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BRS > Urological disorders > Flashcards

Urological disorders Flashcards

1
Q

Consequences of kidney dysfunction?

A

Filtration failure. Hypertension (water retention), metabolic acidosis, anaemia, vitamin D deficiency and secondary hyperparathyroidism.

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2
Q

How does kidney dysfunction cause anaemia?

A

Kidneys produces EPO which stimulates production of erythrocytes.

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3
Q

How does kidney dysfunction lead to secondary hyperparathyroidism?

A

Kidneys have enzyme 1 alpha hydroxylase to convert 25(OH)D3 into calcitriol. Calcitriol inhibits PTH release and so without calcitriol you will have high amounts of PTH in blood.

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4
Q

What are signs of filtration failure in kidney dysfunction?

A

Haematuria and proteinuria. Low serum albumin.

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5
Q

What are the 3 classes of kidney disorders?

A

Inflammatory, obstructive and genetic.

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6
Q

What is inflammation of the bladder called?

A

Cystitis.

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7
Q

What is inflammation of the kidney called?

A

Pyelonephritis.

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8
Q

Urine dipstick for UTI?

A

2+ leucocytes, + nitrite, trace of blood

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9
Q

What is the most common pathogen for inflammatory urological disorders?

A

Bacteria.

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10
Q

What pathogens can cause inflammatory urological disorders in immunocompromised patients?

A

Viruses and fungi.

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11
Q

What is the prescription strategy for a urinary tract infection?

A

Antibiotics. Look at most common bacteria in local area and then modify when urine culture results are available.

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12
Q

What is glomerulonephritis?

A

Inflammation of filtering units in kidney.

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13
Q

What other organs would you check for when looking at inflammatory urological disorders?

A

Lungs.

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14
Q

What imaging technique would start off with when looking at inflammatory urological disorders?

A

Ultrasound.

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15
Q

What are the key features of nephritic syndrome?

A

Haematuria, proteinuria.

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16
Q

Urine Dipstick for nephritic syndrome?

A

3+ blood, 2+ protein

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17
Q

Tests for nephritic syndrome and nephrotic syndrome?

A

Urine dipstick, urine microscopy, urine protein : creatinine ratio.

Blood tests : kidney function and immunological tests.

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18
Q

What test would confirm an IgA nephropathy?

A

Kidney biopsy and immunohistochemistry.

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19
Q

What kind of disease is IgA nephropathy?

A

Nephritic syndrome.

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20
Q

What is the first line treatment for nephropathy?

A

ACE inhibitor or angiotensin receptor inhibitor.

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21
Q

What lifestyle advice for nephropathy?

A

Reduce sodium intake.

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22
Q

How does an ACE inhibitor treat nephropathy?

A

Reduces hypertension. Reduce proteinuria by lowering the intraglomerular pressure, reducing hyperfiltration.

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23
Q

In good pasture syndrome what is targeted?

A

Alpha 3 chain of type IV collagen in Glomerular basement membrane and alveolar basement membrane.

24
Q

Autoimmune conditions that can cause nephropathy?

A

Goodpasture’s disease, systemic lupus erythematosus and vasculitis.

25
Q

Autoantibodies for SLE?

A

Antinuclear antibodies and anti double stranded DNA.

26
Q

Autoantibody for vasculitis?

A

Anti-neutrophil cytoplasm antibody.

27
Q

Urine markers for diabetic nephropathy?

A

Microalbuminuria and proteinuria.

28
Q

Treatments for diabetic nephropathy?

A

ACE inhibitor, Angiotensin receptor inhibitor and SGLT2 inhibitor.

29
Q

What histological features in diabetic nephropathy?

A

Thickened glomerular basement membrane. Deposition of extracellular matrix in the glomerulus (fibrotic tissue).

30
Q

Key features of nephrotic syndrome?

A

Peripheral oedema, severe proteinuria, low serum albumin. Low blood pressure.

31
Q

Urine dipstick for nephrotic syndrome?

A

no blood, 4+ protein.

32
Q

Blood test for nephrotic syndrome?

A

Very low serum albumin concentration

33
Q

What is nephrotic syndrome associated with?

A

Hyperlipidaemia.

34
Q

What would the urine protein:creatine ratio be in individuals who have nephritic or nephrotic syndrome?

A

Raised protein:creatinine ratio.

35
Q

Minimal change glomerulopathy is what kind of nephropathy?

A

Nephrotic syndrome.

36
Q

Treatment for nephrotic syndrome?

A

Corticosteroid, cyclophosphamide, tacrolimus. Diuretics. Anticoagulants.

37
Q

How does tacrolimus help treat nephrotic syndrome?

A

Targets B cell pathway.

38
Q

How do diuretics help treat nephrotic syndrome?

A

Reduce oedema.

39
Q

How do anticoagulants help treat nephrotic syndrome?

A

Prevent thrombosis.

40
Q

Who does minimal change glomerulopathy usually affect?

A

Children.

41
Q

What needs to be used in the kidney biopsy of minimal change glomerulopathy?

A

Electron microscope.

42
Q

What is seen in the kidney biopsy of minimal change glomerulopathy when using an electron microscope?

A

Flattened podocyte foot processes.

43
Q

Major complication of minimal change glomerulopathy?

A

Thrombosis.

44
Q

Where can kidney stones be found?

A

Kidney, ureter and bladder.

45
Q

Presentation of kidney stones?

A

Pain in abdomen. Blood in urine.

46
Q

What do kidney stones increase risk of?

A

UTI.

47
Q

How would you check for kidney stones?

A

Physical examination to see if there is tenderness in loin or back area. Dipstick to see if there is blood in urine. Blood tests for kidney function. X ray, ultrasound or CT scan.

48
Q

Treatment for kidney stones?

A

Shockwave lithotripsy, ureteroscopy, percutaneous nephrolithotomy.

49
Q

What is the inheritance pattern of polycystic kidney disease that develops in a neonatal?

A

Autosomal recessive.

50
Q

What is the inheritance pattern of polycystic kidney disease that develops in an adult?

A

Autosomal dominant.

51
Q

Consequence of polycystic kidney disease?

A

Bleeding and infection of the cysts.

52
Q

What medications is used to treat polycystic kidney disease? What kind of drug is it?

A

Tolvaptan - vasopressin receptor 2 antagonist.

53
Q

How does tolvaptan treat polycystic kidney disease?

A

Slows down formation of cysts.

54
Q

What is a horseshoe kidney?

A

Horseshoe kidney happens when the two kidneys are fused.

55
Q

Consequences of horseshoe kidney?

A

Kidneys stones and infection.

56
Q

Causes of kidney stones?

A

Prostate enlargement, gout and dehydration.

BRS (52 decks)

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