Renal & Urology — Flashcards
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The mechanism of Oxybutynin is _____
Carcinoma in situ (CIS) is a _____ of the bladder
Prostate cancer _____ be seen with a normal PSA?
Hint: can/cannot
If there is a mixture of storage and voiding symptoms that persist after treatment with an alpha-blocker along, then a _____ such as tolterodine or darifenacin may be tried
Example of a thiazide diuretic used to manage renal stones and hypercalcuria _____
Avoid testing for PSA within _____ of a UTI or prostatitis
Renal stones measuring _____ will pass spontaneously wthin 4 weeks
_____ occurs commonly after catheterisation for chronic urinary retention due to rapid decrease in the pressure of the bladder
The upper limit of normal PSA is _____
Renal & Urology UK Medical PG Flashcards - Medical Study Cards
Master Renal & Urology with OnCourse flashcards. These spaced repetition flashcards are designed for medical students preparing for NEET PG, USMLE Step 1, USMLE Step 2, MBBS exams, and other medical licensing examinations.
Renal & Urology Flashcard Deck - 492 Cards
Flashcard 1: bf436201fdd2467bb4524075c13428c5-ao-2
Answer:
Flashcard 2: The mechanism of Oxybutynin is _____
Answer: Anti-muscarinic
Flashcard 3: Carcinoma in situ (CIS) is a _____ of the bladder
Answer: high-grade superficial tumour
Flashcard 4: Prostate cancer _____ be seen with a normal PSA?
Answer: can
Flashcard 5: If there is a mixture of storage and voiding symptoms that persist after treatment with an alpha-blocker along, then a _____ such as tolterodine or darifenacin may be tried
Answer: antimuscarinic (anticholinergic) drug
Flashcard 6: Example of a thiazide diuretic used to manage renal stones and hypercalcuria _____
Answer: Bendroflumethiazide
Flashcard 7: Avoid testing for PSA within _____ of a UTI or prostatitis
Answer: 6 weeks
Flashcard 8: Renal stones measuring _____ will pass spontaneously wthin 4 weeks
Answer: <5mm
Flashcard 9: _____ occurs commonly after catheterisation for chronic urinary retention due to rapid decrease in the pressure of the bladder
Answer: Decompression haematuria
Flashcard 10: The upper limit of normal PSA is _____
Answer: 4ng/ml
Flashcard 11: _____ may indicate recent stone passage, if a ureteric calculus is not present
Answer: Periureteric fat stranding
Flashcard 12: What would an Ultrasound of a Testicular lump revealing a cystic lesion containing heterogenous solid echos suggest _____
Answer: Non-seminoma germ cell tumour (Teratoma)
Flashcard 13: Renal Colic Pain:: Would an NSAID be contrainidicated in a patient with a background of CKD and recent upper GI bleed _____ so prescribe IV Paracetamol
Answer: yes
Flashcard 14: The following drugs may cause urinary retention: _____ Anticholinergics (e.g. Antipsychotics & Antihistamines Opioids NSAIDs Disopyramide
Answer: TCA's (e.g. Amitriptyline)
Flashcard 15: The biggest risk factor for testicular cancer is _____
Answer: Infertility
Flashcard 16: _____ Stones are Radio-lucent
Answer: Urate + Xanthine
Flashcard 17: _____ is preferred over lithotripsy for removal of Renal stones in pregnant women
Answer: Ureteroscopy
Flashcard 18: First-line investigation for testicular cancer is _____
Answer: Ultrasound
Flashcard 19: What is the investigation for suspected epididymo-orchitis in older adults with a low-risk sexual history? _____
Answer: MSSU
Flashcard 20: Carcinoma in situ (CIS) is managed with _____
Answer: TURBT
Flashcard 21: Management for epididymo-orchitis with low STI risk is _____
Answer: oral quinolone for 2 weeks (ofloxacin)
Flashcard 22: Seminomas have a _____ prognosis than Teratomas
Answer: better
Flashcard 23: An indurated prostate refers to a prostate gland that _____
Answer: feels unsually firm or hard
Flashcard 24: Finasteride treatment of BPH may take _____ before results are seen
Answer: 6 months
Flashcard 25: For patients with BPH, if the prostate is significantly enarged then a _____ is considered
Answer: combination of Alpha-1 Antagonists and 5-alpha reductase inhibitors
Flashcard 26: _____ is preferred to morphine in palliative patients with mild-moderate renal impairment
Answer: Oxycodone
Flashcard 27: If renal impairment is more severe _____, buprenorphine and fentanyl are preferred pain management
Answer: alfentanil
Flashcard 28: ARBs are also contrainidicated in _____
Answer: pregnant women
Flashcard 29: ACE Inhibitors have a renoprotective mechanism as reduced Angiotensin II levels _____
Answer: causes vasodilation of the efferent arteriole
Flashcard 30: _____ must be checked 2-3 weeks after starting ACE Inhibitors due to the risk of worsening renal function in patients with renovascular disease
Answer: Renal Function
Flashcard 31: Up to _____ is an acceptable increase in potassium when adminstering ACE Inhibitors
Answer: 5.5 mmol/l
Flashcard 32: ACE Inhibitors are contraindicated in Bilateral Renal Artery Stenosis because _____
Answer: renal perfusion is dependant on efferent arteriole constriction
Flashcard 33: What needs to monitored when prescribing ACE Inhibitors when starting them or increasing dose _____
Answer: U&Es
Flashcard 34: What is the side-effect of ARBs: _____
Answer: hyperkalaemia
Flashcard 35: ARBs shold be used with caution in patients with _____
Answer: renovascular disease
Flashcard 36: 73014fffc1224a21bdb7495cca9ab1c5-ao-3
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Flashcard 37: What Urea scores a point in CURB-65?
Answer: • Urea >7mmol/L
Flashcard 38: 73014fffc1224a21bdb7495cca9ab1c5-ao-4
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Flashcard 39: How do Thiazide diuretics function?
Answer: • Blocks the thiazide sensitive sodium chloride co transporter in the distal tubule • This Keeps Na+ and Cl- in the urine • As water follows sodium, increased water excretion from the kidneys
Flashcard 40: When are ACE inhibitors and ARBs contraindicated?
Answer: • In renovascular disease
Flashcard 41: 557d81e187974a9e8f2a77ce7fff8d72-ao-2
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Flashcard 43: Ureteric stone management: < _____ = shockwave lithotripsy +/- alpha blockers 10-20mm = ureteroscopy
Answer: 10mm
Flashcard 44: 557d81e187974a9e8f2a77ce7fff8d72-ao-4
Answer:
Flashcard 45: Where is the site of action of Bumetanide?
Answer: • Ascending loop of Henle [Loop Diuretic]
Flashcard 46: What rise in serum creatinine from baseline is acceptable when initiating ACE inhibitor treatment?
Answer: • up to 30%
Flashcard 47: What electrolyte imbalances can thiazide diuretics cause?
Answer: • hypokalaemia • hyponatraemia • low chloride • hypercalcaemia • hyperuraemia
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Flashcard 52: 0e462ff8abc441778982d481b75acf23-ao-3
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Flashcard 53: 2f571e47bc5e41dfba13c199e00f3445-ao-2
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Flashcard 58: 711a6778d3644243aad60aadbe804f0a-ao-11
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Flashcard 59: What is the management in suspected epidiymo-orchitis if unknown organism?
Answer: • Ceftriaxone 500mg IM single dose • Oral Doxycycline 100mg BD 10-14 days
Flashcard 60: 711a6778d3644243aad60aadbe804f0a-ao-6
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Flashcard 61: fb0f5eff218749e698e82961e0b226e6-oa-4
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Flashcard 62: 711a6778d3644243aad60aadbe804f0a-ao-8
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Flashcard 63: What is the imaging of choice for renal colic?
Answer: • Non-contrast CT-KUB
Flashcard 64: 711a6778d3644243aad60aadbe804f0a-ao-5
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Flashcard 65: What is the timeframe difference in when IgA nephropathy and Post streptococcus glomerulonephritis present after URTI?
Answer: • IgA nephropathy = 1-2 days • PSGN = 1-2 weeks
Flashcard 66: fb0f5eff218749e698e82961e0b226e6-oa-7
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Flashcard 67: What is the most likely organism to cause Peritonitis secondary to Peritoneal dialysis?
Answer: • Staphylococcus epidermidis
Flashcard 68: • What is TURP syndrome?
Answer: • Life-threatening complication of TURP • Caused by absorption of irrigation fluid
Flashcard 69: • After renal transplant what cancer is most likely to develop?
Answer: • Squamous cell carcinoma of the skin Secondary to immunosupression
Flashcard 70: What must be performed after Vasectomy for it to be confirmed to be used as contraception?
Answer: • Semen analysis + azoospermia confirmed
Flashcard 71: 2f571e47bc5e41dfba13c199e00f3445-ao-1
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Flashcard 73: fb0f5eff218749e698e82961e0b226e6-oa-5
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Flashcard 74: 2f571e47bc5e41dfba13c199e00f3445-ao-3
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Flashcard 76: 0e462ff8abc441778982d481b75acf23-ao-2
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Flashcard 77: 711a6778d3644243aad60aadbe804f0a-ao-3
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Flashcard 79: 0e462ff8abc441778982d481b75acf23-ao-1
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Flashcard 80: What size stones is Percutaneous Nephrolithotomy indicated for?
Answer: • Greater than >20mm
Flashcard 81: What should be done for Anaemia in CKD?
Answer: 1. Correct Iron deficiency -> oral iron replacement 2. Erythropoisis-stimulating agents (ESA)
Flashcard 82: What urine output classifies an AKI?
Answer: <0.5 ml/kg/hr over 6 consecutive hours
Flashcard 83: What is the treatment choice for HIV-associated nephropathy?
Answer: • Antiretroviral therapy
Flashcard 84: Typical presentation of post-streptococcal glomerulonephritis?
Answer: Haematuria, proteinuria/oedema, hypertension, oliguria
Flashcard 85: Which kidney condition is often associated with malignancy?
Answer: Membranous nephropathy
Flashcard 86: What is indicated in Ureteric stones < 10mm in size?
Answer: • Shockwave Lithotripsy (+/- alpha blockers)
Flashcard 87: Why does chronic kidney disease often lead to anaemia?
Answer: Due to reduced production of erythropoietin
Flashcard 88: What is Epididymo-orchitis in individuals with a low STI risk, likely due to?
Answer: • E-Coli (enteric organisms)
Flashcard 89: What is the managment of acute renal colic?
Answer: • IM Diclofenac (75mg) *IV Paracetamol if NSAID is contraindicated or not providing sufficient pain relief
Flashcard 90: What is the screening test for Polycystic Kidney Disease?
Answer: • Ultrasound
Flashcard 91: What is a cause of scrotal swelling which can be palpated as separate from the body of the testicle, also smooth and regular in character?
Answer: • Epididymal Cyst
Flashcard 92: Patient presents with oliguria, fever, joint pain, rash and eosinophilia. Diagnosis?
Answer: • Acute interstitial nephritis
Flashcard 93: 8892364799924d4aa95741d3852db59a-ao-1
Answer:
Flashcard 94: How long is the course of nitrofurantoin in UTI managment?
Answer: • 3 days
Flashcard 95: 8892364799924d4aa95741d3852db59a-ao-3
Answer:
Flashcard 96: 8892364799924d4aa95741d3852db59a-ao-4
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Flashcard 97: What are examples of Loop Diuretics?
Answer: • Furosemide • Bumetanide
Flashcard 98: 8892364799924d4aa95741d3852db59a-ao-5
Answer:
Flashcard 99: What medication can cause Acute interstitial nephritis?
Answer: • Penicillin
Flashcard 100: Urine culture or Urine dipstick in women aged >65?
Answer: • Urine culture
Flashcard 101: _____ acid base abnormalities are compensated by blood buffers
Answer: Acute
Flashcard 102: _____ is caused by increased production/ingestion of HCO3- or loss of H+
Answer: Metabolic alkalosis
Flashcard 103: Chloride-_____ metabolic alkalosis is usually due to volume depletion which activates the RAAS → increased levels of aldosterone → Na+ retention and H+ excretion
Answer: Responsive
Flashcard 104: What is the normal range for anion gap on ABG? _____
Answer: 8-16 mmol/L
Flashcard 105: What is the management for IgA nephropathy? _____ Targeted-release budesonide
Answer: ACEi or ARB for blood pressure
Flashcard 106: Metabolic _____ is compensated by decreased respiratory rate and tidal volume, triggered by medullary chemoreceptors
Answer: alkalosis
Flashcard 107: Urinalysis for IgA nephropathy reveals episodic _____uria and RBC casts
Answer: haemat
Flashcard 108: What is the formula for calculating anion gap? _____
Answer: [Na+] - ([HCO3-] + [Cl-])
Flashcard 109: Metabolic acidosis can have a _____ anion gap when lost HCO3- is replaced by unmeasured anions
Answer: raised
Flashcard 110: _____ can be categorised into chloride-responsive & chloride-resistant based on urinary chloride
Answer: Metabolic alkalosis
Flashcard 111: _____ is the "systemic form" of IgA nephropathy
Answer: IgA vasculitis (Henoch-Schonlein purpura)
Flashcard 112: IgA nephropathy has _____ C3 and normal C4 levels
Answer: normal
Flashcard 113: The causes of _____ anion gap metabolic acidosis may be remembered with the mnemonic HARDASS: H = Hyperalimentation (e.g., Total Parenteral Nutrition (TPN)) A = Addison’s disease (adrenal insufficiency, leading to decreased aldosterone and sodium retention, and increased acid retention) R = Renal tubular acidosis (RTA) (types 1, 2, or 4) D = Diarrhoea (loss of bicarbonate in the stool) A = Acetazolamide (a carbonic anhydrase inhibitor that causes bicarbonate loss in the urine) S = Spironolactone (a potassium-sparing diuretic causing hyperkalemic RTA) S = Saline infusion (excessive NaCl) (dilutional acidosis with hyperchloraemia)
Answer: normal
Flashcard 114: Metabolic acidosis can have a _____ anion gap when lost HCO3- is replaced by Cl- (measured)
Answer: normal
Flashcard 115: Acid-Base compensation: _____ = Immediate Respiratory compensation = Minutes-Hours Renal compensation = Hours-Days
Answer: Blood Buffer
Flashcard 116: IgA nephropathy is a type _____ hypersensitivity reaction
Answer: III
Flashcard 117: IgA nephropathy presents with _____ episodes of gross haemuria folliwng a mucosal infection
Answer: recurrent
Flashcard 118: Haematuria 1-2 days after pharyngitis = _____ Haematuria 1-3 weeks after pharyngitis = PSGN
Answer: IgA nephropathy
Flashcard 119: IgA _____ form in the mesangium causing glomerular injury in IgA nephropathy
Answer: immune complexes
Flashcard 120: _____ is a glomerulonephritis that occurs 1-2 days after a URTI or gastrointestinal infection
Answer: IgA nephropathy (IgAN)
Flashcard 121: Metabolic Alkalosis: pH: _____ pCO2: ↑ HCO3-: ↑
Answer: ↑
Flashcard 122: Metabolic alkalosis management: Chloride-_____ → Saline Chloride-Resistant → Acetazolamide
Answer: Responsive
Flashcard 123: Metabolic alkalosis urinary chloride: <20 mmol/L = _____ >20 mmol/L = Chloride-Resistant
Answer: Chloride-Responsive
Flashcard 124: IgA nephropathy typically occurs _____ following URTI or GI infection
Answer: 1-2 days
Flashcard 125: Metabolic _____ is compensated by increased respiratory rate and tidal volume, triggered by medullary chemoreceptors
Answer: acidosis
Flashcard 126: IgA nephropathy (IgAN) is also known as _____ disease
Answer: Berger
Flashcard 127: Urinalysis for post-streptococcal glomerulonephritis reveals _____uria and RBC casts
Answer: haemat
Flashcard 128: Post-renal AKI can present with a distended _____ on examination
Answer: bladder
Flashcard 129: Ischaemic acute tubular necrosis results from _____
Answer: prolonged renal hypoperfusion
Flashcard 130: What size stones can be considered for Extra corporeal shock wave lithotrispy?
Answer: • Stones with a total volume of less than 2cm
Flashcard 131: The managment of AKI is predominantly _____ with reversal of underlying causes
Answer: supportive
Flashcard 132: What managment is indicated for a renal stone with associated hydronephrosis?
Answer: • Percutaneous nephrostomy [need for urgent decompression]
Flashcard 133: What is the most appropriate managment for someone with nephrotic syndrome?
Answer: • Oral corticosteroids [Prednisolone]
Flashcard 134: What markers would we expected to be raised in patients with Non-seminoma germ cell testicular tumours (teratomas)?
Answer: • hCG • AFP
Flashcard 135: What is the normal range for BE on ABG? _____
Answer: -2 to +2 mmol/L
Flashcard 136: ABG/VBG with acute kidney injury reveals _____
Answer: metabolic acidosis
Flashcard 137: Indications for _____ in patients with AKI: Acidosis Electrolyte abnormalities Ingestion fluid Overload Uraemia *Refractory to medical management
Answer: acute dialysis
Flashcard 138: What is the management of post-renal AKI? _____
Answer: Relieve the obstruction
Flashcard 139: Maintenance phase of acute tubular necrosis = _____uria Recovery phase of acute tubular necrosis = polyuria
Answer: oligo
Flashcard 140: Urinalysis in AKI showing blood +, protein +++, RBC casts suggests _____
Answer: glomerulonephritis
Flashcard 141: Pre-renal AKI can have signs of _____ on examination
Answer: dehydration
Flashcard 142: Acute interstitial nephritis is caused by drugs: _____ Antibiotics (esp. β lactams, sulfa) NSAIDs Diuretics Inhibitors (PPIs) Rifampicin
Answer: anti-Convulsants
Flashcard 143: Post-streptococcal glomerulonephritis follows a primary infection of the _____ or pharynx (streptococcal pharyngitis)
Answer: skin (impetigo)
Flashcard 144: Post-streptococcal glomerulonephritis can present with _____uria, "cola"-coloured urine, hypertension, and facial oedema
Answer: haemat
Flashcard 145: Acute tubular necrosis is associated with _____ casts and epithelial cell casts
Answer: "muddy brown" granular
Flashcard 146: What is the urine osmolality (mOsm/kg) in pre-renal AKI? _____
Answer: > 500 mOsm/kg (normal)
Flashcard 147: What is the likely diagnosis in a patient presenting with fever, rash, oliguria, and raised urine eosinophils on urinalysis after starting a course of penicillin 1 week ago? _____
Answer: Acute interstitial nephritis
Flashcard 148: Intra-renal AKI can have signs of _____ on examination
Answer: fluid overload
Flashcard 149: _____ is a pH <7.35 caused by an increased concentration of H+
Answer: Acidemia
Flashcard 150: Post-streptococcal glomerulonephritis is a type _____ hypersensitivity reaction
Answer: III
Flashcard 151: What imaging is done for AKI with no identifiable cause? _____
Answer: Renal US
Flashcard 152: The classic triad of acute interstitial nephritis is _____, fever & raised urine eosinophils after starting a medication
Answer: rash
Flashcard 153: Timely use of antibiotics for Group A β-haemolytic streptococccal infections _____ prevent post-streptococcal glomerulonephritis
Answer: cannot
Flashcard 154: What is the initial management of pre-renal AKI? _____
Answer: IV fluid challenge
Flashcard 155: Acute interstitial nephritis is associated with _____ casts on urine microscopy and eosinophilia in the blood or urine
Answer: WBC
Flashcard 156: PSGN typically occurs _____ following group A β-haemolytic streptococcal infection
Answer: 1-6 weeks
Flashcard 157: PSGN has _____ C3 and normal C4 levels due to activation of the classical complement pathway
Answer: ↓
Flashcard 158: Acute tubular necrosis (ATN) _____ GFR by tubular epithelial cell death and intraluminal obstruction
Answer: decreases
Flashcard 159: What is the urine osmolality (mOsm/kg) in post-renal AKI? _____
Answer: Varies
Flashcard 160: _____ is a pH >7.35 caused by a decreased concentration of H+
Answer: Alkalemia
Flashcard 161: AKI is urine output < _____ mL/kg/hour for > 6 hours
Answer: 0.5
Flashcard 162: Urinalysis in AKI showing leucocyte +, nitrite + and haematuria suggests _____
Answer: infective post-renal AKI with obstruction
Flashcard 163: Anti-_____ titres are ↑ in PSGN especially after pharyngitis
Answer: streptolysin O (ASO)
Flashcard 164: _____ deposit into the glomerular basement membrane and mesangium causing glomerular injury in post-streptococcal glomerulonephritis
Answer: Immune complexes
Flashcard 165: What is the general management of acute tubular necrosis? _____
Answer: Supportive; remove nephrotoxic drugs, treat underlying cause; maintain euvolaemia!
Flashcard 166: What needs to accompany eGFR to diagnose CKD Stages 1 & 2?
Answer: • Signs of kidney damage on other tests i.e. U&Es, proteinuria
Flashcard 167: Acute tubular necrosis is caused by _____uria in rhabdomyolysis
Answer: myoglobin
Flashcard 168: Metabolic Acidosis: pH: _____ pCO2: ↓ HCO3-: ↓
Answer: ↓
Flashcard 169: Acute tubular necrosis is commonly associated with exogenous substances: _____ Aminoglycosides Lead Cisplatin
Answer: Contrast
Flashcard 170: The aetiology of acute tubular necrosis is _____ or nephrotoxic injury
Answer: ischaemic
Flashcard 171: AKI is a ≥ _____% rise in serum creatinine within the last 7 days
Answer: 50
Flashcard 172: What is the preferred managment for large, proximal renal stones?
Answer: • Percutaneous nephrolithotomy
Flashcard 173: Urinalysis in AKI showing haematuria, blood ++ suggests _____
Answer: obstruction
Flashcard 174: AKI may present with _____
Answer: oligouria or anuria
Flashcard 175: Post-streptococcal glomerulonephritis is more common in _____
Answer: children
Flashcard 176: What is the urine osmolality (mOsm/kg) in intra-renal AKI? _____
Answer: < 350 mOsm/kg
Flashcard 177: Urinalysis in AKI showing blood + and "muddy brown" casts on microscopy suggests _____
Answer: acute tubular necrosis
Flashcard 178: Unresolved _____-renal AKI typically precedes ischaemic acute tubular necrosis
Answer: pre
Flashcard 179: The mainstay management of acute interstitial nephritis is _____
Answer: discontinuation of the offending drug*
Flashcard 180: All patients with suspected AKI should have a(n) _____
Answer: urinalysis
Flashcard 181: Urinalysis in pre-renal AKI is typically _____
Answer: bland
Flashcard 182: Urinalysis in AKI showing leucocytes + and WBC casts on microscopy suggests _____
Answer: acute interstitial nephritis
Flashcard 183: What does Anti-GBM disease typically present with?
Answer: • Haemoptysis • AKI/proteinuria/haematuria
Flashcard 184: Acute interstitial nephritis is a drug-induced type _____ hypersensitivity reaction that affects the renal interstitium and tubules
Answer: IV
Flashcard 185: What is the normal range for HCO3- on ABG? _____
Answer: 22-26 mmol/L
Flashcard 186: _____ is a glomerulonephritis that occurs 1-3 weeks after group A β-haemolytic streptococcal infection
Answer: Post-streptococcal glomerulonephritis (PSGN)
Flashcard 187: Nephrotic syndrome results from damage to _____, disrupting the glomerular filtration barrier and increasing permeability to proteins
Answer: podocytes
Flashcard 188: What are the electron microscopy findings for focal segmental glomerulosclerosis (FSGS)? _____
Answer: Effacement of podocyte foot processes
Flashcard 189: What are the immunofluorescence findings for membranous nephropathy? _____
Answer: Granular depositions (immune complex) along the GBM
Flashcard 190: Minimal change disease is rarely associated with _____
Answer: NSAIDs
Flashcard 191: Hypertension in CKD is managed with _____ IF urine ACR > 30 mg/mmol
Answer: ARB or ACE inhibitors
Flashcard 192: Primary membranous nephropathy is associated with _____ antibodies
Answer: anti-PLA2R
Flashcard 193: What are the initial bloods for chronic kidney disease? _____
Answer: Creatinine for eGFR (other bloods include FBC, U&Es, bone profile)
Flashcard 194: KDIGO staging for acute kidney injury: AKI stage 1 is serum creatinine _____x the baseline
Answer: 1.5-1.9
Flashcard 195: _____ is the sudden decline in renal function resulting in ↑ creatinine and/or ↓ urine ouput, leading to disturbances in electrolyte, fluid, & acid-base balance
Answer: Acute kidney injury (AKI)
Flashcard 196: CKD presents _____ in earlier stages (~G1-G3a)
Answer: asymptomatically
Flashcard 197: The most common cause of post-renal AKI is _____ especially in elderly males
Answer: benign prostatic hyperplasia
Flashcard 198: What are the light microscopy findings for focal segmental glomerulosclerosis (FSGS)? _____
Answer: Focal & segmental glomerular sclerosis with hyalinosis
Flashcard 199: Nephrotic syndrome causes proteinuria (>3.5g/24hr) ± _____uria
Answer: haemat
Flashcard 200: Hypoalbuminaemia in nephrotic syndrome reduces ↓ _____ pressure, leading to oedema
Answer: oncotic
Flashcard 201: Decreased production of the active form of vitamin _____ by the kidneys in CKD contributes to decreased Ca2+
Answer: D (1,25-dihydroxycholecalciferol)
Flashcard 202: What is the likely diagnosis in a patient with end-stage renal disease presenting with intensley painful necrotic ulcerations as seen below? _____
Answer: Calciphylaxis
Flashcard 203: _____ is associated with the collapsing variant of focal segmental glomerulosclerosis (FSGS)
Answer: HIV
Flashcard 204: _____ is an elevation in nitrogenous waste products (primarily blood urea nitrogen (BUN) & serum creatinine) due to impaired renal clearance
Answer: Azotemia
Flashcard 205: Stages of CKD: A1: _____ A2: ACR 3-30 A3: ACR > 30
Answer: ACR < 3
Flashcard 206: What is the first-line imaging for chronic kidney disease? _____
Answer: Renal ultrasound
Flashcard 207: Intra-renal AKI is due to _____
Answer: direct damage to renal parenchyma
Flashcard 208: Advise patients to avoid eating _____ 12 hours before an eGFR/creatinine blood test
Answer: meat
Flashcard 209: What is the definitive management of CKD? _____
Answer: Kidney transplant
Flashcard 210: _____ is used to manage CKD in stage 5 CKD or acute kidney injury
Answer: Renal Replacement Therapy
Flashcard 211: Focal segmental glomerulosclerosis (FSGS) can result from hyperfiltration injury due to _____ or reduced nephron mass
Answer: obesity
Flashcard 212: Management for nephrotic syndrome: Oedema: restrict _____ intake, give loop diuretics Hypertension/protein reduction: ACEi or ARB Hyperlipidaemia: Statin Hypercoaguability: Anticoagulation
Answer: salt & fluid
Flashcard 213: _____ is associated with solid tumours
Answer: Membranous nephropathy
Flashcard 214: Pre-renal AKI is due to _____
Answer: decreased perfusion to the kidney
Flashcard 215: Post-renal AKI is due to _____
Answer: obstruction of urine flow
Flashcard 216: KDIGO staging for acute kidney injury: AKI stage 3 is serum creatinine _____x the baseline
Answer: ≥ 3.0
Flashcard 217: Bone pain in CKD is caused by _____ from ↑ bone resorption
Answer: renal osteodystrophy
Flashcard 218: What is the likely diagnosis in a patient with fatigue, oedema, signs of encephalopathy and below skin changes? _____
Answer: Chronic kidney disease; uraemic frost is a rare skin manifestation of urea crystals on skin
Flashcard 219: _____-renal acute kidney injury is the most common mechanism
Answer: Pre
Flashcard 220: Syptomes of chronic kidney disease can be remembered with the mnemonic "Kidney OUTAGES": _____ renal Osteodystrophy Uraemia Tryglceridaemia Acidosis (metabolic) Growth delay Erythropoietic deficiency (anaemia) Sodium/water retention
Answer: hyperKalaemia
Flashcard 221: KDIGO staging for acute kidney injury: AKI stage 2 is urine output < _____ mL/kg/hour for ≥12 hours
Answer: 0.5
Flashcard 222: Minimal change disease is most commonly _____, but can be triggered by infections (viral URTI), drugs, malignancy, & allergy
Answer: idiopathic
Flashcard 223: Intra-renal AKI is most commonly caused by ischaemic & nephrotoxic _____
Answer: acute tubular necrosis
Flashcard 224: Acute kidney injury causes _____ serum creatinine and/or decreased urine output
Answer: increased
Flashcard 225: What is the likely diagnosis in a patient with periorbital oedema, sudden-onset flank pain with protein +++ & blood + on urinalysis? _____
Answer: Nephrotic syndrome with renal vein thrombosis
Flashcard 226: KDIGO staging for acute kidney injury: AKI stage 1 is urine output < _____ mL/kg/hour for 6-12 hours
Answer: 0.5
Flashcard 227: _____ can precipitate pre-renal AKI by decreasing effective circulating volume
Answer: Diuretics
Flashcard 228: Nephrotic syndrome results in _____lipidaemia **bonus, why?
Answer: hyper
Flashcard 229: Oedema in nephrotic syndrome starts in the _____ region
Answer: periorbital
Flashcard 230: Stages of CKD: G1: _____ G2: GFR 60-89 WITH evidence of kidney damage G3a: GFR 45-59 G3b: GFR 30-44 G4: GFR 15-29 G5: GFR < 15
Answer: GFR ≥ 90 WITH evidence of kidney damage
Flashcard 231: Diagnosis of CKD is typically _____
Answer: incidental
Flashcard 232: Suspect _____ in a patient with chronic kideny disease that has pleuritc chest pain improved on leaning forward
Answer: uraemic pericarditis
Flashcard 233: Loss of _____ in nephrotic syndrome increases ↑ the risk of infection (pneumococcal)
Answer: immunoglobulins
Flashcard 234: Primary nephrotic syndromes in _____ are commonly caused by membranous nephropathy & focal segmental glomerulosclerosis (FSGS)
Answer: adults
Flashcard 235: Nephrotic syndrome has _____ casts on urine microscopy
Answer: fatty
Flashcard 236: When is a renal biopsy done for nephrotic syndrome? _____
Answer: Typically in adults with no clear secondary cause
Flashcard 237: Membranous nephropathy is managed conservatively with _____ and treating the underlying cause
Answer: ACEi or ARB
Flashcard 238: KDIGO staging for acute kidney injury: AKI stage 3 is urine output < _____ mL/kg/hour for ≥24 hours
Answer: 0.3
Flashcard 239: _____ is characterized by proteinuria (>3.5g/24h), hypoalbuminaemia, & oedema
Answer: Nephrotic syndrome
Flashcard 240: Focal segmental glomerulosclerosis (FSGS) is commonly _____, but can be tiggered by obesity, ↓ nephron mass, HIV & heroin use
Answer: idiopathic
Flashcard 241: _____ abuse is associated with focal segmental glomerulosclerosis
Answer: Heroin
Flashcard 242: _____ and ACE inhibitors/ARB can precipitate pre-renal AKI via renal hypoperfusion
Answer: NSAIDs
Flashcard 243: Chronic kidney disease management: Lifestyle: _____ Hypertension: ARB or ACEi Cardiovascular Primary Prevention: Atorvastatin 20mg* Anaemia Hb < 110: Adequate iron levels → ESA therapy Hyperphosphataemia: ↓ intake ± phosphate binders
Answer: Exercise, smoking cessation, healthy BMI
Flashcard 244: Abnormal haemostasis in CKD from _____-induced platelet dysfunction has a normal PT/APTT & increased bleeding time
Answer: uraemia
Flashcard 245: Acute kidney injury pathophysiology: 1. _____ 2. Intra-renal 3. Post-renal
Answer: Pre-renal
Flashcard 246: Focal segmental glomerulosclerosis (FSGS) is most common in _____ & Hispanic ethnicities
Answer: African
Flashcard 247: For anaemia in CKD, rule out _____ before starting patients on erythropoietic stimulating agent
Answer: iron deficiency
Flashcard 248: Suspect _____ in a patient with chronic kidney disease that presents with encephalopathy and asterixis on examination
Answer: uraemia
Flashcard 249: Chronic kidney disease is diagnosed with: • GFR < _____ ml/min/1.73m2 OR • Markers of kidney damage On tests ≥ 90 days apart
Answer: 60
Flashcard 250: What is the prognosis of minimal change disease? _____
Answer: Excellent in children
Flashcard 251: Minimal change disease: Light microscopy → _____ Electron microscopy → effacement of podocyte foot processes
Answer: no changes (normal glomeruli)
Flashcard 252: Chronic kidney disease results in _____ due to decreased production of erythropoietin (EPO) by diseased kidneys
Answer: anaemia
Flashcard 253: Minimal change disease is characterised by _____ of podocyte foot processes
Answer: effacement (fusion)
Flashcard 254: What is the initial urine investigations for chronic kidney disease? _____
Answer: Urine ACR; take an early morning smaple
Flashcard 255: Primary nephrotic syndromes in children are most commonly caused by _____
Answer: minimal change disease
Flashcard 256: What is the prognosis of focal segmental glomerulosclerosis? _____
Answer: Variable → the majority will progress to ESRD
Flashcard 257: _____ proteinuria in minimal change disease reflects isolated podocyte injury & predicts good response to steroids
Answer: Selective
Flashcard 258: AKI is a rise in serum creatinine of ≥ _____ micromol/litre within 48 hours
Answer: 26
Flashcard 259: Intra-renal AKI is also caused by drug-induced _____ and immune-mediated glomerulonephritis
Answer: acute interstitial nephritis
Flashcard 260: Biopsy is routinely done for chronic kidney disease _____
Answer: F
Flashcard 261: Chronic kidney disease: _____ HCO3- ↓ Ca2+ ↑ K+ ↑ Phosphate
Answer: ↓
Flashcard 262: What is the initial investigation for nephrotic syndrome? _____ and urine protein:creatinine ratio
Answer: Urinalysis; protein +++
Flashcard 263: KDIGO staging for acute kidney injury: AKI stage 2 is serum creatinine _____x the baseline
Answer: 2.0-2.9
Flashcard 264: Secondary nephrotic syndrome can be caused by systemic _____
Answer: amyloidosis
Flashcard 265: Membranous nephropathy is most common in the _____ ethnicity
Answer: Caucasian
Flashcard 266: Urine in nephrotic syndrome has a _____ appearance
Answer: frothy
Flashcard 267: Minimal change disease (MCD) most commonly affects _____
Answer: children
Flashcard 268: What imaging is done for nephrotic syndrome? _____
Answer: Renal US
Flashcard 269: What is the management of focal segmental glomerulosclerosis? _____
Answer: Corticosteroids
Flashcard 270: Chronic kidney disease is commonly caused by _____, hypertension, & glomerulonephritis
Answer: diabetic nephropathy
Flashcard 271: Chronic use of _____ can cause analgesic nephropathy leading to CKD
Answer: NSAIDs (e.g., ibuprofen, naproxen)
Flashcard 272: ↓ GFR results in reduced H+ excretion & bicarbonate regeneration leading to _____
Answer: metabolic acidosis
Flashcard 273: ↓ GFR leads to Na+/H2O retention resulting in _____
Answer: volume overload (hypertension, pulmonary/peripheral oedema, & heart failure)
Flashcard 274: CKD with arteriosclerosis of afferent arterioles evolving to glomerulosclerosis is associated with _____
Answer: hypertension
Flashcard 275: CKD with immune complex deposition, inflammation, cellular proliferation causing glomerulosclerosis is associated with _____
Answer: glomerulonephritis
Flashcard 276: ↓ GFR leads to reduced urine excretion and accumulation of _____
Answer: waste products (e.g. urea, creatinine)
Flashcard 277: _____ is a progressive, irreversible decline in kidney function lasting ≥ 3 months
Answer: Chronic Kidney Disease (CKD)
Flashcard 278: The "Shiga-like" toxin in enterohemorrhagic E. Coli (EHEC) can enter the circulation causing _____
Answer: haemolytic uraemic syndrome
Flashcard 279: Patient on peritoneal dialysis with generalized abdominal pain reports cloudy dialysis effluent & mild fever. What is the likely diagnosis? _____
Answer: Peritoneal dialysis-associated peritonitis
Flashcard 280: What is the likely diagnosis in a 72 yr old man with resistant hypertension and an abdominal bruit? _____
Answer: Renal artery stenosis
Flashcard 281: If serum creatinine increases by ≥50% within 1 week of starting an ACEi or ARB then suspect _____
Answer: renal artery stenosis
Flashcard 282: Secondary hypertension may be caused by _____, which leads to increased plasma renin and unilateral atrophy of the affected kidney
Answer: renal artery stenosis
Flashcard 283: What is the most common cause of secondary hypertension in elderly males? _____
Answer: Renal artery stenosis
Flashcard 284: Patients with hypertension should be investigated with _____ for CKD
Answer: U&Es
Flashcard 285: Patients with hypertension should be investigated with _____ for haematuria
Answer: urinalysis
Flashcard 286: Patients with hypertension should be investigated with _____ for proteinuria
Answer: urine albumin:creatinine ratio
Flashcard 287: What is the likely diagnosis in an African-American patient that presents with painless gross hematuria with numerous intact RBCs on microscopic examination? _____
Answer: Renal papillary necrosis (secondary to sickle cell trait)
Flashcard 288: Proteinuria is defined as an ACR >_____ mg/mmol (or albumin ≥200 mg/L)
Answer: 30
Flashcard 289: Patients with hypocalcaemia should have _____ done to exclude chronic kidney disease as the cause
Answer: U&Es
Flashcard 290: Consider the use of _____ in all patients with CKD for the prevention of CVD
Answer: statins
Flashcard 291: Suspect _____ in a patient with urinary tract calculi + fever
Answer: pyelonephritis
Flashcard 292: _____ stones are a rare form of nephrolithiasis, most commonly seen in children
Answer: Cystine
Flashcard 293: What is the advice for nitrofurantion use in pregnancy (UTI)? _____
Answer: Avoid in the 3rd trimester
Flashcard 294: Risk factors for urinary tract calculi: - _____ solute concentration in the urinary filtrate - Low ↓ urine volume
Answer: High ↑
Flashcard 295: Urinary tract calculi often present with _____
Answer: nausea & vomiting
Flashcard 296: Sum up how urinary tract calculi (kidney stones) present: _____
Answer: - Severe unilateral & colicky flank pain that radiates to the groin - Haematuria - N&V
Flashcard 297: Urinary tract calculi may be treated and prevented by encouraging _____ intake
Answer: fluid (+lemon juice)
Flashcard 298: _____ diuretics can precipitate calcium oxalate / phosphate kidney stones
Answer: Loop
Flashcard 299: What type of kidney stone is seen in patients with gout? _____
Answer: Uric acid stone
Flashcard 300: Lower urinary tract infections can present with _____, urinary frequency & urgency, suprapubic pain and offensive-smelling urine
Answer: dysuria
Flashcard 301: Renal stone management: < _____ = offer shockwave lithotripsy 10 - 20mm = shockwave lithotripsy OR ureteroscopy > 20mm = percutaneous nephrolithotomy
Answer: 5 - 10mm
Flashcard 302: Calcium phosphate kidney stones precipitate with _____ urine pH
Answer: increased
Flashcard 303: Uric acid kidney stones precipitate with _____ urine pH
Answer: decreased
Flashcard 304: What is the investigation & management for symptomatic UTIs in pregnancy? _____
Answer: - Urine culture - 7 days of empiric antibiotics: - Nitrofurantoin 100mg modified release BD for 7 days → AVOID in third trimester - Amoxicillin 500mg TDS for 7 days - Cefalexin 500mg TDS for 7 days
Flashcard 305: The staghorn calculi seen in struvite kidney stones may act as a nidus for _____ infection
Answer: urinary tract
Flashcard 306: Proteus mirabilis is a gram -ve bacteria that classically forms large _____, which form from struvite stones, in the renal pelvis
Answer: 'staghorn' calculi
Flashcard 307: What is the investigation & management for asymptomatic catheter-associated bacteriuria? _____
Answer: No investigations or management
Flashcard 308: What type of kidney stone commonly requires surgical removal due to its size? _____
Answer: Magnesium ammonium phosphate (struvite) stones
Flashcard 309: Uric acid kidney stones are often seen in diseases with increased _____ (e.g. leukemia, chemotherapy, myeloproliferative disorders)
Answer: cell turnover
Flashcard 310: Describe the examination finding in pyelonephritis: _____
Answer: Costovertebral angle tenderness → pain on percussion of the flank (usually unilateral, can be bilateral)
Flashcard 311: Which type of calcium kidney stone is more common? _____
Answer: Calcium oxalate
Flashcard 312: Consider prescribing _____ for postmenopausal women with recurrent UTIs
Answer: topical vaginal oestrogen
Flashcard 313: What is the analgesic management for urinary tract calculi? 1st-line: _____ 2nd-line: IV paracetamol
Answer: NSAID any route (traditionally IM diclofenac)
Flashcard 314: What is the investigation & management for symptomatic catheter-associated UTIs? _____
Answer: - Urine culture - Remove or replace indwelling catheter - 7 days of antibiotics (nitrofurantoin, trimethoprim, or amoxicillin 1st-line)
Flashcard 315: Uric acid kidney stones are associated with hyper_____
Answer: uricaemia
Flashcard 316: What is the investigation & management for asymptomatic bacteriuria in pregnancy? _____
Answer: **same as if it is symptomatic! Urine culture - 7 days of empiric antibiotics: - Nitrofurantoin 100mg modified release BD for 7 days → AVOID in third trimester - Amoxicillin 500mg TDS for 7 days - Cefalexin 500mg TDS for 7 days
Flashcard 317: For recurrent calcium oxalate stones consider _____ supplementation and thiazide diuretics
Answer: potassium citrate
Flashcard 318: _____ diuretics can treat calcium oxalate / phosphate kidney stones
Answer: Thiazide
Flashcard 319: What is the advice for trimethoprim use in pregnancy (UTI)? _____
Answer: Avoid in the 1st trimester
Flashcard 320: Magnesium ammonium phosphate (struvite) kidney stones are caused by _____ +ve organisms
Answer: urease
Flashcard 321: _____ is the presence of bacteria in the urine without symptoms of UTI
Answer: Asymptomatic bacteriuria
Flashcard 322: What is the investigation & management for lower UTIs in men? _____
Answer: - Urine culture - 7 days of antibiotics (nitrofurantoin or trimethoprim 1st-line)
Flashcard 323: What is the appearance of uric acid kidney stones on CT? _____
Answer: Radiopaque
Flashcard 324: The second most common urinary tract calculi are _____
Answer: uric acid stones
Flashcard 325: What antibiotics are given in men for acute prostatitis (UTI)? _____
Answer: Quinolones
Flashcard 326: _____ can cause kidney stones
Answer: Protease inhibitors (indinavir)
Flashcard 327: Urinary tract calculi (kidney stones) pain is often characterised as "_____"
Answer: colicky (renal colic)
Flashcard 328: What are the most common urinary tract calculi (kidney stones)? _____
Answer: Calcium oxalate
Flashcard 329: Urinary tract calucli can lead to severe complications including _____ and pyelonephritis
Answer: hydronephrosis
Flashcard 330: Cystine kidney stones precipitate with _____ urine pH
Answer: decreased
Flashcard 331: Urinary tract calucli more commonly affect _____
Answer: males
Flashcard 332: What is the next step in management for a patient with complete upper urinary tract obstruction due to a stone, who also presents with systemic symptoms? _____
Answer: Percutaneous nephrostomy
Flashcard 333: Magnesium ammonium phosphate (struvite) kidney stones precipitate with _____ urine pH
Answer: increased
Flashcard 334: Bacteria in lower UTIs can ascend up the urinary tract causing _____
Answer: pyelonephritis
Flashcard 335: What is the pharmacological management for ureteral stones ≤ 10 mm? _____
Answer: Tamsulosin (alpha blocker)
Flashcard 336: What is the appearance of calcium kidney stones on X-ray and CT? _____
Answer: Radiopaque
Flashcard 337: Urinary tract calculi often present with _____uria & dysuria
Answer: haemat
Flashcard 338: What is the first-line investigation for urinary tract calculi in pregnant women, children, & young people? _____
Answer: Ultrasound KUB
Flashcard 339: _____ UTIs are defined as ≥ 2 episodes in 6 months, or ≥ 3 in 12 months
Answer: Recurrent
Flashcard 340: _____ is the formation or presence of calculi (stones) within the urinary tract, including the kidneys, ureters, bladder, or urethra
Answer: Urinary tract calculi (urolithiasis)
Flashcard 341: Patients with urinary tract calculi are often unable to _____ due to the pain
Answer: sit still
Flashcard 342: If a patient with urinary tract calculi passes a stone, it should be sent for _____
Answer: analysis (check the composition of the stone)
Flashcard 343: What is the investigation & management for uncomplicated lower UTIs? _____
Answer: - No investigation needed - 3 days of antibiotics (nitrofurantoin or trimethoprim 1st-line)
Flashcard 344: What is the appearance of struvite kidney stones on CT? _____
Answer: Radiopaque
Flashcard 345: Urinary tract calculi (kidney stones) cause _____ unilateral flank pain that radiates to the groin
Answer: severe
Flashcard 346: What is the most common cause of urinary tract obstruction in adults and can cause unilateral hydronephrosis? _____
Answer: Urinary tract calculi (urolithiasis)
Flashcard 347: What is the appearance of cystine kidney stones on CT? _____
Answer: Weakly radiopaque
Flashcard 348: Percutaneous nephrostomy is indicated for urinary tract obstruction with superimposed _____
Answer: infection
Flashcard 349: Magnesium ammonium phosphate (struvite) kidney stones classically form _____ in renal calyces
Answer: staghorn calculi
Flashcard 350: Management of uric acid kidney stones may include _____, especially in patients with gout or tumour lysis syndrome
Answer: allopurinol
Flashcard 351: What is the first-line investigation for urinary tract calculi (kidney stones)? _____
Answer: Non-contrast CT KUB (urgent within 24 hours)
Flashcard 352: _____ kidney stones are the third most common and also called struvite stones
Answer: Magnesium ammonium phosphate
Flashcard 353: What antibiotics are used in lower UTIs? 1st-line: _____ or trimethoprim If pregnant: Amoxicillin or Cefalexin
Answer: Nitrofurantoin
Flashcard 354: Name the common urinary tract calculi: ~75% _____ ~10% Uric acid stones ~5-10% Struvite (magnesium ammonium phosphate) stones <5% Calcium phosphate, Cystine stones
Answer: Calcium oxalate stones
Flashcard 355: Urinary tract calculi = _____ Urinary tract calculi and pregnancy = Ultrasound
Answer: Non-contrast CT scan
Flashcard 356: UTIs classification: _____ = UTI in healthy, non-pregnant women Complicated = UTI in pregnant women, men, indwelling catheter (symptomatic), anatomical/functional abnormalities of urinary tract
Answer: Uncomplicated
Flashcard 357: In younger male patients presenting with epididymo-orchitis is vital you think of _____ as a differential
Answer: testicular torsion
Flashcard 358: What is the management for epididymo-orchitis with suspected STI cause? _____ Refer to sexual health
Answer: Empiric antibiotics → IM ceftriaxone + oral doxycycline
Flashcard 359: _____ = inflammation of the epididymis ± inflammation of the testicles
Answer: Epididymo-orchitis
Flashcard 360: _____ is inflammation/infection of the bladder
Answer: Cystitis
Flashcard 361: What are the investigations for epididymo-orchitis? _____ to investigate UTI NAAT to investigate STI
Answer: Urinarlysis & MSU culture
Flashcard 362: Prehn sign (relief of pain when lifting testes) is suggestive of _____
Answer: epididymo-orchitis
Flashcard 363: Epididymitis < _____ years are mainly caused by STIs (Chlamydia trachomatis, Neisseria gonorrhoeae) Epididymitis > 35 years & children are mainly caused by UTIs (E. coli)
Answer: 35
Flashcard 364: When taking a urine sample for urine dipstick or culture, instruct the patient to collect it _____
Answer: midstream
Flashcard 365: What non-pathological state is associated with UTIs? _____
Answer: Pregnancy
Flashcard 366: Urinary tract infection typically arises by bacteria _____ into the bladder from the vaginal introitus
Answer: ascending
Flashcard 367: _____ presents with fever
Answer: Epididymo-orchitis
Flashcard 368: What is the management for epididymo-orchitis with suspected UTI cause? _____
Answer: Empiric antibiotics → oral quinolone for 2 weeks (ofloxacin)
Flashcard 369: _____ are at ↑ risk of UTIs because of a shorter urethra
Answer: Females
Flashcard 370: _____ = acute onset (hours) Epididymo-orchitis = slower onset (days)
Answer: Testicular torsion
Flashcard 371: _____ is infection of the kidney
Answer: Pyelonphritis
Flashcard 372: _____ is an infection of any part of the urinary tract (bladder, urethra, ureter, or kidneys)
Answer: Urinary tract infection (UTI)
Flashcard 373: Posterior testicular pain is suggestive of _____
Answer: epididymo-orchitis
Flashcard 374: Chronic epididymitis ≥ _____
Answer: 3 months
Flashcard 375: Urine dipstick may have +ve _____ result in UTIs
Answer: leukocyte esterase & nitrites
Flashcard 376: _____ is a common cause of UTIs in sexually active young females
Answer: Staphylococcus saprophyticus
Flashcard 377: Which patient demographics are complicated UTIs? - _____ - Men - Indwelling catheter (symptomatic)
Answer: Pregnant women
Flashcard 378: _____ is inflammation/infection of the urethra
Answer: Urethritis
Flashcard 379: What iatrogenic risk factor is associated with UTIs? _____
Answer: Catheterisation
Flashcard 380: _____ is inflammation/infection of the ureter
Answer: Ureteritis
Flashcard 381: _____ = -ve Prehn sign Epididymo-orchitis = +ve Prehn sign
Answer: Testicular torsion
Flashcard 382: UTIs classification: _____ = affecting the urethra & bladder Upper = affecting the ureter & kidneys
Answer: Lower
Flashcard 383: Epididymo-orchitis is rarely a side-effect of _____
Answer: amiodarone
Flashcard 384: Urinary tract infections with +ve urine _____ are likely caused by a gram-negative organism
Answer: nitrites
Flashcard 385: In elderly patients, UTIs can present with acute _____
Answer: delirium
Flashcard 386: What is the most common organism that causes UTIs? _____
Answer: E. coli >70%
Flashcard 387: _____ presents with unilateral scrotal pain & swelling with dysuria & low-grade fever
Answer: Epididymo-orchitis
Flashcard 388: The most common iatrogenic cause of dehydration is _____
Answer: diuretics
Flashcard 389: When assessing risk for pressure sores use the _____
Answer: Waterlow score
Flashcard 390: When assessing risk for pressure sores use the _____ or Norton assessment tool
Answer: Braden scale
Flashcard 391: Polycystic kidney disease ↑ risk of _____ because of ↑ risk of berry (saccular) aneurysms present
Answer: subarachnoid haemorrhage
Flashcard 392: In the terminal phase of an illness, antibiotics _____ typically prolong life, but may make patients more comfortable
Answer: do not
Flashcard 393: _____ and fentanyl are preferred to morphine in palliative patients with severe renal impairment
Answer: buprenorphine
Flashcard 394: _____ is preferred to morphine in palliative patients with mild-to-moderate renal impairment
Answer: Oxycodone
Flashcard 395: The worst complication of pyelonephritis is _____
Answer: urosepsis
Flashcard 396: The most common organism that causes pyelonephritis is _____
Answer: E. coli
Flashcard 397: Patients being managed for pyelonephritis in should seek medical help if their symptoms do not start to improve within _____ of taking the antibiotics
Answer: 48 hours
Flashcard 398: What is the 1st-line antibiotic for pyelonephritis in pregnant women? _____
Answer: Cefalexin (500mg BD for 7-10 days)
Flashcard 399: What is the initial investigation for pyelonephritis? _____
Answer: Midstream culture & susceptibility (before empiric antibiotics)
Flashcard 400: Pyelonephritis is an infection of the kidney that presents with _____ pain, fever, N&V and UTI symptoms
Answer: flank
Flashcard 401: What is the 1st-line antibiotic for pyelonephritis in non-pregnant women & men? _____
Answer: Cefalexin (500mg BD for 7-10 day)
Flashcard 402: What is the imaging of choice for complicated pyelonephritis? _____
Answer: Contrast CT abdomen & pelvis
Flashcard 403: Prostate cancer work-up includes _____ staging & Gleason grading
Answer: TNM
Flashcard 404: Abdominal examination assess for _____ when screening for benign prostatic hyperplasia
Answer: palpable bladder in urinary retention
Flashcard 405: Prostate cancer causes osteo_____ lesions
Answer: blastic
Flashcard 406: Rectal Examination prostate cancer: _____
Answer: Hard, asymmetric, nodular
Flashcard 407: What are Lower Urinary Tract Symptoms LUTS? _____
Answer: STORAGE Frequency Urgency Nocturia VOIDING Weak stream Intermittent stream Straining Emptying incompletey / post-micturition dribbling
Flashcard 408: Prostate cancer can present _____ pain
Answer: back
Flashcard 409: Approximately 95% of testicular cancers are _____ tumours
Answer: germ cell
Flashcard 410: Testicular cancer germ cell tumours caetogories: _____ Non-seminoma 50%
Answer: Seminoma 50%
Flashcard 411: What is the screening programme for prostate cancer? _____
Answer: Trick question... there is NONE! NO PSA!!!!
Flashcard 412: What is the management for metastatic prostate cancer disease? _____
Answer: Hormonal therapy → anti-androgen therapy, GnRH agonist or antagonist
Flashcard 413: What are the pros & cons of radical prostatectomy vs radiotherapy for prostate cancer? _____
Answer: Pros - Can have radiotherapy after surgery - Both curative - Single procedure Cons - Erectile dysfunction is common - Incontinence is common
Flashcard 414: _____ is a common condition and can be referred to as benign prostatic hypertrophy
Answer: Beneign prostatic hyperplasia (BPH)
Flashcard 415: BPH increases the risk of prostate cancer _____
Answer: F
Flashcard 416: _____ typically presents with Lower Urinary Tract Symptoms (LUTS) and smooth, enlarged prostate on examination
Answer: Beneign prostatic hyperplasia (BPH)
Flashcard 417: What is the first-line investigation for suspected clinical localised prostate cancer? _____
Answer: Multiparametric MRI
Flashcard 418: What is the first-line pharmacological management for benign prostatic hyperplasia? _____ (bonus for drug class*)
Answer: Alpha-1 antagonist e.g. tamsulosin
Flashcard 419: What is the last resort management of BPH? _____
Answer: Surgery (TURP)
Flashcard 420: What symptom score can be used for bening prostatic hyperplaisa? _____
Answer: IPSS - International Prostate Symptoms Score
Flashcard 421: _____ is the most common malignancy in men aged 15-35 years old
Answer: Testicular cancer
Flashcard 422: An x-ray of the spine that shows focal, sclerotic, hyperdense lesions is suggestive of _____
Answer: prostate cancer
Flashcard 423: Risk factors for benign prostatic hyperplasia: _____ Family history
Answer: Age (especailly > 50 years)
Flashcard 424: _____ is the most common early symptom of Benign Prostatic Hyperplasia
Answer: Urinary frequency/nocturia
Flashcard 425: Prostate cancer can present with _____uria
Answer: haemat
Flashcard 426: If MRI confirms prostate cancer then perform a _____
Answer: biopsy
Flashcard 427: What are the initial investigations/examinations for BPH? _____
Answer: DRE & PSA
Flashcard 428: What are the initial investigations for prostate cancer? _____
Answer: Digital rectal examination & PSA
Flashcard 429: Digital Rectal Examination diagnosis: Hard, asymmetric, nodular = _____ Smooth, firm, enlarged = benign prostatic hyperplasia Boggy, soft, tender = prostatitis
Answer: prostate cancer
Flashcard 430: Dihydrotestosterone stimulates the prostate to grow so _____ ↑ with age
Answer: BPH
Flashcard 431: What is the most important question on the International Prostate Symptoms Score (IPSS)? _____
Answer: Quality of Life = "if you were to spend the rest of your life with your urinary condition the way it is now, how would you feel about that?"
Flashcard 432: Describe Gleason grading for prostate cancer: _____
Answer: The two most common growths are analysed and given a score from Grade 1 to 5. E.g. 3+4 = 7. 2 is the lowest and 10 is the highest. 10 suggests the most poorly differentiated cells thus most advanced cancer development
Flashcard 433: Prostate cancer is often asymptomatic but can present with Lower Urinary Tract Symptoms: _____, poor flow, urge incontinence
Answer: urinary frequency/nocturia
Flashcard 434: Testicular cancer most commonly presents with _____ solid testicular lump
Answer: painless
Flashcard 435: What is the second-line pharmacological management for benign prostatic hyperplasia? _____ (bonus for drug class*)
Answer: 5α-reductase inhibitors e.g. finasteride
Flashcard 436: Digital rectal examination for benign prostatic hyperplasia: _____ symmetrical enlargement
Answer: Smooth
Flashcard 437: Prostate cancer risk factors: Advanced _____ Obesity Family history African descent
Answer: age
Flashcard 438: Management of BPH initially involves _____
Answer: lifestyle advice
Flashcard 439: _____ germ cell tumors = elevated AFP and β-hCG Seminomatous germ cell tumors = only elevated β-hCG
Answer: Non-seminomatous
Flashcard 440: Prostate cancer is _____ growing
Answer: slow
Flashcard 441: Testicular cancer risk factors: Cryptorchidism Family history _____ Klinefelter's syndrome
Answer: Infertility
Flashcard 442: A patient with suspected BPH should do a _____ chart for in specialist assessment
Answer: urinary frequency-volume
Flashcard 443: Testicular exam for testicular cancer: _____
Answer: Tethered "stuck on" hard lump that may be craggy
Flashcard 444: What are the three main mx options for local prostate cancer (T1/T2)? _____ Radical prostatectomy Radical radiotherapy
Answer: Active surveillance
Flashcard 445: Urothelial (transitional cell) carcinomas can occur in any region along the urinary tract but most commonly occur in the _____
Answer: bladder
Flashcard 446: A 2-week urgent referral for bladder cancer should be made in patients aged ≥ _____ years who present with: - Unexplained visible haematuria without a UTI - Visible haematuria that recurs or persists following successful treatment of a UTI
Answer: 45
Flashcard 447: What is the most common cancer in men? _____
Answer: Prostate
Flashcard 448: What investigations may be done for bladder cancer locoregional staging & distant disease? _____
Answer: MRI pelvis, distant CT scanning
Flashcard 449: Bladder cancer typically presents after age _____
Answer: 60
Flashcard 450: The most important factor for prognosis of a urothelial (transitional cell) carcinoma is the degree of _____
Answer: invasion
Flashcard 451: What is the management of T1 stage bladder tumours? _____
Answer: Intravesical BCG
Flashcard 452: Most prostate cancers are _____
Answer: adenocarcinomas
Flashcard 453: _____ cancer most commonly presents with painless haematuria
Answer: Bladder
Flashcard 454: Prostate cancer lymphactic spread invades the _____ lymph nodes first
Answer: obturator
Flashcard 455: What is the management of T2 stage bladder tumours? _____
Answer: Radical cystectomy
Flashcard 456: What is the investigation of choice for bladder cancer? _____
Answer: Cystoscopy + biopsies
Flashcard 457: Bladder tumours are staged using _____ criteria
Answer: TNM
Flashcard 458: What is the biggest risk factor for bladder cancer in Western countries? _____
Answer: Smoking → responsible for 40% of cases
Flashcard 459: Bladder cancer affects _____ more commonly
Answer: males
Flashcard 460: What industries are aniline dyes common in (RF for urothelial carcinoma)? _____
Answer: Printing & textiles → chemical, cable, rubber, leather, painting, & dye industries
Flashcard 461: What drugs are risk factors for urothelial (transitional cell) carcinomas ? _____
Answer: Cyclophosphamide, phenacetin
Flashcard 462: _____ is a malignant growth in the prostate that has a lifetime risk of 1 in 6 men
Answer: Prostate cancer
Flashcard 463: What is the management of Ta stage bladder tumours? _____
Answer: Transurethral Resection of Bladder Tumour (TURBT)
Flashcard 464: TNM for bladder cancer (urothelial carcinoma): Ta = _____ T1 = tumour invades sub epithelial connective tissue T2 = Invades muscle layers
Answer: non invasive papillary carcinoma
Flashcard 465: For patients aged ≥ _____ years, 2-week urgent referral for bladder cancer should be considered if they have unexplained non-visible haematuria along with either dysuria or an ↑ elevated WBC count
Answer: 60
Flashcard 466: _____ infection is associated with squamous cell carcinoma of the bladder in Middle eastern males
Answer: Schistosoma haematobium
Flashcard 467: Bladder cancer types: _____ >90% Squamous cell carcinoma Adenocarcinoma
Answer: Urothelial (transitional cell) carcinoma
Flashcard 468: Urothelial (transitional cell) carcinoma is a urinary tract cancer associated with _____ dyes
Answer: aniline (azo)
Flashcard 469: _____ cancer is the 2nd most common urological cancer
Answer: Bladder
Flashcard 470: Urothelial (TC) carcinoma of the _____/ureter may cause flank pain + haematuria
Answer: kidney
Flashcard 471: What is the first-line management of stress incontinence? _____
Answer: Pelvic floor muscle training
Flashcard 472: What is the management of testicular torsion? _____
Answer: Urgent surgical exploration → bilateral orchiopexy
Flashcard 473: If urgency and stress incontinence symptoms are both present, it is referred to as _____
Answer: mixed incontinence
Flashcard 474: _____ urinary incontinence is the involuntary leakage of urine when intra-abdominal pressure ↑ (e.g coughing, sneezing, & exercise)
Answer: Stress
Flashcard 475: Urinary incontinence most commonly affects _____
Answer: elderly females
Flashcard 476: What is the first-line management of urge incontinence? _____
Answer: Bladder training
Flashcard 477: What is the second-line management of stress incontinence? _____
Answer: Surgery - retropubic mid-urethral tape/sling procedures
Flashcard 478: What is the management of stress incontinence if pelvic floor muscle training fails and surgery is declined? _____
Answer: Duloxetine
Flashcard 479: The main risk factor for urinary incontinence is _____
Answer: age
Flashcard 480: _____ incontinence is due to incomplete bladder emptying, often caused by bladder outlet obstruction (e.g. BPH)
Answer: Overflow
Flashcard 481: _____ incontinence is due to comorbid physical, cognitivie, or environmental barriers that prevent timely access to the toilet
Answer: Functional
Flashcard 482: What investigations are done to determine any underlying causes/exacerbations of urinary incontinence? _____
Answer: Urine dipstick to test for infections Pelvic examination to identify pelvic contraction
Flashcard 483: Testicular torsion peaks at age ~_____
Answer: 14
Flashcard 484: Testicular torsion presents as _____ pain, high-riding testis, and absent cremasteric reflex
Answer: sudden testicular
Flashcard 485: What is the initial investiagtion of urinary incontinence? _____
Answer: Bladder diaries for a minimum of 3 days
Flashcard 486: Immediate release oxybutynin for urge incontinence should be avoided in _____, instead mirebegron is used
Answer: older women
Flashcard 487: For urinary incontinence, a _____ should be done to confirm pelvic floor muscle contraction
Answer: pevlic examination
Flashcard 488: Testicular torsion is diagnosed clinically + with scrotal examination, but if diagnosis is uncertain then _____ is performed
Answer: urgent ultrasound
Flashcard 489: _____ urinary incontinence is the sudden, intense urge to void that cannot be deferred
Answer: Urgency
Flashcard 490: What happens when the testis are elevated in testicular torsion? (Prehn's sign) _____
Answer: It does NOT ease the pain
Flashcard 491: _____ is the torsion/twisting of spermatic cords that results in testicular ischaemia
Answer: Testicular torsion
Flashcard 492: What condition is essential to exclude for an acute scrotal presentation in young males? _____
Answer: Testicular torsion
Keywords: Renal & Urology flashcards, medical flashcards, NEET PG preparation, USMLE Step 1 flashcards, Anki alternative, spaced repetition medical, OnCourse flashcards
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