Renal Tract Flashcards
(24 cards)
what is cystitis?
inflammation of the bladder
what is the major pathogenic cause of UTIs?
E. coli
what kind of pathogen is e. coli?
gram-negative, anaerobic, rod-shaped bacteria
what is the typical finding of UTIs on MC&S?
nitrites + - gram negative bacteria
leukocytes +
what is the treatment of UTIs?
trimethoprim/nitrofurantoin
or nitrofurantoin then cefalexin/amoxicillin if trying to conceive
when are nitrofurantoin and trimethoprim avoided?
nitrofurantoin: third trimester
trimethoprim: first trimester
what is the treatment for prostatitis?
ciprofloxacin
what is the difference in presentation of cystitis and pyelonephritis?
pyelonephritis may have vomiting, febrile and complain of loin pain. they will be pyrexic and have renal angle tenderness
what is a side effect of trimethoprim?
isolated creatinine increase
what type of Abx should be given to a UTI caused by Klebsiella?
ESBL e.g. pivmecillam and meropenem
what is the management of pyelonephritis?
admit patient to hospital for IV Abx: broad spec cephalosporin / quinolone / gentamicin
what is AKI?
a rapid (within 7 days) and sustained (lasting > 24 hours) reduction in renal function resulting in oliguria and a rise in serum urea and creatinine it is usually reversible
what are the causes of AKI?
pre-renal: shock e.g. hypovolaemic, and renovascular disease e.g. renal artery stenosis, and dehydration
renal: acute glomerulonephritis, acute tubular necrosis, acute interstitial nephritis (drug induced), haemolytic uraemia syndromes or vasculitides
post-renal: kidney stone, tumour, BPH, strictures
what are the investigations for AKI?
bloods: FBC, U&E, LFT, glucose, clotting, calcium ESR
ABG: hypoxia (oedema), acidosis, potassium
urine: dip, MCS
ECG: hyperkalaemia
CXR: pulmonary oedema
renal US: renal size and hydronephrosis
what are the indications of dialysis in AKI?
AEIOU: acidosis (<7.20) electrolyte imbalance (hyperkalaemia) intoxication (poisoning) oedema uraemia (encephalopathy or pericarditis)
what is the difference in presentation between AKI and CKD?
CKD: weight loss, reduced appetite, pruritis, anaemia, chronic fatigue
AKI: confusion and seizures, OLIGURIA, n/v, SOB dehydration, acute fatigue
what is the definition of CKD?
a gradual, irreversible decline in kidney function
this requires either a decreased GFR or markers of kidney damage (albuminuria, electrolyte abnormalities, structural or histological renal abnormalities)
present for >3 months!
what are the causes of CKD?
glomerular: IgA nephropathy, SLE
vascular: vasculitis and renal artery stenosis
amyloidosis and myeloma
congenital: polycystic kidney disease and Alport syndrome
systemic: diabetes and hypertension
MOST COMMON: diabetes, hypertension, chronic glomerulonephritis, polycystic kidney disease
what are the complications of CKD?
use CRF HEALS:
CVD, renal osteodystrophy, fluid (oedema), hypertension, electrolyte disturbance (hyperkalaemia, acidosis), anaemia, leg restlessness, sensory neuropathy
which drugs cause hyponatraemia?
SSRIs e.g. sertraline causes SIADH
carbamazepine
sulfonyureas
tricyclics
what is the MOA for spirinolactone?
aldosterone antagonist
which stones are related to UTIs?
magnesium carbonate (struvite) stones
which stones are related to hyperparathyroidism?
calcium carbonate stones
what are the signs of polycythaemia?
HIGHHb:
headaches, I (eye) sight blurry/itching, overGrown spleen-splenomegaly, hearing problems (tinnitus), hypertension, breathlessness
