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Phase 2a > Renal/ Urology > Flashcards

Renal/ Urology Flashcards

(66 cards)

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1
Q

What are the lower urinary tract symptoms?

A

STORAGE:
- frequency
- urgency
- nocturne
- incontinence

VOIDING:
- poor flow
- intermittency
- straining
- terminal dribbling
- hesitancy

POST MICTURITION:
- sense of incomplete voiding
- post-micturition dribbling

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2
Q

Why do people typically get lower urinary tract storage symptoms?

A

overactive bladder
improper emptying

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3
Q

What is the difference between terminal dribbling and post-micturition dribbling?

A

terminal dribbling occurs while still on toilet when patient thinks they are done, post-micturition is usually having urinated in underwear after patient left bathroom

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4
Q

What is an atonic bladder?

A

bladder doesn’t contract and relax

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5
Q

What are the types of incontinence?

A

stress
urge
mixed

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6
Q

Who typically gets stress incontinence? Why?

A

pregnant women after vaginal delivery
due to damage of pelvic floor muscles

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7
Q

What is urge incontinence?

A

when you get the sudden urge to urinate and cannot get to the toilet in time

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8
Q

What are the risk factors for renal cell carcinoma?

A

smoking
obesity
genetic

hypertension
dialysis

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9
Q

What are two genetic syndromes that cause kidney cancer?

A

von hippel lindau
tuberous sclerosis

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10
Q

Why do you try and preserve a kidney with a tumour instead of removing it?

A

Patients with cancer on the kidney are much more likely to also get cancer in the other kidney, so if you remove the first kidney then you only have one left which could also become cancerous

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11
Q

Why would a tumour cause a varicocele?

A
  • right testicular vein drains into vena cava
  • left testicular vein drains into left renal vein
  • testicular vein occluded by tumour leads to a varicocele- usually in the left testicle
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12
Q

What is a varicocele?

A

a mass of varicose veins in the scrotum

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13
Q

What is the gold standard treatment for kidney cancer?

A

partial nephrectomy
open or robotic

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14
Q

What are the noncancerous causes of haematuria?

A

stones
infections
prostate- cancer or benign enlargement
nephrological causes
no cause found

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15
Q

What is GFR?

A

glomerular filtration rate

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16
Q

What is the normal range for GFR?

A

90 to 120 mL/min/1.73 m2

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17
Q

How does GFR change with age?

A

GFR decreased with age

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18
Q

What is CKD?

A

chronic kidney disease

abnormalities of kidney structure or function which lasts longer than 3 months and has implications on health

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19
Q

What is classed as CKD in terms of GFR?

A

either:

  • GFR < 60ml/min/1.73m2

OR

  • GFR < 90ml/min/1.73m2 + one of:
    albuminurea/ proteinurea
    urine sediment abnormalities (e.g. haematuria)
    electrolyte abnormalities due to tubular disorders
    abnormalities detected by histology
    structural abnormalities detected by imaging
    history of kidney transplantation
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20
Q

What are the causes of CKD?

A

diabetes
hypertension
glomerulonephritis
congenital causes
persistant pyelonephritis
obstruction
nephrotoxic drugs

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21
Q

Which drugs are nephrotoxic?

A

NSAIDS
ACEIs
antidepressants
many antibiotics

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22
Q

How do we categorise UTIs

A

lower tract
upper tract

OR

asymptomatic bacteriruia
complicated
uncomplicated

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23
Q

What is pyuria?

A

white cells/ leukocytes in urine

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24
Q

What is bacteriuria?

A

bacteria in the urine

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25
What is an uncomplicated UTI?
UTI in non pregnant woman
26
What is a complicated UTI?
Any UTI except for those in non pregnant women
27
What is a way to make UTIs less likely for a man?
circumcision
28
What is the main cause of UTI?
E. coli >50% of cases
29
What pathogens can cause UTI?
e.coli proteus klebsiella enterococci staph. saprophyticus s.aureus pseudomonas aeruginosa
30
What type of UTI is most associated with catheterisation?
klebsiella
31
What type of patient is associated with proteus UTI?
patients with renal stones
32
What type of patients get staph.saprophyticus UTIs?
young women
33
What are the causes of UTI?
bladder stones/ tumour ureteric stones obstruction from BPH catheterisation bowel flora (in women, shower urethra) e.coli from bladder colonisation stasis in ureter during pregnancy
34
What are the symptoms of a lower UTI?
dysuria (painful urination) increased frequency
35
What are the symptoms of an upper UTI?
haematuria fever patients more systemically unwell in an upper UTI
36
How do we diagnose a UTI?
urine dipstick with microscopy and culture
37
What does a urine dipstick measure?
leukocytes nitrates blood protein pH glucose ketones
38
What will the urine dipstick show in a UTI?
will show leukocytes and nitrates plus other substances depending on cause of UTI
39
What is an early morning urine sample used for?
used to look for TB, allows bacilli to build up overnight
40
What does urine microscopy pick up?
WBCs RBCs casts bacteria epithelium cells
41
What does epithelial cells on urine microscopy mean?
indicates a poorly taken sample
42
How do we treat asymptomatic bacteriuria?
if >65 then do not treat they don't cause harm and is exposure to antibiotics for no reason
43
How does treatment for uncomplicated and complicated UTIs differ?
uncomplicated: 3 days course of antibiotics complicated: always send sample for culture longer antibiotic course of 7 days
44
What antibiotics are used to treat UTIs?
avoid broad spectrum antibiotics NITROFURANTOIN trimethoprim pivemcillinam fosfomycin cefalexin amoxicillin
45
Why can we not prescribe nitrofurantoin to pregnant women in their 3rd trimester?
can cause fetal jaundice
46
In which people should we treat asymptomatic bacteriuria? Why?
pregnant women because 20-40% of pregnant women with untreated asymptomatic bacteriuria will develop pyelonephritis
47
What are the symptoms of pyelonephritis?
loin pain fever pyuria
48
What is pyelonephritis?
kidney infection
49
Where in the urinary tract do you typically get stones?
renal, ureteric, bladder
50
What are kidney stones made from?
can be: calcium oxalate/ phosphate (80%) uric acid struvite (infection stones) cystine (congenital)
51
How can we prevent kidney stones?
overhydration low salt diet normal dairy intake healthy protein intake reduce BMI active lifestyle
52
What are the symptoms of kidney stones?
loin pain renal colic UTI symptoms recurrent UTIs haematuria
53
What is a KUBXR?
kidney ureter bladder x-ray
54
What is the target 24 hour urine output be for a 70kg adult patient?
840-2520ml
55
What is the target urine output for an adult?
0.5-1.5ml/kg/hr
56
What time of renal injury does naproxen cause?
naproxen is an NSAID interstitial renal injury
57
How does NSAIDS damage the kidney?
NSAIDS decrease prostaglandins which results in unopposed constriction of afferent arterioles
58
Which zone of the prostate is most commonly affected by cancer?
peripheral zone
59
What is the most common site of metastases for prostate cancer?
bone
60
What cellular changes occur in BPH?
hyperproliferation of epithelial and stromal cells in the transition zone of the prostate gland
61
Describe the venous drainage of the left testicle.
pampiniform plexus lest testicular vein left renal vein IVC
62
Which organism is associated with both UTI and renal stones?
proteus
63
What are the typical findings on urinalysis with nephrotic syndrome?
proteinuria and frothy appearance
64
What is the most common cause of nephrotic syndrome in children in the UK?
minimal change disease
65
How does minimal change disease present in children?
oedema everywhere
66
Which ion do loop diuretics inhibit and by what mechanism?
sodium by inhibiting the Na2ClK symporter in the thick ascending loop of henle

Phase 2a (18 decks)

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