- Anaemia - Hypertension - SOB (fluid overload, cardiomyopathies etc.) - Cognitive impairment - Anorexia - Nausea and vomiting - Oliguria - Nocturia - Haematuria/proteinuria - Peripheral oedema - Itches and cramps

Renal & Urology Flashcards by Toni Paton

How is CKD classified?

Stage 1: >90 eGFR
Stage 2: 60-89
Stage 3a (moderately impaired): 45-59
-Stage 3b (moderately impaired): 30-44
-Stage 4 (severely impaired): 15-29
-Stage 5 (advanced/on dialysis): <15

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How is kidney disease investigated?

FBC, U&Es, LFTs, CK and coag
eGFR
Urinalysis (blood or protein)
Urine PCR/ACR
Histology
Imaging (USS

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Name some of the causes of CKD

Diabetes
Glomerulonephritis
Hypertension
Renovascular disease
Polycystic kidney disease

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How can CKD present?

Anaemia
Hypertension
SOB (fluid overload, cardiomyopathies etc.)
Cognitive impairment
Anorexia
Nausea and vomiting
Oliguria
Nocturia
Haematuria/proteinuria
Peripheral oedema
Itches and cramps

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How can CKD be managed?

Treatment of underlying disease
Slowing the rate of renal decline
Prevention and treatment of complications
Preparation for renal replacement therapy

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Name some of the complications of CKD

Acidosis
Anaemia
Bone disease
CV risk
Electrolytes
Fluid overload
Gout
Hypertension
Iatrogenic issues

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Name the risk factors for prostate cancer

Age
Race/ethnicity (Afro-Caribbean
Family history

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How does prostate cancer present?

Mostly asymptomatic (diagnosed through opportunistic PSA testing)
Urinary symptoms: weak stream, hesitancy, incomplete emptying, frequency, urgency, urge incontinence, UTI, haematuria
Perineal/suprapubic/loin pain
Renal failure
Haemospermia
Tenesmus
Impotence

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How is prostate cancer diagnosed?

PSA
PR exam
TRUS guided prostate biopsies

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How can localised prostate cancer be managed?

Watchful waiting
Radiotherapy
Radical prostatectomy

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How can locally advance prostate cancer be managed?

Hormone therapy +/- surgery or radiotherapy

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Name the types of hormonal therapy for prostate cancer

Surgical castration
Chemical castration
Anti-androgens
Oestrogens

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How does testicular present?

Painless lump
Tender inflammed swelling
History of trauma

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Name the tumour markers used for testicular cancer

AFP (teratoma)
HCG (seminoma)
LDH (tumour burden)

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How can testicular cancer be diagnosed?

MSSU
USS
CXR
Tumour markers

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How can testicular cancer be managed?

-Radical orchidectomy

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What is the most common type of testicular cancer?

Germ cell tumour

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Name the antibiotics of choice for lower UTIs in women

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Trimethroprim 3 days

- Nitrofurantoin

Name the antibiotics of choice for lower UTIs in men

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7 days of trimethroprim or nitrifurantoin

- 14 days of a quinolone (e.g. ciprofloxacin) if possible prostatitis

Which antibiotics can be used for UTIs in pregnancy?

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Nitrofurantoin (not at term)

- Cephalexin

Describe the stages of AKI

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Stage 1: 1.5-2x baseline creatinine

Stage 2: 2-3x baseline creatinine
Stage 3: 3x baseline

How should AKIs be managed?

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S: suspect sepsis
H: hypovolaemia
O: obstruction (bladder scan)
U: urinalysis
T: toxins (med review and avoid nephrotoxics)

How can hyperkalaemia be managed?

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Calcium gluconate
Salbutamol or insulin-dextrose
Dialysis or diuresis

Describe the presentation of a nephritic state

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Urine sediment
Haematuria
Dysmorphic RBCs
Cellular casts
Hypertension
Renal impairment

How does nephrotic syndrome present?

- Oedema - Proteinuria - Hypoalbuminaemia - Hyperlipidaemia

Name the nephrotic type glomerulonephritis

- Minimal change disease | - Membranous nephropathy

Name the nephritic type glomerulonephritis

- Diffuse proliferative - Post-infective - Crescentic GN

How can post-infective GN be managed?

- Loop diuretis | - Vasodilators (amlodipine)

How can crescentic GN be managed?

- Steroids - Plasma exchange - Cytotoxics - B cell therapy - Complement inhibitors

How can nephrotic syndrome be managed?

- Salt and fluid restriction - Loop diuretics - ACEIs - Heparin or warfarin - Statins

How can minimal change disease be managed?

- Prednisolone | - Relapses: cyclosporin, tacrolimus etc.

How can acute urinary retention be managed?

- Catheterisation | - Alpha blocker e.g. alfuzosin

How do urinary tract stones present?

- Renal pain - Ureteric colic (radiates to the groin) - Dysuria - Haematuria - Testicular or vulval pain - UTI - Loin tenderness - Pyrexia

How can urinary tract stones be managed?

- NSAIDs - Paracetamol or opiods - Alpha blockers

How can benign prostatic obstruction be managed?

- Watchful waiting - Alpha blockers - 5 alpha reductase inhibitors - TURP or other resective surgery

What is the most common type of bladder cancer?

Transitional cell carcinoma

How does bladder cancer present?

- Painless visible haematuria - Recurrent UTI - Dysuria, frequency, nocturia, urgency and urge incontinence - Bladder pain

How can bladder cancer be investigated?

- Urine culture - Cystourethroscopy - CT urogram or USS - Cytology - BP and U&Es

How can bladder cancers be managed?

- Endoscopic or radical resection - Chemotherapy - BCG therapy - Radiotherapy

How do upper tract urothelial cancers present?

- Frank haematuria - Unilateral ureteric obstruction - Flank or loin pain

How can upper tract urothelial cancers be managed?

- Nephro-ureterectomy - Endoscopic treatment - Surveillance cystoscopy

How do renal adenocarcinoma present?

- Asymptomatic - Flank pain, mass and haematuria - Paraneoplastic syndrome (anorexia cachexia, pyrexia, hypertension, hypercalcaemia, abnormal LFTs, anaemia, polycythaemia and raised ESR - Metastatic disease

How can renal adenocarcinoma be managed?

- Radical nephrectomy - RCC is radioresistant and chemoresistant - Tyrosine kinase inhibitors - Immunotherapy

Renal & Urology Flashcards

(43 cards)