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Flashcards in renal disease Deck (19):
1

where are the kidneys

retropritoneally on either side of vertebral columns from T12 to 13

2

functions kidney

elimination of waste material
regulation of volume and composition of body fluid
endocrine function - production of erythropoietin, renin, vit D in it's active form
autocrine function - production of endothelin, prostaglandins, renal natriuretic peptide

3

symptoms suggesting renal tract disease

dysuria (pain on micturition)
frequency of micturition
urinary retention
haematuria
alteration of urine volume (either polyuria or oliguria)
pain anywhere on renal tract
non spec symps: lethargy, anorexia, pruritus

4

dysuria caused by

inflammation involving urethra (urethritis) or bladder (cystitis)
inflammation involving vagina or glans penis

5

polyuria

XS urine output > 3L in 24h
must be differentiated from urinary frequency and nocturia

6

causes of polyuria

XS thirst
diabetes insipidus
CKD
solute diuresis

7

oliguria

low urine output
maintained over several hours indicate AKI or UT obstruction

8

anuria

no urine
suggests bilateral ureteric or bladder outflow obstruction

9

first steps in renal disease investigation

estimation of eGFR is used to determine the degree of renal dysfunction
hx and exam
urine dipstick
urine microscopy

10

blood tests renal disease

urea and creatinine conc represents dynamic equilibrium between production and elimination but levels dont rise above normal until 50-60% reduction in gfr

11

urine dipstick

detects blood, protein, glucose, ketones, bilirubin, urobilinogen and pH
also nitrates and leucocyte elastase for UTIs

12

what on urine dipstick suggests renal tract disease

haematuria or proteinuria

13

blood only apparent at start of micturition suggests

urethral disease

14

blood at end of micturition suggests

bleeding from prostate or bladder base

15

blood as even discolouration throughout urine suggests

bleeding from source in bladder or above

16

how sample obtained urine microscopy

midstream urine specimen

17

white cells in urine ?

10 or more WBC per cubic milimetre = pyuria = inflam reaction in UT = UTI

18

bacteria in urine ?

> 10^5 (women) or 10^3 (man) of pathogenic organisms per mL of urine in fresh midstream specimen = UTI

19

transcutaneous renal biopsy

renal biopsy under US control