Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Phase 4 > Renal and friends > Flashcards

Renal and friends Flashcards

(171 cards)

Start Studying
1
Q
  1. What is the term for blockage of urine flow ?
A
  • Obstructive uropathy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q
  1. What is the term that describes kidney swelling ?
A
  • Hydronephrosis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q
  1. What is the term for urine passing from the bladder to the ureter ?
A
  • Vesicoureteric reflux
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q
  1. What is the term for abnormal nerve function in the bladder ?
A
  • Neurogenic bladder
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q
  1. What are the classifications of acute kidney injury ?
A
  • Pre-renal
  • Renal
  • Post-renal
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q
  1. What are the top causes of upper renal obstruction ?
A
  • Kidney stones
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q
  1. What are the top causes of lower renal obstruction ?
A
  • Benign prostatic hyperplasia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q
  1. What is used to bypass an upper renal obstruction ?
A
  • Nephrostomy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q
  1. What is the most common cause of acute urinary retention ?
A
  • Benign prostatic hyperplasia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q
  1. What medication can be used to treat urinary retention ?
A
  • Confirm with US then catheterisation
  • Tamsulosin (alpha-blocker)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q
  1. What can be used if urethral entry is not possible with a catheter ?
A
  • Suprapubic catheter
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q
  1. How does benign prostatic hyperplasia present ?
A
  • Urinary hesitancy
  • Frequency
  • Terminal dribbling
  • Nocturia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q
  1. How is BPH scored ?
A
  • International prostate symptom score
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q
  1. What are medical options for BPH ?
A
  • Alpha blockers e.g. tamsulosin
  • 5-alpha reductase inhibitors e.g. finasteride
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q
  1. What are surgical options for BPH ?
A
  • Transurethral resection (TURP)
  • Transurethral electrovaporisation (TEVAP)
  • Holmium laser enucleation (HoLEP)
  • Open prostatectomy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q
  1. How does acute bacterial prostatitis present ?
A
  • 2 weeks of pain in the perineum and rectum
  • Pain on opening bowels
  • Pain on ejaculation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q
  1. What would the findings on DRE be for a pt with acute bacterial prostatitis ?
A
  • Tender and enlarged prostate
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q
  1. What is the cut off for acute verse chronic acute bacterial prostatitis ?
A
  • 3 months
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q
  1. What micro tests would be ordered for a pt with acute bacterial prostatitis ?
A
  • Mid-stream urine for culture
  • Chlamydia and gonorrhea and NAAT
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q
  1. What is 1st line abx for patients with acute bacterial prostatitis ?
A
  • Ciprofloxacin
  • Ofloxacin
  • Trimethoprim
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q
  1. What is the duration of abxs in a patient with acute bacterial prostatitis ?
A
  • 2-4 weeks
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q
  1. What are the false +ve and false -ve rates for PSA ?
A
  • 75% false positive
  • 15% false negative
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q
  1. What is 1st line imaging for localised disease with prostate cancer ?
A
  • Multiparametric MRI
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q
  1. What test can confirm the diagnosis of prostate cancer ?
A
  • Prostate biopsy
  • Can be transrectal or transperineal
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
25. What is the test for spread of prostate cancer to the bones ?
- Isotope bone scan
26
26. What is the grading system for prostate cancer ?
- Gleason grading system
27
27. What is the hormone is involved in the growth of prostate cancer ?
- Androgens (testosterone)
28
28. What hormone treatment options are available for prostate cancer ?
- GNRH agonists - Androgen-receptor blockers (block testosterone)
29
29. What non-hormonal treatment options are available for prostate cancer ?
- Radiotherapy - Brachytherapy - Surgery
30
30. What are surgical complications of prostate removal ?
- Erectile dysfunction - Urinary incontinence
31
31. A 35 yo presents with 3 days of unilateral testicular pain ?
- Epididymo-orchitis
32
32. What are key differentials for Epididymo-orchitis ?
- Testicular torsion
33
33. What are the top causes of Epididymo-orchitis ?
- Escherichia coli - Chlamydia trachomatis - Neisseria gonorrhea - Mumps
34
34. What antibiotic options are available for Epididymo-orchitis ?
- If the organism is unknown: Ceftriaxone 500mg intramuscularly single dose, plus doxycycline 100mg by mouth twice daily for 10-14 days - Oral Ciprofloxacin if sensitivity is known - If enteric organisms ofloxacin, levofloxacin or co-amoxiclav
35
35. What are key adverse effects of quinolone abxs (e.g. ciprofloxacin, levofloxacin, ofloxacin) ?
- Tendon damage/rupture - Lower seizure threshold
36
36. What reflex will be absent in testicular torsion ?
- Cremasteric reflex
37
37. What is the associated deformity for testicular torsion ?
- Bell-Clapper deformity
38
38. What are the surgical options for testicular torsion ?
- Orchiopexy (fixing the position) - Orchidectomy (removing the testicle)
39
39. What would the outcome be of delayed treatment for TT ?
- Ischemic  necrosis  reduced fertility
40
40. What ultrasound sign will be seen in testicular torsion ?
- Whirlpool sign
41
41. What is a hydrocele ?
- An accumulation of fluid in the tunica vaginalis - Can be communicating or non-communicating
42
42. How will a hydrocele present ?
- Soft, non-tender swelling of the hemi-scrotum usually anterior and below the testical - Swelling is confined to the scrotum and you can ‘get above’ the mass on examination - Transilluminates with a pen torch - Testis may be difficult to palpate if hydrocele is large
43
43. What is a varicocele ?
- An abnormal enlargement of the testicular veins - Usually asymptomatic but may be important as associated with infertility - Much more common on the left side - ‘Bag of worms’
44
44. What is an epididymal cyst ?
- The most common cause of scrotal swellings seen in primary care - ~30% of men will get one
45
45. What is a complication of varicocele ?
- Infertility
46
46. What can cause a hydrocele ?
- Testicular cancer
47
47. What about a varicocele would prompt an urgent referral and why ?
- The varicocele does not disappear on lying down - Possibility of a retroperitoneal tumour
48
48. A 22 yo presents with a hard painless testicular lump. What is the diagnosis ?
- Testicular cancer
49
49. What cells can testicular cancers arise from ?
- Germ cells
50
50. What are RFs for testicular cancer ?
- Family history - Infertility - Increased height - Undescended testes
51
51. What type of tumour can cause gynecomastia ?
- Leydig cell tumour
52
52. What are the initial investigations for testicular cancer ?
- Ultrasound
53
53. What are tumour markers for testicular cancer and what types of cancer do they corelate to ?
- Alpha-fetoprotein  teratomas - Beta-HCG  teratomas and seminomas - Lactate dehydrogenase (LDH)  Non-specific
54
54. What is the staging system for testicular cancer ?
- Royal Marsden
55
55. What are common sites of metastasis of testicular cancer ?
- Liver - Lymphatics - Lungs - Brain
56
56. How would a UTI present in a young female ?
- Dysuria - Suprapubic pain - Frequency - Urgency
57
What feature of a UTI suggests that the infection could be spreading to the kidneys ?
- Fever - Loin/back pain - Vomiting
58
58. What is the most common cause of a UTI ?
- E.coli
59
59. What are the most common dipstick findings in a UTI ?
- Nitrites - Leukocytes - Blood
60
60. What is 1st line management ?
- Nitrofurantoin - Trimethoprim
61
61. What duration of Abx is given for UTI in a non-pregnant women ?
- 3 days
62
62. What duration of Abx is given for UTI in a pregnant patient ?
- 7 days
63
63. What duration of Abx is given for UTI in men ?
- 7 days
64
64. What duration of Abx is given for UTI in catheters ?
- 7 days
65
65. 40 yo women with increased frequency and urgency of urination and suprapubic pain is relieved by emptying her bladder. What is the diagnosis ?
- Interstitial cystitis - Bladder pain syndrome
66
66. What would be found in the bladders of patient suffering from interstitial cystitis or bladder pain syndrome ?
- Hunter lesions - Granulations
67
67. What test is used to visualize the bladder mucosa ?
- Cystoscopy
68
68. How is interstitial cystitis managed – supportive management ?
- Diet changes such as avoiding alcohol, caffeine and tomatoes - Stopping smoking - Pelvic floor exercises - Bladder retraining - Cognitive behavioral therapy - Transcutaneous electrical nerve stimulation (TENS)
69
69. How is interstitial cystitis managed – oral medications ?
- Analgesia - Antihistamines - Anticholinergic medications (e.g., solifenacin or oxybutynin) - Mirebegron (beta-3-adrenergic-receptor agonist) - Cimetidine (histamine-2-receptor antagonist) - Pentosan polysulfate sodium - Ciclosporin (an immunosuppressant)
70
70. How is interstitial cystitis managed – intravesical medication ?
- Lidocaine - Pentosan polysulfate sodium - Hyaluronic acid - Chondroitin sulphate
71
71. What is the mechanism of action of Solifenacin ?
- Anticholinergic
72
72. What is the MOA of mirabegron ?
- Beta-3-receptor agonist
73
73. What is the MOA of cimetidine ?
- Histamine-2-receptor antagonist
74
74. How are medications administered to the bladder ?
- Intravesical
75
75. A 68 yo female presents with painless macroscopic haematuria – what is the most likely diagnosis ?
- Bladder cancer
76
76. What carcinogen is linked to bladder cancer ?
- Aromatic amines
77
77. What infection is linked to bladder cancer ?
- Schistosomiasis
78
78. What extra requirements for a 2ww in a >60 with microscopic haematuria are needed ?
- Dysuria or - Raised WBC on FBC
79
79. What is the main staging criteria for bladder cancer ?
- Non-muscle invasive or - Muscle invasive
80
80. What is the early-stage surgery for bladder cancer ?
- Transurethral resection of bladder tumour (TURBT)
81
81. What immunotherapy can be used for bladder cancer ?
- Intravesical BCG vaccine
82
82. What late stage surgery can be used for bladder cancer ?
- Radical cystectomy
83
83. What can be used to urine after a radical cystectomy ?
- Urostomy
84
84. What is the triad of symptoms for pyelonephritis
- Fever - Back pain - Nausea vomiting
85
85. What is the most common cause of pyelonephritis ?
- E.coli
86
86. What bacteria can cause pyelonephritis ?
- MCC – e.coli - Klebsiella pneumonia - Enterococcus - Pseudomonas - Staphylococcus saprophyticus
87
87. What are the findings seen on urine dip for pyelonephritis ?
- Nitrates - Leukocytes - Blood
88
88. What are findings on bloods for pyelonephritis ?
- WBC raised - CRP raised
89
89. What oral abx can be used for pyelonephritis ?
- Cefalexin - Co-amoxiclav (if culture results are available) - Trimethoprim (if culture results are available) - Ciprofloxacin (keep tendon damage and lower seizure threshold in mind)
90
90. What is the treatment for sepsis ?
- Sepsis 6 - Urine - Cultures - lactate - Fluids - Oxygen - Tazasin
91
91. What potential cause would you suspect of pyelonephritis which does not respond to treatment ?
- Renal abscess - Kidney stones
92
92. What scan we be done for suspected kidney damage ?
- DMSA scan
93
93. How would kidney stones present ?
- Renal colic = Unilateral loin to groin pain + colicky pain (fluctuating in severity) as the stones move and settles - Also haematuria, nausea and vomiting, reduced urine output and symptoms of sepsis if infection develops
94
94. What are key complications of kidney stones ?
- Obstruction - Infection
95
95. What can kidney stones form from ?
- Calcium oxalate (MCC) or calcium phosphate - Uric acid - Struvite - Cystine
96
96. What is the most common type of kidney stone ?
- Calcium Oxalate
97
97. What is the initial imaging for renal stones ?
- CT KUB
98
98. What type of kidney stones are not seen on X-ray ?
- Uric acid
99
99. What is the most effective analgesia for renal stones ?
- NSIADs e.g. diclofenac
100
100. What medication aids passage of kidney stones ?
- Tamsulosin
101
101. What surgical interventions are available for kidney stones ?
- Extracorporeal shock wave lithotripsy - Ureteroscopy and laser lithotripsy - Percutaneous nephrolithotomy
102
102. In renal cell carcinoma what hormone/enzyme causes polycythemia ?
- Erythropoietin
103
103. In renal cell carcinoma what hormone/enzyme causes hypercalcemia ?
- Parathyroid hormone-related protein
104
104. In renal cell carcinoma what hormone/enzyme causes hypertension ?
- Renin
105
105. What type of renal cancer presents in under 5’s ?
- Wilm’s tumour
106
106. What staging system is used for renal cell carcinoma ?
- TNM staging system
107
107. How is renal cell carcinoma managed ?
Nephrectomy
108
109. What cancers can be caused by immunosuppression ?
- Skin squamous cell carcinoma - Non-Hodgkin lymphoma
109
110. What would bilateral abdominal bulky masses indicate ?
- Polycystic kidney disease
110
111. What is cyclosporine used to treat and what is a common side effect ?
- Prevents transplant rejection - Gum hypertrophy
111
112. What is the diagnostic criteria for AKI ?
- Rise in creatinine of more than 25 micromol/L in 48 hours - Rise in creatinine of more than 50% in 7 days - Urine output of less than 0.5 ml/kg/hour over at least 6 hours
112
112. What categories of causes are there for AKI ?
- Pre-renal e.g. dehydration, shock and HF - Renal e.g. Acute tubular necrosis, glomerulonephritis, rhabdomyolysis - Post-renal e.g. stones, tumours, BPH, strictures and neurogenic bladder
113
113. What is the most likely cause of AKI in an 89 yo lady with HTN, HF and memory impairment ?
- Pre-renal e.g. dehydration/antihypertensives
114
114. What is the management of a non-infective AKI ?
- Stop nephrotoxic drugs e.g. ACE-I - Cautious fluid rehydration
115
115. What are the most common causes of CKD ?
- Diabetes - Hypertension
116
116. What staging criteria is used for CKD using eGFR ?
- G1 = eGFR > 90 - G2 = eGFR 60-89 - G3a = eGFR 45-59 - G3b = eGFR 30-44 - G4 = eGFR 15-29 - G5 = eGFR < 15
117
117. What staging criteria is used for CKD using ACR ?
- A1 = ACR < 3mg/mmol - A2 = ACR 3-30mg/mmol - A3 = ACR > 30mg/mmol
118
118. What referral criteria is used for CKD ?
- eGFR < 30 - ACR > 70 - Uncontrolled HTN - Accelerated progression
119
119. What is 1st line for blood pressure if urine albumin to creatinine ration (ACR) is > 30 ?
- ACE-I or ARB - (ARB preferred in Black African/Caribbean)
120
120. What can cause anaemia in CKD ?
- Low erythropoietin
121
121. What are the indications for acute dialysis ?
- AEIOU - Acidosis - Electrolytes - Intoxication (overdose) - Oedema - Uraemia symptoms
122
122. What stage of CKD requires long-term dialysis ?
- CKD stage 5
123
123. What catheter are used in peritoneal dialysis ?
- Tenckhoff
124
124. What options are available for hemodialysis ?
- Tunnelled cuffed catheter - Arterio-venous fistula
125
125. What blood vessels can be formed into an AV fistulae ?
- Radio-cephalic - Brachio cephalic - Brachio-basilic
126
126. What are complications of AV fistulae ?
- Aneurysm - Infection - Thrombosis - Stenosis - Steal syndrome - High-output heart failure
127
127. What immunosuppressants are used after renal transplant ?
- Tacrolimus - Mycophenolate - Prednisolone
128
128. A 24 yo man presents with haematuria. Urine dipstick shows 4+ blood and 2+ protein. What is the most likely diagnosis ?
- Glomerulonephritis
129
129. What type of glomerulonephritis is associated with IgA deposits and glomerular mesangial proliferation ?
- IgA nephropathy (Berger’s disease)
130
130. What type of glomerulonephritis is associated with IgA and complement deposits on the basement membrane ?
- Membranous glomerulonephritis
131
131. What type of glomerulonephritis is associated with tonsillitis ?
- Post-streptococcal glomerulonephritis
132
132. What type of glomerulonephritis is associated with pulmonary haemorrhage ?
- Goodpasture syndrome
133
133. What are the main treatments for glomerulonephritis ?
- Immunosuppression e.g. Steroids - ACE-I or ARBs for blood pressure
134
134. A 45 yo presents with fever, rash and mild oedema. He recently started naproxen after a shoulder injury. BP is 163/96. Blood results should raised creatinine and eosinophils. What is the diagnosis ?
- Acute interstitial nephritis
135
135. What can cause nephritis ?
- Hypersensitivity reaction e.g. to NSAIDs
136
136. What is the diagnostic test for nephritis ?
- Kidney biopsy for histology
137
137. What is the management for nephritis ?
- Remove/treat the underlying cause - Steroids
138
138. How does acute tubular necrosis present ?
- Features of AKI: raised urea, creatinine, potassium - Muddy brown casts in the urine
139
139. What is the most common cause of acute tubular necrosis ?
- AKI
140
140. What can cause renal ischemia ?
- Shock - Sepsis - Dehydration
141
141. What common toxins can cause acute tubular necrosis ?
- Radiology contrast dye - Gentamycin - NSAIDs - Lead - Myoglobin secondary to rhabdomyolysis
142
142. What findings would present on urinalysis of acute tubular necrosis ?
- Muddy brown casts
143
143. What is the treatment for acute tubular necrosis ?
- Stop nephrotoxic medications - IV fluids
144
144. What is renal tubular acidosis ?
- Metabolic acidosis due to pathology in the tubules of the kidneys - The tubules balance H+ and bicarbonate ions (HCO3-) between the blood and urine to maintain pH - There are 4 types with type 4 being the most common
145
145. What are the different types of renal tubular acidosis ?
- Type 1 - when the distal tubule cannot excrete hydrogen ions. - Type 2 - when the proximal tubule cannot reabsorb bicarbonate from the urine to the blood - Type 3 – mix of 1&2 - Type 4 - caused by reduced aldosterone causing hyperkalemia
146
146. What is the pathophysiology of renal tubular acidosis type 1
- Inability to generate acidic urine (H+) in the distal tubule - Causing hypokalemia - Complications: nephrocalcinosis and renal stones
147
147. What are the cause of renal tubular acidosis type 1
- Idiopathic - RA - SLE - Sjogren’s - Amphotericin B toxicity - Analgesic nephropathy
148
148. What is the pathophysiology of renal tubular acidosis type 2
- Decreased HCO3- reabsorption in the proximal tubule - Causing hypokalemia and alkalosis (I know right) - Complications include Osteomalacia
149
149. What are the cause of renal tubular acidosis type 2
- Idiopathic - Part of Fanconi syndrome - Wilson’s disease - Carbonic inhibitors e.g. acetazolamide or topiramate
150
150. What is the pathophysiology of renal tubular acidosis type 4
- A reduction in aldosterone leads in turn to a reduction in proximal tubular ammonium excretion - Causing hyperkalemia
151
151. What are the cause of renal tubular acidosis type 4
- Hypoaldosteronism - DM
152
152. An 18 yo presents 5 days after recovering from a period of blood diarrhoea. She has reduced urine output, dark urine and bruising. What is the diagnosis ?
- Haemolytic uraemic syndrome
153
153. What can cause haemolytic uraemic syndrome ?
- E.coli producing 0157 - Shigella producing Shiga toxin
154
154. What is the triad of features associated with haemolytic uraemic syndrome ?
- Haemolytic anaemia - Low platelet count - AKI
155
155. How is haemolytic uraemic syndrome managed ?
- Supportive - Anti-hypertensive medication - Blood transfusion and dialysis if required
156
156. In rhabdomyolysis when muscle breaks down. What are the products and which is most toxic to the kidneys ?
- Myoglobin (most toxic to kidneys) - Potassium - Phosphate - Creatinine kinase
157
157. What colour is the urine in rhabdomyolysis ?
- Red-brown - Myoglobinuria
158
158. What is the key diagnostic test for rhabdomyolysis ?
- Creatine kinase (CK)
159
159. What is the treatment for rhabdomyolysis ?
- IV fluids
160
160. What are ECG changes associated with hyperkalemia ?
- Absent P waves - Broad QRS complexes - Tall T waves (occurs first)
161
161. What medications can most commonly cause hyperkalemia ?
- Aldosterone antagonists - ACE-I - Angiotensin 2 receptor blockers - NSAIDs
162
162. What can commonly cause false hyperkalemia results ?
- Haemolysis while taking the sample
163
163. What needs to be monitored with hyperkalemia ?
- ECG changes
164
164. What is the main treatment to correct hyperkalemia ?
- Insulin and dextrose infusions
165
165. What treatment can be used to stablise the heart muscle cells ?
- IV calcium gluconate
166
166. A 50 yo with end stage renal failure and palpable masses in the abdomen presents. What is the most likely diagnosis ?
- Polycystic kidney disease
167
167. What is the inheritance in adult PKD ?
- Autosomal dominant
168
168. How would PKD impact the brain, colon and heart ?
- Brain  cerebral aneurysms - Colon  Diverticular disease - Heart  Valve disease (mitral regurgitation)
169
169. What is the initial investigation for PKD ?
- Ultrasound
170
170. How does PKD cause gross haematuria ?
- Cyst rupture
171

Phase 4 (17 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions