Questions and Answers
What is typically an abnormal laboratory finding in patients with kidney disease?
Which symptom is commonly associated with obstructing nephrolithiasis?
Which urinalysis finding indicates proteinuria in a patient?
What is a notable distinction between acute and chronic renal injury?
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What condition is likely if a patient exhibits new-onset hypertension?
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Which of these is an abnormal finding typically seen in routine imaging of the kidneys?
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What does a decrease in estimated glomerular filtration rate (eGFR) indicate?
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Which electrolyte value might be abnormal in a patient with advanced kidney disease?
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Which condition might manifest as skin changes or a rash with renal disease?
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What symptom is least likely to be directly linked to kidney disease?
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Study Notes
Labs and Imaging Techniques
- Hydronephrosis evaluated via ultrasound (US); extrinsic or intrinsic disease detected through CT scans; tumors assessed using MRI.
Acute vs. Chronic Renal Disease
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Acute Renal Injury:
- Characterized by increased serum creatinine (SCr) within hours or days, or decreased urine output (UO) for more than six hours.
- SCr increase > 26.5 µmol/L (0.3 mg/dL), or more than 50% of baseline.
- UO < 0.5 mL/kg body weight.
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Chronic Renal Disease:
- Involves structural kidney damage with a glomerular filtration rate (GFR) < 60 mL/min per 1.73 m² body surface area for over three months.
Patient Cases
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Case 1:
- 54-year-old male with poorly controlled type II diabetes.
- Presents with an oozing foot wound; denies polyuria, polydipsia, or weight loss.
- Current HbA1C: 8.9 µg/dL; on metformin and semaglutide.
- Urine examination options to evaluate renal disease include albumin, protein tests.
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Case 2:
- 34-year-old female with a history of sepsis and low blood pressure during hospitalization.
- Follow-up after discharge and long-term antibiotic therapy.
Renal/Urinary System Diseases
- Renal disease can manifest at various levels; may be asymptomatic or discovered incidentally.
- Symptoms can include fatigue, proteinuria, and conditions like polycystic kidney disease (PCKD).
- Screening recommended for patients with comorbidities such as diabetes mellitus.
Medication and Social History Impacts
- Medications can cause symptoms like polyuria, polydipsia, and nocturia (e.g., lithium).
- Lead exposure linked to renal failure; aniline dye linked to bladder cancer, both associated with nephrotoxicity.
Gold Standard for Renal Disease Evaluation
- Initial work-up for renal disease includes:
- Urinalysis (UA): dipsticks, sediment examination, and morphology analysis.
Presentation of Kidney Disease
- Common presentations include abnormal lab results: increased BUN, increased SCr, decreased eGFR.
- Asymptomatic findings: microscopic hematuria, proteinuria, and microalbuminuria.
- Changes in urinary habits: frequency, urgency, and nocturia.
- New-onset hypertension and worsening edema may occur.
- Nausea, vomiting, and malaise are non-specific symptoms.
- Flank pain could indicate obstructing nephrolithiasis.
- Incidental imaging may reveal various kidney abnormalities (e.g., horseshoe kidney, angiomyolipoma).
- Systemic diseases (e.g., scleroderma, lupus) may cause renal-related skin changes.
Glomerular Filtration Rate (GFR)
- The GFR is influenced by hydrostatic pressure and oncotic pressure across the glomerular capillary wall, affecting filtration dynamics.
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Description
This quiz covers the imaging techniques used to assess renal disease, including hydronephrosis on ultrasound, intrinsic or extrinsic disease on CT scans, and tumors on MRI. Enhance your understanding of these modalities as part of the diagnostic process in renal and urinary tract conditions.
