other urinary pathology

Question 1

How is the biopsy of prostate graded?

Answer 1

Gleason grading => add best and wors areascor outof 12areas looked at

Question 2

What is aspecific treatment for prostate cancer and what characteristicsof cancer does it relay on?

Answer 2

LHRH=>reduces testosteron by overworking andterior pituitary

Question 3

what are the markers for testicular cancer

Answer 3

placental alkaline phosphate

HCG

Question 4

How can bladder cancer by dignosed?

Answer 4

intra venous urogram
Ultrasound
Cystoscopy
Biopsy

Question 5

Whata are the host factors that leadto development of UTIs

Answer 5

short femal urethra
obstruction (tumour, pregnancy, stasis)
neurological
uretic reflex problem

Question 6

what is the difference in symptoms between cystitis and polynephritis

Answer 6

both show dysuria, freqyuency, urgency and fever BUT polynephritis is more systemic with some loin pain

Question 7

What cases of UTI are uncomplicated?

Answer 7

No known abnormalities of urinary tract infection
Not pregnant
No other co morbidities
Female

Question 8

What cases of UTI are complicated?

Answer 8

Males 
Young children 
Pregnant females 
People with structural abnormalities 
Elderly

Question 9

Name 3 organsism that can cause UTI

Answer 9

E. coli
Staphylococcus saprophyticus
Klebsille
Pseudoones aurogenosa

Question 10

What are thechanges observe d in urin with infection?

Answer 10

visual: turbidity
urine dipstick: raised leukocytes and nitrate (sometimes)
NOT haematuria and proteinuria

Question 11

what is the treatment for cytitis?

Answer 11

trimethoprim or nitrofurantoin x 3 days

in complicated x5 daysmay also use cephalaxin

Question 12

what is the treatment for polynephritis?

Answer 12

Co-amoxiclav or Ciprofloxacin x 14 days

Question 13

What is a state of increased ureaq in blood known as?

Answer 13

azotaemia

Question 14

What are the possible findings in the history of pre-renal ARF?

Answer 14

thirst, weight loss (fluid loss related) cause fro ineffecive circulatory volume

Question 15

What are the possible findings in the history of renal ARF?

Answer 15

previous abnormal urinalysis, toxin/nephrotoxic drugs exposure, hypertension, new medication

Question 16

What are the possible findings in the history of post-renal ARF?

Answer 16

Frequency, hesitancy, nocturia
History of nephrolithiasis or neoplasia
Renal colic

Question 17

What signs and urinalysis findings can you observe in pre-renal failure?

Answer 17

low BP, JVP, high pulse

high urin osmolarity and creatin and low sodium

Question 18

What signs and urinalysis findings can you observe in renal failure?

Answer 18

hypertension 
Proteinuria 
Haematuria 
Pyuria 
Renal epithelial cells in urine 
Casts

Question 19

What signs and urinalysis findings can you observe in post-renal failure?

Answer 19

distended bladder, enlarged prostate, renal calculus

Question 20

Name some drug classes that make the ARF worse

Answer 20

NSAI, ACEI, gentamicin

Question 21

What are causes of renal failure?

Answer 21

Renal artery or vain occlusion
Intrarenal vascular => thrombus, cholesterol emboli
Glomerulonephritis
Acute tubular necrosis => nephrotoxic drugs/pre-renal insult
Intestinal disease -> drugs, infiltration

Question 22

What would be the observations of urine microscopy in diffrent types of renal failure?

Answer 22

o Pre-Renal
 Hyaline cast – Aggregations of protein seen in concentrated urine (normal)
o Acute Tubular Necrosis
 Muddy Brown Cast =>shedding of tubular cells
o Rapidly Progressive Glomerulonephritis
 Red Blood Cell Cast=> blood in urine

Question 23

name causes of CKD

Answer 23

immunological, infection, inharited, vascular, hypertension, systemic disease, obstructive

Question 24

What are the three most common causes of CKD

Answer 24

ischaemic heart disease, hypertension and diabetes = 85%

Question 25

What is the effectof CKD on bone

Answer 25

renal bone diseaase 1. reduced phosphate loss wincreases calcium scavenging and leads to hyperparathyrodism 2. reduced vit D hydroxylation contributes to hyperparathyrodism and osteomalacia

Question 26

What symptoms are you expect with CKD

Answer 26

``` Tiredness, Breathlessness, Restless legs o Sleep reversal o Seizure o Aches and pains o Nausea and vomiting o Itching o Chest Pain neuropathy, sizures ```

Question 27

what are the advantages of haemodynamic dialysis

Answer 27

effective (25+ survival) 3 times a week easily prescribed

Question 28

what are the disadvantages of haemodynamic dialysis

Answer 28

``` fluid/diet restrictions limited holiday expensive CVS instability acess problem => arterovenous fistula ```

Question 29

what are the advantages of peritoneal dialysis

Answer 29

low technology, home use, easy to learn, allows mobility, stable CVS

Question 30

what are the disadvantages of peritoneal dialysis

Answer 30

``` frequent i.e. 4/day no long term survivcal peritonates limited dialisys dose high revenue ```