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Summary Urinary Core Conditions
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A condensed summary of the urinary core conditions for the Leeds MBChB year 3 syllabus
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URINARY CORE CONDITIONS SUMMARYCondition Summary Epidemiology Pathophysiology Prognosis Aetiology Risk Factors S/S Investigations DDs Treatment Complications
Pre-renal: injury impairs renal
perfusion, activating RAAS; Pre-renal: azotaemia Underlying renal
Poor due to the Reduced urine Volume expansion;
hypovolaemia stimulates ADH, (from haemorrhage, disease; HTN; DM;
nature of production; N&V; RBC transfusion; Hyperphosphataemia;
AKI Acute decline resulting in concentrated urine
patients; recovery
sepsis, heart failure) CCF; haemorrhage;
dizziness; PND;
U&Es; urinalysis;
vasopressors; volume overload;
in kidney Elderly hospitalised Intrinsic: impaired renal perfusion Intrinsic: tubular cirrhosis; excess fluid urine culture; FBC; CKD, increased muscle
(acute kidney function, with patients and tissue hypoxia causes tubular
is related to
necrosis, nephritis, loss; surgery; sepsis; orthopnoea; VBG; renal USS; mass; drug side-effects diuretic; RRT; treat uraemia; ESRD;
cause, severity oedema; underling condition; hyperkalaemia; CKD;
injury) reduced GFR necrosis and ischaemia
and duration of
vascular disease nephrotic syndrome;
hypotension/HTN;
CXR; ECG
catheterisation; relief metabolic acidosis
Post-renal: obstruction causes Post-renal: drugs (NSAIDS,
injury tachycardia of obstruction
increased intratubular pressure obstruction ACEi); pancreatitis
causing ischaemia/atrophy
Hyperplasia of both epithelial and Frequency; weak Urinalysis; PSA; Alpha-blocker;
BPH progression; UTI;
BPH Enlargement
stromal prostatic compartments, Majority can Shifts in age-related stream; incomplete BOTHER score; Overactive bladder; behavioural
renal insufficiency;
Elderly causing an increased stromal- expect moderate hormonal changes, Non-Asian race; emptying; urgency; volume charting; CT prostatitis; prostate management; 5aRi;
(benign prostatic (hyperplasia) of M epithelial ratio; occurs particularly in improvement to creating an androgen/ smoking nocturia; hesitency; abdomen/pelvis; cancer; UTI; bladder PDE-5 inhibitor; anti- bladder stones; sexual
the prostate dysfunction; acute urinary
hyperplasia) the transitional zone; over time symptoms oestrogen imbalance straining; post-void cystoscopy; I-PSS; cancer; stricture cholinergic; TURP;
retention
results in bladder outlet obstruction dribbling urodynamic study open prostatectomy
Appendicitis; ectopic
One, or a pregnancy; ovarian Conservative
combination, of
Plaques form on the basement Acute/severe flank Urinalysis; FBC; cyst; diverticulitis; management
Calculi Stones within membrane, eroding through the Lifelong disease increased levels of High protein/salt pain; N&V; urinary U&Es; pregnancy bowel obstruction; (hydration, anti- Urosepsis; ureteric
White adults urinary solutes, intake; white
(urinary tract the urinary
M>F
urothelium and forming a stable process, high rate
decreased levels of ancestry; chronic
frequency/urgency; test; CT abdomen/ pancreatitis; peptic emetics, analgesia); injuries/stricture; visceral
system surface on which calcium oxalate of recurrence haematuria; pelvis/KUB; renal ulcer; gastroenteritis; Abx; surgical stone organ injury
stones) crystals can grow stone inhibitors, low dehydration; obesity testicular pain USS; IV pyelogram AAA; pyelonephritis; removal; dietary
urinary volume, and torsion; constipation; modifications
low/high urinary pH cholecystitis/colic
Smoking; T2DM; Tobacco/chemical
Good, provided BPH; haemorrhagic
occupational carcinogen Urinalysis; cytology;
Mortality higher in Carcinogens are concentrated and early cystitis; prostatitis; UTI; Transurethral Prostatic urothelial
exposure to exposure; pelvic KUB USS; CT/IV
Carcinoma, Carcinoma of adult women and excreted in urine, exposing them to presentation; carcinogens; pelvic radiation; Haematuria; urogram; FBC; nephrolithiasis; RCC/ resection; carcinoma; upper tract
bladder the bladder black people the cells that line the urinary tract; poor with muscle dysuria; frequency urothelial carcinoma; intravesicular chemo/ TCC; hydronephrosis;
radiation; chronic chemotherapy; U&Es; CT abdomen/
M>F this is prolonged in the bladder involvement, even radiation cystitis; radio/immunotherapy urinary retention
inflammation/ Schistosoma/chronic pelvis; cystoscopy
with cystectomy diverticulitis
indwelling catheters bladder infection
Elevated PSA; Radiation-induced
High-grade prostatic intra-epithelial PSA; testosterone;
Black and elderly Curable, but frequency; weight Observation; external- dysuria/nocturia/
Carcinoma, neoplasia (PIN) is the precursor of LFTs; FBC; U&Es;
Carcinoma of (most commonly survival depends Unknown; high-fat Black ethnicity; high loss; hesitency; beam radiotherapy; diarrhoea/rectal bleeding/
invasive prostate cancer; spreads prostate biopsy; BPH; chronic prostatitis
prostatic the prostate adenocarcinoma) on initial stage at diet; genetics levels of dietary fat nocturia; dysuria; prostatectomy; lymph retention/proctitis/
M along the capsular surface of the bone scan; pelvic CT
diagnosis abnormal PR exam, node dissection incontinence/ stricture;
gland and can spread further scan
lethargy; bone pain erectile dysfunction
Smoking; residence Asymptomatic; Benign renal cyst;
Adults from FBC; LDH; LFTs; Surgery; local ablation Anaemia; adverse effects
VHL protein functions to degrade in develop country; haematuria; flank ureteric/bladder cancer;
Carcinoma, developed countries Smoking; obesity; corrected calcium; therapy; from treatment;
Carcinoma of hypoxia-inducible factor (HIF); Generally good, black/American- pain; palpable upper urinary tract
(most commonly HTN; transplant coagulation profile; consideration for hypercalcaemia;
renal the kidney without VHL, HIF promotes genes unless metastatic Indian; obesity; HTN; abdominal mass; urothelial tumour;
adenocarcinoma) dialysis creatinine; urinalysis; clinical trial or erythrocytosis; SIADH;
for various growth factors hereditary non-specific secondary metastasis;
M>F USS; CT targeted therapy hepatic dysfunction
syndromes systemic symptoms renal infarction/infection
Initial renal insult causes a cascade DM kidney disease;
Chronic (>3m) Progressive DM; HTN; childhood
CKD loss of renal Black and
of events, including an increase in
condition that will
DM; HTN; PCKD;
kidney disease;
Fatigue; oedema; Serum creatinine; HTN nephrosclerosis; ACEi/ARB; statin; Anaemia; CVD; protein-
intra-glomerular pressure (with obstructive uropathy; N&V; pruritis; urinalysis; urine ischaemic nephropathy; CCB; RRT; deficit; metabolic
(chronic kidney function, Hispanic adults hypertrophy) and permeability to eventually lead to glomerular nephritis/ smoking; obesity; anorexia; foamy- micro-albumin; renal obstructive uropathy; erythropoietin- acidosis; hyperkalaemia;
determined by M>F ESRD and need autoimmune
disease) GFR
macromolecules (causing scarring/
for RRT
nephritic syndrome
disorders
appearing urine USS; eGFR nephrotic syndrome; stimulating agent pulmonary oedema
inflammation/fibrosis) glomerulonephritis
Anatomical or functional obstruction
Swelling of Calculi; urolithiasis; Calculi; urolithiasis; Flank pain; Renal USS; Urine drainage with
of urine flow anywhere along the Good if
one or both Adults M<F pregnancy; BPH; thrombus; UTI; distention; UTI cystoscopy; FBC; urethral catheter or
Hydronephrosis kidneys due to Elderly M>F
urinary tract causes increased diagnosed/
ureteric stenosis; scarring; tumour; symptoms; U&Es; PR for
Renal sinus cysts
nephrostomy; treat
UTI; CKD
ureteral pressure, leading to marked treated promptly
urine build-up cancer BPH; pregnancy haematuria prostate enlargement underlying cause
decline in renal function
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