renal Flashcards by Niamh Hearty

drug interaction: PPI

clopidogrel

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drug interaction: theophylline

macrolide antibiotics

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drug interaction: macrolide antibiotics

statins +thoephylline

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drug interaction: statins

macrolide antibiotics + fibrates

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drug interaction: tricyclic antidepressants

type 1 anti-arrhythmic drugs - sodium channel blockers (quinidine, disopyramide,)

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drug interaction: ACEi

sulfonylurea

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whats the most common area for cancer to develop on the prostate?

Peripheral zone

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whats the most common area for benign prostatic hyperplasia to develop on the prostate

Transition zone

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partly cystic, heterogenous surface, bright yellow like Homer Simpson

Clear cell carcinoma

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mahogany brown with a central stellate scar. benign, rich in mitochondria, stains pink

oncocytoma

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lymphatic drainage of the testes

Para-aortic lymph nodes

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ADPKD- chromosome?

chromosome 16

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ARPKD -chromosome?

chromosome 6

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UTI antibiotics? not pregnant?

TRIMETHOPRIN or NITROFURANTION 3days

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UTI antibiotic pregnant in 1st and 2nd trimester

Nitrofurantoin

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UTI antibiotic 3rd trimester pregnant?

Trimethoprim

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Bleeding during the start of urination

prostate or urethra

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Bleeding during the end of urination

bladder neck

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Bleeding during the whole time of urination

kidney, ureter or bladder

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BPH treatment

alpha-1 antagonists e.g. tamsulosin, alfuzosin

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how long do 5 alpha-reductase inhibitors e.g. finasteride take to work?

6 months

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mixture of storage symptoms and voiding symptoms in BPH

Apha-blocker alone, then an antimuscarinic (anticholinergic)

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BPH treatment if patient has a significantly enlarged prostate and is considered to be at high risk of progression

5 alpha-reductase inhibitors e.g. finasteride

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pathology of prostate cancer?

adenocarcinoma

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prostate cancer investigation?

MRI- first line!

which has a better prognosis, seminomas or teratomas?

seminomas

what type of tescicular tumour may cause gynecomastia

leydig cell tumours

which is sensitve to radiation smeinomas or non seminomas?

seminomas

what do leydig cells do?

synthesise and secrete testosterone

what do Sertoli cells do?

spermatogenisis, inhibit secretion-turns off GnRH, LH, FSH- decreses testosterone

Alpha-fetoprotein (AFP) indicates what type of testicular cancer

non-seminoma cancers- Tetromas

Beta HCG

raised in both non-seminomas and some seminoma

Hcg

seminomas

elevated both AFP and β-hCG

non- seminomatous germ cell tumour eg. teratoma

where does fluid accumulate in hydrocele?

tunica vaginalis

painless enarged tescicular lump cant be transluminated

tescticular cancer or varicocele

bag of worms

varicocele

negative pren sign + no cremasteric reflex

testicular torsion

Postive pren sign + intact cremasteric reflex

epididymis (epididymoorchitis)

tram track depositions

membranoproliferative glomerularnephritis

spike and dome appearance

membranous glomerulonephritis

nephrotic syndrome associated with malignancy?

membranous glomerulonephritis

effacement of foot processes

minimal change disease

what type of collagen is affected in the anti-glomerular basement membrane (goodpastures disease)

type IV

linear IGA deposits

goodpastures

how does Calcium resonium work?

increases potassium excretion by preventing enteral absorption

what does calcium gluconate do?

Stabilisation of the cardiac membrane. Calcium gluconate dissociates into calcium ions and gluconate ions in the bloodstream

what do insulin/dextrose infusions do for hyperkalaemia?

short-term shift in potassium from ECF to ICF Insulin stimulates the sodium-potassium ATPase pump, which facilitates the movement of potassium from the extracellular fluid (blood) into the intracellular fluid (cells). Dextrose (glucose) is co-administered with insulin to prevent hypoglycemia, a potential side effect of insulin administration

what do salbutamol nebulisers do in hyperkalaemia?

It shifts potassium from the extracellular to the intracellular compartment

mechanism of loop diuretics

increase urine output by inhibiting sodium and chloride reabsorption in the thick ascending limb of the loop of Henle

Trousseau's sign positive

hypocalcaemia

X-linked T4 collagen mutation (M>F) Sensorineural deafness, ocular abnormality, haematuria

Alport’s Syndrome

Adults; multiple, large, bilateral cysts UTIs, haematuria, HTN PKD 1/2 mutation Berry aneurysm/mitral valve prolapse

Autosomal Dominant PKD

RF in childhood/utero (Potter’s syndrome) HTN, portal HTN, RF Congenital hepatic fibrosis

Autosomal Recessive PKD

Middle-aged, haemoptysis Haematuria + HTN Linear immunofluorescence on renal biopsy T4 glomerular basement membrane AB

Goodpasteure’s Syndrome

c-ANCA +ve URTI: nasal septum perf, sinusitis, mastoiditis LRTI: haemoptysis Renal: haematuria, RBC casts

Wegener’s Granulomatosis (Granulomatosis w polyangitis)

Post-URTI/immunisation/allergy Podocytes on EM GN in children

Minimal Change Disease

Nephroblastoma Intra-abdo mass in <10s Large flank mass +/- haematuria

Wilm’s Tumour

HIV-associated nephropathy

focal segmental glomerulosclerosis

mixed nephritic-nephrotic picture

Membranoproliferative Glomerulonephritis (MPGN)

hepatitis B, lupus or drugs such as NSAID asscoiated nephotic syndrome?

Membranous Glomerulopathy

what type of kidney stone is associated with chemo?

urate stones

what reverses warfarin?

Phytomenadione- vitamin K

IgG and C3 subepithelial deposition

post strep glomerulonephritis

crescentic glomerulonephritis

rapidly progressive glomerulonephritis

Subepithelial humps

post-streptococcal glomerulonephritis (PSGN)

Urea rises more than creatinine- High ratio

Pre-renal (↓ perfusion) Dehydration – Shock – GI bleeding – Heart failure

Both urea and creatinine rise proportionally Normal ratio

Intrinsic renal (e.g., ATN, GN)

↓ Low ratio, Creatinine rises more

Rare, but can suggest rhabdomyolysis or low protein states Trimethoprim can cause an isolated rise in creatinine by competing with creatinine for secretion into the renal tubules

Treatment of Focal Segmental Glomerulosclerosis (FSGS)?

corticosteroids and Immunosuppressants like cyclophosphamide

what anti epiletic drug can cause renal stones

Topiramate

New drug + fever + rash + ↑ eosinophils

Acute interstitial nephritis

Sepsis or shock + muddy brown casts

Acute tubular necrosis

"5 P's of Acute interstitial nephritis"

Penicillins & antibiotics Proton pump inhibitors Painkillers (NSAIDs) Pee pills (diuretics) Phenytoin & anticonvulsants AIN = ~7–10 days after starting drug (delayed hypersensitivity)

what does ACE inhibitors do to the glomeruli arterioles

Efferent Expansion- dilates the efferent arterioles

what does NSAIDs do to the glomeruli arterioles

Shrink Afferent arterioles- vasoconstrict

kimmel stietil- wilson noodule

diabetic neuropathy

"basket-weave" appearance on histology

Alport syndrome Longitudinal splitting of the lamina densa of the glomerular basement membrane

semi-opaque stone with a 'ground-glass' appearence

cystine stone

radiolucent stone

Uric acid

what drug can be used to prevent calcium stones?

Thiazide diuretics -inhibit the sodium-chloride cotransporter in the distal convoluted tubule, which leads to increased calcium reabsorption into the blood via the calcium-sodium exchange, therefore lowering urinary calcium levels.

renal Flashcards

(81 cards)