Renal and Urology
Kidney injury, chronic kidney disease, electrolytes and urological disease.
- Acute Kidney Injury Staging with the KDIGO criteria, working through pre-renal, intrinsic and post-renal causes, the nephrotoxic drugs to stop immediately, and the AEIOU indications for urgent dialysis.
- Chronic Kidney Disease Staging by eGFR and albuminuria together, why cardiovascular death is likelier than reaching dialysis, and the blood pressure control, ACE inhibitor and SGLT2 inhibitor that slow progression.
- End Stage Renal Disease and Renal Replacement Therapy Haemodialysis, peritoneal dialysis, transplantation and conservative care: how each works, why a fistula needs eight weeks to mature, and the complications specific to each modality.
- Transplantation and Immunosuppression Donor matching and the iliac fossa graft, separating hyperacute from acute and chronic rejection, and the calcineurin inhibitor toxicities and long-term cancer risk that follow.
- Nephrotic Syndrome Heavy proteinuria, hypoalbuminaemia and oedema: the histological causes by age, why these patients clot and catch infections, and which types respond to steroids.
- Glomerulonephritis Nephritic syndrome and the individual glomerulonephritides: the timing that separates IgA nephropathy from post-streptococcal disease, and the crescents of rapidly progressive disease.
- Diabetic Nephropathy Annual ACR screening, the natural history from hyperfiltration to overt proteinuria, the four pillars that slow it, and the features that should make you suspect a different diagnosis.
- Polycystic Kidney Disease PKD1 versus PKD2 and what each means for timing, the berry aneurysms and other extrarenal disease, and the patients in whom tolvaptan is worth its side effects.
- IgA Vasculitis Palpable purpura over the buttocks and legs with arthritis, abdominal pain and nephritis, why meningococcal sepsis must be excluded first, and the urine testing that runs for months.
- Rhabdomyolysis Muscle breakdown releasing myoglobin, potassium and CK: why the urine dipstick lies, why fluids come before anything else, and the hyperkalaemia that can kill before the creatinine even rises.
- Urinary Tract Infection Reading the dipstick and knowing when not to, the NICE antibiotic choices and durations, and why a UTI in a man or a child is never just a UTI.
- Pyelonephritis The triad of fever, loin pain and vomiting, who needs admission and imaging, and the obstructed infected kidney that needs draining not just antibiotics.
- Urinary Tract Calculi The colicky loin-to-groin pain, why non-contrast CT KUB is first line, which stones pass on their own, and the infected obstructed kidney.
- Hydronephrosis Separating obstructive from non-obstructive causes, the unilateral versus bilateral rule, and relieving obstruction before renal function is lost.
- Urinary Retention and Obstructive Uropathy Acute versus chronic retention, catheterising safely, and recognising high-pressure chronic retention before the kidneys are lost.
- Urinary Incontinence Separating stress from urge incontinence and both from overflow, the bladder diary and pelvic floor training that come first, and the drugs to avoid in frail patients.
- Benign Prostatic Hyperplasia Scoring severity with the IPSS, excluding prostate cancer on examination, and the alpha-blocker and 5-alpha reductase inhibitor decision.
- Prostate Cancer Interpreting PSA and its pitfalls, the MRI-before-biopsy pathway, Gleason grading, and androgen deprivation and its harms.
- Prostatitis Acute bacterial prostatitis and chronic pelvic pain syndrome: why the prostate must not be massaged acutely, and why courses run for weeks.
- Bladder Cancer Painless visible haematuria until proven otherwise: the referral thresholds, why TURBT decides everything, and non-muscle-invasive versus muscle-invasive disease.
- Renal Cancer The classic triad that is now rare, the paraneoplastic syndromes and left varicocoele, and why most renal cancers are found incidentally.
- Testicular Torsion The 6-hour surgical emergency: recognising it clinically, why imaging must never delay theatre, and the bell-clapper deformity that means both testes are fixed.
- Testicular Cancer A painless testicular lump in a young man: seminoma versus non-seminoma, the markers taken before surgery, and why sperm banking comes first.
- Epididymitis and Orchitis Gradual-onset scrotal pain with a tender epididymis: choosing antibiotics by likely organism and age, and always excluding torsion first.
- Hydrocoele, Varicocoele and Epididymal Cyst Using transillumination and whether you can get above the lump, and the two scrotal presentations that are not benign at all.
- Phimosis and Paraphimosis Physiological versus pathological phimosis, and the retracted foreskin that cannot be replaced: why paraphimosis is an emergency and how to reduce it.
- Penile Cancer A rare squamous cell carcinoma driven by HPV, phimosis and lichen sclerosus: the lesion hidden under the foreskin, and why the inguinal nodes decide survival.
- Hyperkalaemia Reading the ECG, the calcium-insulin-salbutamol sequence, and why calcium protects the heart but does not lower the potassium.
- Hypokalaemia U waves and a long QT: using blood pressure and acid-base status to find the cause, safe replacement rates, and why magnesium must be corrected first.
- Hyponatraemia Classifying by volume status and osmolality, separating SIADH from cerebral salt wasting, and correcting slowly enough to avoid osmotic demyelination.
- Hypernatraemia Almost always a water deficit rather than too much salt: who is at risk, calculating replacement, and correcting slowly to avoid cerebral oedema.
- Hypercalcaemia Bones, stones, groans and psychiatric moans: correcting for albumin, using PTH to split the causes in two, and fluids before bisphosphonates.
- Hypocalcaemia Tetany, Chvostek's and Trousseau's signs and a long QT: using phosphate and PTH to find the cause, and when to give IV calcium gluconate.
- Acid-Base Disorders The anion gap and delta ratio, the renal tubular acidoses, chloride-responsive versus resistant alkalosis, and spotting a mixed disorder.