Nephrology. Clinical Cases Uncovered

Description

Nephrology is an important speciality; patients with acute or chronic kidney failure are encountered in every medical and surgical speciality, as well as in General practice. On most General Medical rotations and on most surgical wards there are patients with renal problems. Renal medicine is taught on rotation during degree courses, and Foundation training programmes frequently include attachments in nephrology, urology, and renal transplantation. Nephrology: Clinical Cases Uncovered contains clinical presentations with real-life patient cases and outcomes as seen on the wards and in exams, and leads students through a practical approach to diagnosis and management of kidney disease.
Following a question-answer approach, including self-assessment material and a ‘refresher’ section on the basic science of this clinical area, Nephrology: Clinical Cases Uncovered features investigations and the treatment options available for patients with renal disease, including those requiring renal replacement therapy with dialysis and transplantation. Difficult concepts are clarified, using simple diagrams to explain the link between pathology and clinical presentation.

Nephrology: Clinical Cases Uncovered is ideal for medical students, junior doctors on the Foundation Programme, GP trainees, and specialist nurses and nurse practitioners. This book is also a useful refresher for Nephrology trainees at the beginning of their specialist training programme.

Table of Contents

Preface.
Acknowledgements.
How to use this book.
Normal range for investigations.

Part 1 Basics.

Basic science.
Approach to the patient.
Clinical overview.

Part 2 Cases.

• Patients with acute renal failure.

Case 1 An 84-year-old man with a reduced urine output.
Case 2 A 74-year-old man with acute renal failure.
Case 3 A 64-year-old man with back pain and polydipsia.
Case 4 A 20-year-old female with facial swelling and coke-coloured urine.
Case 5 A 68-year-old man with hearing loss, fatigue and arthralgia.
Case 6 A 19-year-old man with macroscopic haematuria.
Case 7 A 27-year-old female with a rash and renal impairment.
Case 8 A 26-year-old man with haemoptysis and oliguria.
Case 9 A 25-year-old female presents with rash and joint pain.
Case 10 An 18-year-old female with lethargy and headache.

• Patients with nephrotic syndrome.

Case 11 A 56-year-old man with ankle swelling.
Case 12 An 80-year-old with abdominal discomfort and ankle swelling.
Case 13 A 23-year-old obese female with ankle swelling.
Case 14 A 15-year-old female with with facial swelling and frothy urine.

• Patients with hypertension.

Case 15 A 50-year-old woman with hypertension.
Case 16 A 60-year-old male smoker with hypertension and renal impairment.

• Patients with urine dipstick abnormalities.

Case 17 A 25-year-old woman with dysuria and urine dipstick abnormalities.
Case 18 A 40-year-old ex-intravenous drug user with protein and blood on urine dipstick.
Case 19 A 35-year-old man with macroscopic haematuria.
Case 20 An 82-year-old lady with dark urine.

• Acid-base and electrolyte problems.

Case 21 A 28-year-old type I diabetic man with abdominal pain and vomiting.

Case 22 A 22-year-old with weakness and lethargy.

Case 23 A 58-year-old type 2 diabetic with confusion and hyponatraemia.

• Patients with CKD/ESRF.

Case 24 A 49-year-old man with headache and malaise.
Case 25 A 23-year-old man with shortness of breath.
Case 26 A 34-year-old man on haemodialysis.
Case 27 A 54-year-old man with end-stage renal failure.
Case 28 A 50-year-old man on peritoneal dialysis with abdominal pain.

• Renal transplantation.

Case 29 A 49-year-old man with chronic kidney disease.
Case 30 A 38-year-old man with a rise in creatinine 2 weeks post-renal transplant.
Case 31 A 45-year-old man with a renal transplant and fever.

Part 3 Self-assessment.

MCQs.
EMQs.
SAQs.

Answers.
Index of cases by diagnosis.
Index.

Author Information

Dr Menna Clatworthy, Clinical Lecturer in Renal Medicine, University of Cambridge