Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Phase 2a Concise > Renal + UG > Flashcards

Renal + UG Flashcards

(90 cards)

Start Studying
1
Q

Acute kidney injury

A

syndrome of abrupt decreased renal function

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

AKI patho/ dx

A

Criteria for dx

  • Rise in creatinine >26umol/L in 48hrs
  • Rise in creatinine 1.5x baseline
  • Urine output <0.5ml/kg/h for 6+ hrs

3 stages in AKI

May cause sudden life-threatening biochem disturbances

Associated with - diarrhoea, haematuria, haemoptysis, hypotension, urine retention

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

AKI causes

A

Pre-renal (decreased perfusion/drop in BP/flow obstruction)
haemorrhage, burns, D+V, sepsis (systemic vasodilation), NSAIDs, ACEi/ARB - renal hypoperfusion, atherosclerosis - flow obstruction

Renal (intrinsic renal disease)
glomerulonephritis, ATN, drug reaction, infiltration, vasculitis, DIC

Post renal
in renal tract - stone, malignancy, clot, prostatic hypertrophy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

AKI Px

A

depends on underlying cause

signs
maybe palpable bladder, kidneys
arrhythmias (hyperkalaemia)
pericarditis - with uraemia
impaired platelet function - bruising
infection - immune suppression
postural hypotension
oedema

symptoms
oliguria
symptoms of uraemia - fatigue, weakness, anorexia, N+V, confusion, seizures, coma
SOB - anaemia and PO secondary to volume overload
Thirst

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

AKI DDx

A

AAA, alcohol toxicity, alcoholic and DKA, chronic renal failure, dehydration, GI bleed, HF, metabolic acidosis, CKD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

AKI Ix

A

Bloods - FBC, U+E, creatinine, Ca, phosphate, anaemia and ESR high suggests myeloma/vasculitis

Urine dipstick - can suggest infection (leukocytes, nitrates), glomerular disease (blood, protein)

Urine (mid-stream) and blood cultures - ?infection

USS

CT-KUB

ECG, CXR, renal biopsy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

AKI Mx

A

Treat cause

Stop nephrotoxic drugs - NSAIDs, ACEi, gentamicin, amphotericin

Optimise fluid balance - crystalloid

Tx hyperkalaemia - calcium gluconate, insulin and glucose

Tx acidosis - sodium bicarb

Tx PO - diuretics, furosemide

Renal replacement therapy (RRT) - haemofiltration, haemodialysis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Benign prostatic hyperplasia

A

increase in size of prostate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

BPH patho

A

benign proliferation of muculofibrous and glandular layers

Inner (transitional) zone enlarges (prostate carcinoma sees peripheral layer expansion)

Narrows urethra

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

BPH Px

A

signs
abdo exam - enlarged bladder

symptoms
LUTS - frequency, urgency, hesitancy, incomplete bladder emptying, need to push/strain, nocturia, poor stream/flow, post-micturition dribbling, UTI, haematuria,

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

BPH DDx

A

bladder tumour, stones, trauma, prostate cancer, chronic prostatitis, UTI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

BPH Ix

A

DRE - prostate enlarged, smooth

Serum electrolytes, renal USS - exclude renal damage

Transrectal USS - see prostate

PSA may be raised in large BPH

Biopsy, endoscopy

Low flow rate

Frequency vol chart - nocturia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

BPH Mx

A

avoid caffeine, alcohol, void twice in a row

Alpha 1 antagonist - oral tamsulosin - relaxes SM in bladder neck. S/E drowsiness, dizziness, ejaculatory failure. CI postural hypotension

5-alpha-reductase inhibitor - oral finasteride - blocks testosterone -> dihydrotestosterone (active form, responsible for prostatic growth). S/E impotence, decreased libido

Surgery - TURP, TUIP, open prostatectomy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Chronic kidney disease

A

abnormal kidney structure/function, present for 3+ months

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

CKD patho

A

progressive impairment in renal function

classification based on decreased kidney function (GFR), or kidney damage (presence of albuminuria) and the cause of kidney disease (glomerular, tubulointerstitial, blood flow…)

tends to progress to end stage renal failure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

CKD causes

A

UK - diabetes, glomerulonephritis, HTN, renovascular disease

PKD, infective, obstructive, reflux nephropathies, SLE, amyloidosis, myeloma, hypercalcaemia, vasculitis, drugs

RFs - FHx, CVD, proteinuria, smoking, ethnicity (african, Afro-Caribbean, Asian)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

CKD Px

A

signs
increased skin pigmentation, pallor, HTN, peripheral oedema, LVH, pleural effusions
CKD cx - anaemia, pericarditis
Underlying disease - eg SLE

symptoms
malaise
anorexia, wt loss
insomnia
nocturia, polyuria (impaired concentrating ability)
itching
N+V+D
amenorrhoea, erectile dysfunction
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

CKD DDx

A

AKI (CKD - normochromic anaemia, small kidneys on USS, renal osteodystrophy)

acute on chronic kidney disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

CKD Ix

A

ECG - hyperkalaemia

Urinalysis - haematuria, proteinuria, mid-stream to MC&S, albumin:creatinine ratio, protein:creatinine ratio

Urine microscopy

Serum biochem - U+E, bicarb, creatinine (high urea, creatinine), low eGFR, raised ALP, raised PTH if CKD stage 3+

Bloods - raised phosphate, low Ca, low Hb

Auto-AB screening for disease, eg SLE, scleroderma. Viral antigen tests

USS - small kidneys

CT

Biopsy, histology

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

CKD Mx

A

Treat BP
Treat bone disease, tx PTH if raised - vit D, calcitriol
Control diabetes
CVD - simvastatin, aspirin

Anaemia - iron/folate/folic acid
Acidosis - sodium bicarb
Oedema - furosemide

RRT - haemofiltration, haemodialysis, peritoneal dialysis

Kidney transplant

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

CKD Cx

A

Anaemia - due to reduced EPO production by kidney

Bone disease - renal osteodystrophy - renal phosphate retention, impaired 1,25-diOH vit D production -> fall in Ca, PTH increases to compensate, skeletal decalcification

Neurological - dysfunction, polyneuropathy

CVD - higher risk

Skin disease - pruritus, brown discolouration of nails

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Glomerulonephritis

A

inflammation of glomeruli and nephrons

can cause

  • damage to filtration mechanism - haematuria, proteinuria
  • glomerular damage constricts blood flow - compensatory HTN
  • loss of filtration capacity - AKI
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Nephritic syndrome

A

inflammation - may involve glomerulus, tubule, interstitial renal tissue

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Nephritic syndrome causes

A

often immune response triggered by infection

IgA nephropathy
post-strep infection
IE, SLE, bacterial infection
Systemic sclerosis
ANCA vasculitis
Goodpasture's
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Nephritic syndrome Px
``` GFR decrease haematuria proteinuria HTN oedema from salt and water retention oliguria uraemia - anorexia, pruritus, lethargy, nausea ```
26
Nephritic syndrome Ix
measure eGFR, proteinuria, U+E, albumin Culture - from throat/infected skin Urine dipstick - proteinuria, haematuria Renal biopsy if needed
27
Nephritic syndrome Mx
Tx cause | HTN - salt restriction, loop diuretics, CCB
28
Nephrotic syndrome
Due to podocyte damage
29
Nephrotic syndrome patho
triad of proteinuria, hypoalbuminaemia, oedema Podocyte pathology - abnormal structure/function, immune damage, injury, death - proteins leak out Hyperlipidaemia often present - liver goes into overdrive due to albumin and protein loss - increased clot risk, raised cholesterol Causes - primary renal disease (eg minimal change disease, membranous nephropathy), secondary (eg DM, lupus, myeloma)
30
Nephrotic syndrome Px
``` mild BP increase Proteinuria >3.5g/24hr mild decrease in GFR hypoalbuminaemia oedema - ankles, genital, abdo wall frothy urine ```
31
Nephrotic syndrome DDx
CCF - oedema, but has raised JVP Liver disease, eg cirrhosis - hypoalbuminaemia and oedema, but signs of chronic liver failure
32
Nephrotic syndrome Ix
``` renal biopsy urine dipstick CXR/USS serum albumin low serum creatinine, eGFR, lipids, glucose tests for underlying cause ```
33
Nephrotic syndrome Mx
Tx cause reduce oedema - diuretics, fluid and salt restriction reduce proteinuria - ACEi/ARB Reduce cx risk - warfarin, simvastatin
34
Nephrotic syndrome Cx
susceptible to infection thromboembolism hyperlipidaemia
35
Renal cell carcinoma
Kidney cancer, arises from PCT epithelium may spread (renal vein, via lymph, bone, liver, lung)
36
RCC RFs
smoking, obesity, HTN, renal failure, PKD, FHx
37
RCC Px
often asym ``` signs abdo mass varicocele - invasion of left renal vein, compression of left testicular vein polycythaemia - EPO production HTN - from renin secretion by tumour Iron deficient anaemia - from haematuria fever ``` symptoms haematuria loin/left flank pain wt loss
38
RCC Ix
USS, CT chest abdo, MRI Bloods - polycythaemia/anaemia, ESR raised, abnormal liver biochem Renal biopsy Bone scan if signs, or serum Ca raised
39
RCC Mx
Localised - surgery - nephrectomy, ablative (cryoablation, radiotherapy) Metastatic - immunotherapy, molecular therapy
40
Bladder cancer
type of transitional cell carcinoma can spread to pelvic structures, lymph nodes, liver, lungs
41
Bladder cancer Px
painless haematuria recurrent UTIs void irritability
42
Bladder cancer Ix
cystoscopy (bladder endoscopy), biopsy Urine microscopy - sterile pyuria CT/MRI/ image lymph nodes
43
Bladder cancer Mx
surgical resection, chemo cystectomy (bladder removal) chemo and radio
44
Prostate cancer
most are adenocarcinomas arising from peripheral zone can spread to seminal vesicles, bladder, rectum, via lymph, bone, brain, liver, lung A hormone-sensitive malignancy (testosterone)
45
Prostate cancer Px
``` LUTS nocturia hesitancy poor stream terminal dribbling obstruction wt loss, bone pain, anaemia ```
46
Prostate cancer DDx
BPH, prostatitis, bladder tumours
47
Prostate cancer Ix
DRE - hard, irregular prostate Raised PSA Trans-rectal ultrasound scan (TRUSS), biopsy Urine biomarkers, MRI
48
Prostate cancer Mx
no spread prostatectomy, radiotherapy, hormone therapy metastatic orchidectomy LHRH agonist - goserelin/leuprorelin Androgen receptor blockers - bicalutamide for symptoms - analgesia, tx metastases, radiotherapy
49
Testicular tumours
tumour of testes mostly from germ cells - seminomas, teratomas
50
Testicular tumour RFs
undescended testes, infant hernia, infertility, FHx
51
Testicular tumours Px
signs hydrocele abdo mass ``` symptoms painless lump in testicle testicular pain/abdo pain cough, SOB - lung metastases back pain - para-aortic lymph node metastases ```
52
Testicular tumour DDx
testicular torsion, lymphoma, hydrocele, epididymal cyst
53
Testicular tumour Ix
USS biopsy, histology Serum tumour markers - alpha-fetoprotein, b-hCG CXR, CT - staging
54
Testicular tumour Mx
Orchidectomy Radiotherapy Chemo offer sperm storage
55
UTIs
inflammatory response of urothelium to bacterial invasion - associated with bacteriuria, pyuria ``` 5 pathogens in primary care - KEEPS Klebsiella E coli Enterococci Proteus spp Staph (coagulase -ve) (broader range in hospital/catheterised) ``` Upper tract - pyelonephritis Lower tract - cystitis, prostatitis, epididymo-orchitis, urethritis Uncomplicated - normal renal tract structure, function Complicated - structural/functional abnormality, eg stones, obstruction ``` RFs female - shorter urethra sex pregnancy, menopause catheter tract obstruction - urine stasis ```
56
Pyelonephritis
infection of renal parenchyma and soft tissues of renal pelvis and upper ureter E coli commonly
57
Pyelonephritis Px
loin pain fever pyuria oliguria if causes AKI bacteriuria rigors headache, malaise, N+V
58
Pyelonephritis Ix
Urine dipstick - foul smelling, cloudy - nitrites, leucocytes, protein Mid-stream urine sample - MC&S Bloods - WCC elevated, CRP, ESR USS - ?calculi, obstruction
59
Pyelonephritis Mx
Rest, fluids, analgesia ABs - oral ciprofloxacin/co-amoxiclav severe - IV gentamicin/IV co-amoxiclav Surgery - drain abscesses, relieve calculi
60
Cystitis
urinary infection of bladder E coli commonly
61
Cystitis Px
signs offensive smelling/cloudy urine abdo/loin tenderness ``` symptoms dysuria frequency urgency suprapubic pain haematuria ```
62
Cystitis Ix
Mid-stream urine sample Dipstick urinalysis - positive leucocytes, blood nitrites Cystoscopy to exclude cancer
63
Cystitis Mx
ABs trimethroprim/cefalexin ciprofloxacin/co-amoxiclav
64
Prostatitis
infection or inflammation of the prostate gland Acute - strep faecalis, E coli, chlamydia Chronic - bacterial/non-bacterial
65
Prostatitis Px
``` acute systemic unwellness fever, rigors, malaise pain on ejaculation voiding LUTS - poor stream, hesitancy, incomplete emptying, terminal dribbling, straining, dysuria pelvic pain ``` chronic acute for >3 months recurrent UTIs pelvic pain
66
Prostatitis Ix
DRE - tender, hot to touch, hard from calcification Urine dipstick - leucocytes, nitrites Mid-stream MC&S STI screen TRUSS - transurethral USS
67
Prostatitis Mx
``` acute IV gentamicin, IV co-amoxiclav 2-4wks ciprofloxacin 2nd line - trimethroprim TRUSS guided abscess drainage if needed ``` chronic 4-6 wks ciprofloxacin tamsulosin NSAIDs, ibuprofen
68
Urethritis
urethral inflammation due to infectious/non-infectious cause Primarily a sexually acquired disease
69
Urethritis causes
N.gonorrhoea Chlamydia (most common) Trichomonas vaginalis Trauma, stricture, irritation, urinary calculi
70
Urethritis Px
may be asym signs skin lesions ``` symptoms dysuria +/- discharge, blood/pus urethral pain penile discomfort systemic symptoms ```
71
Urethritis Ix
NAAT (nucleic acid amplification test) female - vaginal swab, endocervical swab, first void urine Male - first void urine Microscopy of genital secretions Blood cultures Urine dipstick, urethral smear
72
Urethritis Mx
chlamydia oral azithromycin, or 1wk oral doxycycline pregnant - oral erythromycin / oral azithromycin gonorrhoea IM ceftriaxone, oral azithromycin patient education, contact tracing
73
Epididymal cyst
Smooth, extratesticular, spherical cyst in head of epididymis Lies above, behind testis, contains clear and milky fluid ``` Px lump, often multiple, maybe bilateral painful once large well defined, will transluminate (since fluid filled) testes palpable separate to cyst ``` DDx spermatocele - fluid and sperm filled cyst in epididymis hydrocele - fluid collection surrounds whole testis varicocele Ix scrotal USS Mx surgical excision if painful
74
Hydrocele
abnormal collection of fluid in tunica vaginalis Primary /secondary Px scrotal enlargement - non-tender, smooth, cystic swelling not usually painful unless infected testis palpable within cyst lies anterior, below testis, will transluminate Ix USS serum alpha-fetoprotein and hCG to exclude cancer Mx resolve spontaneously therapeutic aspiration, surgical removal
75
Varicocele
abnormal dilation of testicular veins in pampiniform venous plexus, caused by venous reflux (lack of effective valves, increased reflux from compression of renal vein) left side more commonly affected - angle at which left testicular vein enters left renal vein Px distended scrotal blood vessels dull ache, scrotal heaviness scrotum hangs lower on that side DDx secondary to other pathological processes blocking testicular vein, eg kidney tumours, retroperitoneal tumours Ix venography, colour doppler USS Mx surgery if pain, infertility, testicular atrophy
76
Polycystic kidney disease
multiple cysts develop in kidney -> renal enlargement, kidney tissue destruction loss of function - mechanical compression, apoptosis of healthy tissue, reactive fibrosis autosomal dominant/recessive
77
PKD Px
``` signs bilateral kidney enlargement HTN renal stones (uric acid) progressive renal failure ``` ``` symptoms loin pain haematuria renal colic due to clots excessive water and salt loss nocturia ``` extrarenal SAH, polycystic liver disease, pancreatitis, ovarian cysts
78
PKD DDx
acquired, simple kidney cysts, dominant/recessive, medullary sponge kidney
79
PKD Ix
USS Genetic testing
80
PKD Mx
BP control Treat stones, give analgesia Laparoscopic removal of cysts / nephrectomy (whole kidney) RRT for ESRF screen family, counselling
81
Renal calculi
renal stones - crystal aggregates, form in CDs
82
Renal calculi patho
classically get stuck: - pelviureteric junction - pelvic brim - vesicoureteric junction stones form when solute conc exceeds saturation obstruction -> hydronephrosis - obstruction and dilation of renal pelvis stone types - calcium oxalate (75%) - magnesium ammonium phosphate - also urate, hydroxyapatite, cystine, others
83
Renal calculi causes
hypercalciuria high PTH, excessive diet Ca intake, renal disease (eg PKD) hyperoxaluria high diet intake, low dietary Ca, increased intestinal absorption due to GI disease, eg Crohn's uric acid stones hyperuricaemia, dehydration, ileostomies infection induced stones usually UTI - Ca/Mg mixed cystine stones from cystinuria - genetic condition
84
Renal calculi RFs
``` anatomical abnormalities, eg duplex, obstruction dehydration infection hypercalcaemia, hyperoxaluria, hypercalciuria, hyperuricaemia renal disease drugs diet gout FHx ```
85
Renal calculi Px
signs pain - loin to groin, in waves (ureter peristalsis), rapid onset, spasmodic dysuria/anuria, strangury (burning when peeing), frequency haematuria infection proteinuria sterile pyuria symptoms N+V
86
Renal calculi DDx
vascular damage, bowel pathology, ectopic pregnancy, ovarian cyst torsion
87
Renal calculi Ix
Urine dipstick - haematuria Mid-stream specimen to MC&S KUBXR - kidney, ureter, bladder x ray NCCT-KUB - non-contrast CT USS
88
Renal calculi Mx
``` Analgesic for renal colic - diclofenac IV fluids ABs - IV cefuroxime, gentamicin Antiemetics Oral nifedipine (CCB) or oral tamsulosin ``` Surgical extracorporeal shockwave lithotripsy (ESWL) Endoscopy with YAG laser Percutaneous nephrolithotomy (PCNL) - keyhole surgery
89
Renal calculi Cx
hydronephrosis, blockage of urinary flow, renal damage, infection
90
Testicular torsion
twisting of spermatic cord perhaps after sport ``` Px inflammation of one testis - tender, hot, swollen sudden onset pain in one testis abdo pain N+V ``` DDx epididymo-orchitis, tumour, trauma, hydrocele Ix doppler USS, urinalysis to rule out infection Mx surgery - bilateral fixation of testes Cx infertility, infection, infarction of testes

Phase 2a Concise (9 decks)

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