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Flashcards in Urinary Pathology Deck (59):
1

Define Acute Kidney Injury.

EITHER
- increased serum creatinine >/= 26.5um within 48hrs
OR
- serum creatinine > 1.5 x baseline within the last 7 days
OR
- urine volume 0.5ml/kg/hr for 6hrs

2

List causes of AKI.

Pre-renal
- falling renal blood flow leading to decreased GFR
- low cardiac output, hypovolaemia and hypotension due to heart failure
Renal
- acute tubular necrosis
- glomerulonephritis
- myeloma
- injection of IV contrast
- Drug toxicity
Post-renal
- kidney stones
- strictures
- fibrosis
- prostatic disease
- cancer

3

List the symptoms of AKI.

- anorexia
- nausea
- vomiting
- puritis
- confusion
- drowsiness
- reduced urine output
- hyperkalaemia
- metabolic acidosis

4

What investigations would you carry out into AKI?

- ultrasound
- urinalysis
- catheterisation
- assess fluid levels

5

Who would you treat AKI?

- BP control
- IV fluids
- stop precipitating drugs
- treat complications

6

Define Chronic Kidney Disease.

- presence of kidney damage
OR
- GFR <60ml/min/1.73^2 present >3 months

7

List causes of CKI.

- polycystic kidney disease
- renovascular disease
- multiple myeloma of the kidney
- TB
- urinary tract obstruction
- hypertension
- diabetes

8

List symptoms of CKI.

- early stages are often asymptomatic
- malaise
- lethargy
- loss of appetite
- weight loss
- insomnia
- nocturia
- nausea
- vomiting
- diarrhoea
- mental slowing
- scratch marks

9

What investigations would you carry out into CKI?

- urinalysis
- urine microscopy
- U&Es
- ultrasound
- CT
- MRI

10

How would you treat CKI?

- BP control
- treat underlying cause

11

Define Minimal Change Disease.

- glomerular disease in which he glomeruli appear to be undamaged on light microscopy, however hey are damaged on electron microscopy

12

List symptoms of minimal change disease.

- usually affects male children
- very high facial oedema
- proteinuria
- hyperlipidemia

13

What investigations would you carry out into minimal change disease?

- MSSU
- renal biopsy
- ?culture

14

Who would you treat minimal change disease?

- high dose corticosteriods

15

Define IgA Glomerulonephritis.

- IgA present in mesangium causes focal and segmental glomerulonephritis

16

List symptoms of IgA glomerulonephritis.

- usually affects children and young males
- haematuria
- proteinuria

17

What investigations would you carry out into IgA glomerulonephritis.

- renal culture
- MSSU
- cystoscopy
- renal biopsy

18

How would you treat IgA glomerulonephritis?

- ACEinhibitors
- steroids

19

Define Membranous Nephropathy.

- increased basement membrane of glomerular capillary means IgG becomes stuck, causing holes and allowing albumin through

20

Give two symptoms of menbranous nephropathy.

- oedema
- anaemia

21

What investigations would you do into membranous nephropathy?

- renal biopsy
- MSSU
- U&Es

22

How would you treat membranous nephropathy?

- ACEinhibitors
- cyclophosphamide
- steroids

23

Define Post-Infective Glomerulonephritis.

- glomerulonephritis 2-3 weeks after sore throat or ear infection

24

Give symptoms of post-infective glomerulonephritis.

- oedema
- anaemia
- proteinuria
- haematuria

25

What investigations would you carry out into post-infective glomerulonephritis?

- renal biposy
- MSSU
- U&Es
- FBC
- renal culture

26

How would you treat post-infective glomerulonephritis?

- BP control
- diuretics
- salt restriction
- corticosteroids
- dialysis

27

Define Goodpasture's Syndrome.

- anti-GBM antibodies are directed against the collegen of the basement membrane, causing problems with filtration

28

Lists symptoms of Goodpasture's syndrome.

- proteinuria
- malaise
- weight loss
- chills
- joint pain
- haematuria
- oedema

29

What investigations would you carry out into Goodpasture's syndrome?

- MSSU
- renal biopsy
- U&Es

30

How would you treat Goodpasture's syndrome?

- plasma exchange to remove circulating anti-GBM antibodies
- steroids

31

Define Benign Prostatic Enlargement.

- increased prostate size without any malignancy

32

List symptoms of Benign Prostatic Enlargement.

- increased frequency of urination
- nocturia
- difficulties initiating stream
- urinary retention
- incontinence

33

What investigations would you carry out into benign prostatic enlargement.

- digital rectal examination
- urine culture
- prostate-specific antigen
- renal function test
- ultrasound

34

How would you treat benign prostatic enlargement?

- alpha-blockers
- 5-alpha reductase inhibitors
- surgery

35

Define Acute Urinary Retention.

- painful inability to void with a palpable and precussable bladder

36

List causes of acute urinary retention.

- benign prostatic hyperplasia
- pelvic nerve damage

37

Define Chronic Urinary Retention.

- painless, palpable and precussable bladder after voiding

38

How would you treat chronic urinary retention?

- catherterisation

39

Define Diabetic Nephropathy.

- glomerulonephritis as a result of the complications of diabetes

40

List symptoms of diabetic nephropathy.

- nocturia
- lethargy
- headaches
- malaise
- polyuria
- oedema

41

What investigations would you carry out into diabetic nephropathy?

- glycaemic control
- BP control
- ACE inhibitors

42

Define Transitional Cell Carcinoma.

- carcinoma of the urothelium that lines the bladder walls and lumen wall

43

List symptoms of transitional cell carcinoma.

- painless, visible haematuria
- recurrent UTI
- dysuria
- change in frequency
- nocturia
- increased urgency
- bladder pain

44

What investigations would you carry out into transition cell carcinoma?

- urine culture, cystoscopy, biopsy, CT urogram, ultrasound, U&Es, urine dipstick

45

How would you treat transitional cell carcinoma?

- resection
- chemotherapy
- radiotherapy

46

List symptoms of renal cell carcinoma.

- haematuria
- loin/flank pain
- mass in flank
- malaise
- anorexia
- weight loss

47

What investigations would you carry out into renal cell carcinoma?

- ultrasounds
- CT
- MRI
- DO NOT biopsy as kidney is highly vascular

48

How would you treat renal cell carcinoma?

- surgery
- chemotherapy

49

Define nephrolithasis.

- formation of kidney stones that obstruct the ureters and prevent the flow of urine into the bladder

50

List causes of nephrolithasis.

- hypercalcaemia
- dehydration
- hypercaluria
- infection

51

List symptoms of nephrolithasis.

- flank pain, radiating down gonads
- constant or intermittant
- haematuria
- UTI

52

What investigations would you carry out into nephrolithasis?

- urine dipstick
- eGFR
- calcium levels
- CT

53

How would you treat nephrolithasis?

- extracoporeal shockwave therapy
- surgery

54

List symptoms of prostate cancer.

- patients only symptomatic if local invasion
- haematuria
- terminal dribbling
- increased frequency
- increased time to void
- increased time to initiate voiding

55

What investigations would you carry out into prostate cancer?

- opportunistic PSA testing
- digital rectal examination
- ultrasound
- biopsy

56

How would you treat prostate cancer?

- surgery
- chemotherapy
- androgen-receptor blockers

57

List symptoms of testicular cancer.

- most commonly men 15-35
- painful testicular mass
- metastasis to para-aortic lymph nodes
- gynacomastia

58

What investigations would you carry out into testicular cancer?

- ultrasound
- MRI
- assay of serum tumour markers
- CT

59

How would you treat testicular cancer?

- rapid surgery
- chemotherapy
- lymph node dissection