Renal Finals

AEIOU: Acidosis, Electrolyte abnormalities, Intoxication (lithium, salicism, methanol), Overload, Uraemia

Reduce fluid intake, potassium restriction, phosphate restriction

Tenckhoff catheter

Continuous ambulatory peritoneal dialysis, automated peritoneal dialysis

Haemofiltration involves filtering blood through a high pressure column, as opposed to haemodialysis which is a countercurrent system.

Common non-severe: headache, itching, cramps. Disequilibrium syndrome (cerebral oedema), hypotension, hyperkalaemia, fluid balance.

Arm elevation test (for outflow obstruction) - fistula should collapse. Augmentation test (for anastomotic stenosis) - pulsation when vein occluded

4-6 weeks

1. thrombosis 2. venous stenosis, 3. aneurysm, 4. infections 5. steal syndrome

Do not let anyone take blood from or cannulate a fistula arm

1. CVC (tunnelled or non tunnelled) 2. PD 3. Vascath (haemofiltration)

low re-circulation rate, lower infection rate than in situ CVA, efficient dialysis, lower thrombosis rate

Peritoneal adhesions, stoma, hernia

peritonitis, site infection, constipation, pleural effusions

Can be done at home, easier to go on holiday abroad

diabetes, ADPCKD, hypertension, glomerulonephritis

Cardiopulmonary insufficiency, hepatic disease, cancer, active infection

Rutherford Morrison scar

External iliac vein, external iliac arter

steroids, azathioprine, ciclosporin (or tacrolimus)

Rejection (hyperacute, acute, chronic), immunosuppression (infection, EBV mediated lymphoproliferation), other (UTIs, kidney thrombosis)

Lasts 10-15 years, affected by donor type and age. Live 10-15 years longer than if on dialysis

Vascular (BuddChiari, RVF), Infectious (glandular fever, hepatitis, abscesses, malaria), neoplasm (mets, hcc, haem), autoimmune (sarcoid, amyloid), metabolic (ALD, haemochromatosis, NAFLD), Iatro (TB drugs), Congenital (Riedel's lobe)

infiltration (leukaemia, lymphoma, myeloproliferation), increased function (extravascular haemolysis, extramedullary haematopoiesis, infection), Vascular congestion (cirrhosis, splenic vein obstruction, hepatic vein obstruction)

infection (hepatitis, malaria), infiltration(myeloproliferative disorders), portal hypertension, infiltration (amyloidosis, sarcoidosis)

two holes made in central large bowel and brough to the surface to protect a distal anastamosis.

when both ends of a resected segment are brought to the surface to form a stoma.

whole colon has been removed e.g. UC, FAP, Hirschsprung's disease

Cystectomy for bladder cancer.

Early: high output stoma causing dehydration and hypokalaemia, retraction, bowel obstruction, ischaemia of stoma.

parastomal hernia, prolapse, fistulae, psychological, skin dermatitis, fistulae.

stoma nurse, empty when 2/3 full, daily irrigation, change every 2-4 days, diet, wear in shower

lots of fluids. Small amounts of fibre for first 2 months. Avoid: nuts, coconut, sweetcorn, celery, broccoli, beans, fizzy drinks (blockage, flatulence).

ASIS to pubic tubercle

spermatic cord (vas deferens, testicular artery, testicular nerves, pampiniform plexus, lymph vessels), ilioinguinal nerve

round ligament of uterus, ilioinguinal nerve.

MALT: Muscle (internal oblique, roof), Aponeurosis (external oblique, anterior), ligament (inguinal ligament, floor), tendon (transversalis fascia, posterior)

halfway between ASIS to pubic symphysis = femoral artery

midpoint between ASIS to pubic tubercle = deep inguinal ring

midpoint of inguinal ligament

just superior and medial to pubic tubercle

indirect (60%), direct (40%)

below and lateral to pubic tubercle

above and emdial to pubic tubecle

anywhere between deep inguinal ring and scrotum