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Renal & urology Flashcards

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1
Q

Epididymal cyst characteristics: get above? separate/testicular, solid/cystic, transilluminable

A

Can get above
Separate
Cystic
Transilluminable

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2
Q

Hydrocele characteristics: get above? separate/testicular, solid/cystic, transilluminable

A

Can get above (usually)
Testicular
Cystic
Transilluminable

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3
Q

Varicocele characteristics: get above? separate/testicular, solid/cystic, transilluminable

A

“Bag of worms”

Can get above
Separate
Solid
Not transilluminable

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4
Q

Inguinal hernia: get above? separate/testicular, solid/cystic, transilluminable

A

Cannot get above
Separate
Solid
Not transilluminable

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5
Q

Epididymitis: get above? separate/testicular, solid/cystic, transilluminable

A

Can get above
Separate
Solid
Not transilluminable

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6
Q

Orchitis: get above? separate/testicular, solid/cystic, transilluminable

A

Can get above
Testicular
Solid
Not transilluminable

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7
Q

Testicular tumour: get above? separate/testicular, solid/cystic, transilluminable

A

Can get above
Testicular
Solid
Not transilluminable

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8
Q

Most common renal stone

A

Calcium oxalate

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9
Q

Best investigation for renal stones

A

NC CTKUB

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10
Q

Medication to prevent calcium stones

A

Thiazide diuretics

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11
Q

Medication to prevent oxalate stones

A

Cholestyramine and pyridoxine – reduce oxalate secretion

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12
Q

Medication to prevent uric acid stones

A

Allopurinol

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13
Q

Management of complex renal calculi

A

Percutaneous nephrolithotomy

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14
Q

Which type of renal stone is radiolucent?

A

Uric acid stones

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15
Q

NICE AKI diagnostic criteria

A

1 of:
Rise in creatinine of ≥ 26µmol/L in 48 hours
≥ 50% rise in creatinine over 7 days
Fall in urine output to less than 0.5ml/kg/hour for more than 6 hours in adults (8 hours in children)

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16
Q

CKD stages according to GFR

A

1: > 90
2: 60-90
3a: 45-60
3b: 30-45
4: 15- 30
5: < 15

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17
Q

Pre-renal causes of AKI

A

Hypovolaemia secondary to diarrhoea/vomiting
Renal artery stenosis

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18
Q

Intrinsic causes of AKI

A

Glomerulonephritis
Acute tubular necrosis (ATN)
Acute interstitial nephritis (AIN)
Rhabdomyolysis
Tumour lysis syndrome

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19
Q

Post-renal causes of AKI

A

Kidney stone in ureter or bladder
Benign prostatic hyperplasia
External compression of the ureter

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20
Q

Examples of nephrotoxic drugs

A

NSAIDs
ACE-I
ARB
Loop diuretics

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21
Q

Examples of drugs which worsen AKI

A

Metformin
Digoxin
Lithium

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22
Q

RIFLE system

A

Categorising AKI

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23
Q

AKI management

A

Calcium gluconate for hyperkalaemia

Prerenal: fluids
Intrinsic: specialist treatment
Postrenal: catheter

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24
Q

Presence of eosinophilia in AKI

A

Acute interstitial nephritis

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25
Acute tubular necrosis urine microscopy findings
Muddy, brown casts
26
Management of hyperkalaemia in AKI
Calcium gluconate - protect myocardium Insulin & dextrose - shift K+ intracellularly / Loop diuretics - remove K+ from body
27
Why are ACE inhibitors can be given in CKD but not AKI?
In CKD, filtration pressure is reduced by ACEi – minimise loss of blood components AKI, filtration further impaired as GFR is falling. CKD – filtration is already fucked
28
3 complications of CKD
Renal osteodystrophy Anaemia Oedema
29
Medications used to maintain BP in CKD
ACEi / ARBs
30
Management of mineral bone disease in CKD
1: Low phosphate diet 2: Phosphate binders: sevelamer 3: Vitamin D: calcitriol 4: Parathyroidectomy
31
Kidney size in CKD
Small
32
Electrolyte abnormalities seen in CKD
Hypocalcaemia due to raised PTH
33
Complications seen in CKD
Anaemia Oedema Hypertension Proteinuria Mineral bone disease
34
Benign prostatic hyperplasia symptoms
LUTS: voiding, dribbling, incomplete empting, hesistancy
35
Benign prostatic hyperplasia investigations
DRE - smooth, enlarged prostate PSA
36
Benign prostatic hyperplasia management
1) Tamsulosin (alpha 1 blocker) 2) Finasteride (5 alpha reductase inhibitor)
37
Prostate cancer management options
Localised: radical prostatectomy Advanced: zoladex (GnRH agonist)
38
Most common type of prostate cancer
Adenocarcinoma
39
Varicocele pathophysiology
Abnormal enlargement of testicular veins
40
Hydrocele pathophysiology
Fluid in tunica vaginalis
41
Testicular torsion clinical features
Unilateral, swollen, tender testicle Prehn's sign -ve Absent cremaster reflex
42
Testicular torsion management
Surgical detorsion - do not await imaging
43
Epididymitis clinical features
Acute, unilateral pain Prehn's sign +ve
44
Epididymitis management
Urine NAAT for causative organism < 35 IM Ceftriaxone + doxycycline (assuming STI) >35 – ciprofloxacin
45
Testicular cancer clinical features
Painless lump, non-transilluminable Possible lung metastasis Gynaecomastia
46
Why is biopsy contraindicated in testicular cancer?
Risk of seeding into scrotum
47
Testicular cancer tumour markers
Seminoma - b-HCG Teratoma - AFP
48
Testicular cancer risk factors
Undescended testes Family history
49
Most common testicular cancer
Seminoma
50
Testicular cancer management
Orchidectomy Offer sperm banking
51
Nephritic syndrome causes
SLE Post strep GN Small vessel vasculitis Goodpasture's/anti-GMB disease IgA nephropathy
52
Nephritic syndrome investigations
Diagnostic: Kidney biopsy Urinalysis: Hematuria Bloods: increased ESR and CRP, sometimes anaemia
53
Nephritic syndrome management
BP control: ACE-I/ARB - to reduce proteinuria and preserves renal function Corticosteroids
54
Management of Goodpasture's disease
Plasma exchange, steroids + cyclophosphamide
55
Presentation of Goodpasture's disease
SOB Oliguria
56
Most common cause of nephritic syndrome
IgA nephropathy
57
Management of nephrotic syndrome
Fluid and salt restriction Loop diuretics- to manage oedema Treat cause ACE-I/ARB to reduce protein loss Manage complications
58
Causes of nephrotic syndrome
Minimal change disease (most common in children) Focal segmental glomerulosclerosis Membranous nephropathy (most common in adults)
59
Which cause of nephrotic syndrome is associated with malignancy?
Membranous nephropathy
60
Causes of focal segmental glomerulosclerosis
Idiopathic HIV Heroin Lithium
61
Diagnosis of minimal change disease
Normal appearance on microscopy
62
Bladder cancer investigations
Urine cytology to rule out infection – bloods, urine sample Best: Flexible cystoscopy + biopsy CTT urogram for staging
63
Bladder cancer management
T1: TURBT – transurethral resection of bladder tumour Followed by chemotherapy via catheter - intravesical chemotherapy – CISPLASTIN T2-3: radical cystectomy T4: palliative chemo + radiotherapy
64
Bladder cancer risk factors
Phenacetin – banned analgesic Smoking – #1 risk factor Analine – rubbers & dyes (PAINTERS, HAIRDRESSERS) – aromatic amines! Alcohol abuse Cyclophosphamide – medication to treat cancers & autoimmune disorders
65
What is the greatest risk factor for bladder cancer?
Smoking
66
Bladder cancer symptoms
Painless haematuria Suprapubic, pelvic mass Frequency, urgency
67
Most common type of bladder cancer
Transitional cell carcinoma
68
Schistosomiasis bladder cancer association
Squamous cell carcinoma
69
Renal cancer symptom triad
Haematuria Flank pain Palpable abdominal mass
70
Renal cancer investigations
Bloods: polycythaemia from erythropoietin secretion Raised BP: due to renin secretion Ultrasound CT/MRI CXR- shows cannon ball mets
71
Renal cancer risk factors
Haemodialysis Smoking Hypertension
72
Renal cancer staging + management
Stage I: partial or radical nephrectomy Stage II: radical nephrectomy Stage III: radical nephrectomy and adrenalectomy Stage IV: systemic treatment
73
Renal cancer metastatic sites
Bone Liver Lungs
74
Renal cancer most common site of origin
90% proximal tubular epithelium
75
UTI most common causative organisms
KEEPS: Klebsiella E coli- most common causing >50% of cases Enterococci Proteus Staphylococcus coagulase negative
76
Pyelonephritis presentation
Loin pain Fever Pyuria
77
Antibiotics for UTI
3 days 1st: Nitrofurantoin/Trimethoprim 2nd: Pivmecillinam
78
Indications for 7 days antibiotics for UTI in adults
Male Pregnancy
79
Antibiotic management for prostatitis
Ciprofloxacin or levofloxacin for 14 days
80
Antibiotic management for pyelonephritis
Empirical 1st: Cefalexin/Ciprofloxacin

Medicine (13 decks)

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