alpha-1 antagonist
reduces smooth muscle tone of prostate and bladder

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4
Q

moa finasteride for BPH

A
  • 5-alpha reductase inhibitor
  • blocks conversion testosterone to dihydrotestosterone
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5
Q

types of bladder malignancy?

A
  • transitional cell/ urothelial - most common
  • squamous cell - schistosomiasis
  • adenocarcinoma
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6
Q

options after bladder cystectomy

A

urostomy - ileal conduit
neo-bladder

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7
Q

what is a significant result for urine albumin:creatinine ratio (ACR)

A

> 3

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8
Q

CKD GFR scoring

A
  • G1 = eGFR >90
  • G2 = eGFR 60-89
  • G3a = eGFR 45-59
  • G3b = eGFR 30-44
  • G4 = eGFR 15-29
  • G5 = eGFR <15 (known as “end-stage renal failure”)
    only diagnose stage 1 or 2 if markers of kidney disease
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9
Q

nephrotic syndrome criteria

A
  • peripheral oedema
  • proteinuria >3.5g/24 hour
  • serum albumin <30g/L
  • hypercholesterolaemia + thrombotic disease also seen
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10
Q

findings renal biopsy minimal change disease

A
  • normal glomeruli on light microscopy
  • fusion of podocytes and effacement of foot processes on electron microscopy
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11
Q

management minimal change disease

A

pred

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12
Q

renal biopsy findings in membranous glomerulonephritis

A

basement membrane thickened with subepithelial deposits (IgG and complement)
spike and dome

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13
Q

management membranous glomerulonephritis

A
  • ACEi or ARB
  • immunosuppression
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14
Q

presentation IgA nephropathy

A
  • macroscopic haematuria in young person with recent (1-2 days) history of URTI
  • nephrotic range haematuria rare
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15
Q

renal biopsy in post-streptococcal glomerulonephritis

A
  • subepithelial humps caused by immune complex deposits
  • granular/starry sky appearance
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16
Q

features anti-glomerular basement membrane disease (goodpastures)

A
  • pulmonary haemorrhage + haemoptysis
  • rapidly progressive glomerulonephritis
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17
Q

renal biopsy anti-GBM disease

A

linear IgG deposits along basement membrane

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18
Q

which disease causes the formation of epithelial crescents in glomeruli

A

rapidly progressive glomerulonephritis

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19
Q

presentation interstitial nephritis

A
  • AKI + hypertension
  • fever
  • rash
  • arthralgia
  • eosinophilia
  • sterile pyuria
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20
Q

causes of hyponatraemia in a euvolaemic patient

A
  • SIADH
  • hypothyroidism
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21
Q

causes of hyponatraemia in a hypovolaemic patient

A

renal loss - diuretics (loop, thiazides) + addison’s
extrarenal loss - diarrhoea, vomiting, sweating, burns

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22
Q

what is central pontine myelinolysis

A
  • when sodium corrected too quickly
  • myelin sheath damaged by change in osmotic balance
  • causes acute paralysis, speech + swallowing problems
  • only correct hyponatraemia at <10mmol/L/24 hour
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23
Q

tumour markers in testicular cancers

Study These Flashcards
A

seminomas - hCG in 20%
non-seminomas - beta-HCG and/or aFP in 80%

24
Q

management urinary tract calculi

Study These Flashcards
A

analgesia = NSAIDs at home, IM diclofenac for patients requiring admission
- small = expulsion therapy e.g. tamsulosin
- medium = shockwave lithotripsy
- big = nephrostomy

25
hormonal management prostate cancer
- Goserelin - transient increase in testosterone then a blockade - androgen receptor antagonist e.g. bicalutamide
26
presentation renal cell carcinoma
- renal mass - loin pain - haematuria - pyrexia - left sided varicocele - endocrine effects (erythropoietin, ACTH, PTHrp
27
ACEi should be stopped if what percentage of creatinine rise is seen within 2 weeks?
>30%
28
stage 1 AKI - what increase of creatinine from baseline?
1.5-1.9
29
stage 2 AKI - what increase of creatinine from baseline?
2-2.9
30
stage 3 AKI - what increase of creatinine from baseline?
>3
31
electrolyte requirements for fluid therapy for adults
sodium, potassium and chloride - 1mmol/kg/day
32
what is a hydrocele
collection of fluid within tunica vaginalis that surrounds the testes
33
which side are varicoceles more common on
left side
34
communicating vs non-communicating hydrocele
communicating - patency of processus vaginalis, in newborns non-communicating - excess fluid production
35
features varicocele
throbbing pain dragging sensation associated with sub-fertility or infertility bag of worms disappears when lying down (if it doesn't = concern for retroperitoneal tumours)
36
what size kidney stones require intervention
>5mm
37
requirement CKD diagnosis
GFR < 60 or markers of kidney damage present for > 3 months
38
medical management stress incontinence
duloxetine - if conservative management fails
39
management urge incontinence
conservative - bladder retraining anticholinergic - oxybutinin, solifenacin intravesical injection botox sacral neuromodulation
40
management urge incontinence
conservative anticholinergic - oxybutinin, solifenacin intravesical injection botox sacral neuromodulation
41
organism which causes UTI associated stones
proteus mirabilis
42
investigation testicular lump
ultrasound
43
features inguinal hernia
above and medial to pubic tubercle strangulation rare
44
features femoral hernia
below and lateral to pubic tubercle more common in women non-reducible typically high risk of obstruction and strangulation
45
management femoral hernia
surgical repair necessity given risk of strangulation
46
management renal stone + systemic features of infection
IV abx and urgent renal decompression due to risk of sepsis
47
recomendations for maintenance fluids
25-30ml/kg/day of water 1mmol/kg/day of potassium, sodium and chloride 50-100g/day of glucose
48
features renal cell carcinoma
haematuria loin pain abdominal mass pyrexia of unknown origin varicocele
49
common cause of peritoneal dialysis associated peritonitis
staph epidermis
50
what is stauffer syndrome
paraneoplastic syndrome associated with renal cell cancer cholestasis/hepatosplenomegaly
51
why is there an increased risk of thromboembolism in nephrotic syndrome
loss of antithrombin III and plasminogen
52
most common valvular abnormality seen in polycystic kidney disease
mitral valve prolapse or mitral regurg
53
features henoch-schonlein purpura
palpable purpuric rash over buttocks and extensor surfaces abdo pain polyarthritis IgA nephropathy
54
sympathetic nerve to bladder
hypogastric nerve constriction of neck and urethra
55
VBG salicylate overdose
1st - resp alkalosis 2nd - metabolic acidosis

renal + urology (2 decks)

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