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Flashcards in Genitourinary Deck (312):
1

finding in renal biopsy in MPGN

dense deposit in glomerular basement membrane

2

quid of dense deposit

C3

3

Physiopatho in MPGN

persistent activation of alternative pathway of complement

4

quid of nephritic factor

IGG against c3 convertase

5

clue for MPGN

Hematuria and SN

6

action of cyclosporin

inhibits interleukin 2 transcription

7

what s the most common side effect of cyclo

nephrotoxicity

8

how nephrotoxicity induced by cyclo manifest

hyperkalimia
Hus sometimes

9

side effect of cyclo to remember(5)

nephrototoxycity
tremor
hta
gum hypertrophy
hyperkaliemia

10

Mycophenolate side effect

marrow suppression

11

azathioprine side effect(3)

diarhee
leukopenia
hepatotoxicity

12

patient with autosomal dominant polykystic renal disease with intracerebral hemorrrage,why

rupture of berry aneurism

13

most common extra renal manif of ADPKD

Hepatic cyst

14

other extra renal manif of ADPKD(3)

Mitral valve prolapse/aortic regurgitation
colonic diverticula
abdominal wall hernia or inguinal hernia

15

urinalysis sign of nephritis

WBC cast

16

patient on cephalexin develops dark urine

drug induced intersticial nephritis

17

hallmark of drugs induced intersticial nephritis(2)

eosiniphiluria
hypereosniphilie

18

treatment of drug induced intersticial nephritis

stop the offending agent

19

the first phenomenon occuring in diabetic

glomerular hyperfiltration

20

why GFR increases in diabetics patient

because of glomerular hypertrophy

21

perio to have high GFR in diabetic patient

0-5 ans

22

laps of time to have microalbuminuria

5-10 years

23

why you will have microalbuminuria

mesangial expansion

24

quid of arterial hyalinosis

thickening of the basement membrane=mesangial expansion

25

what will happen after ten years in diabetics patient(2)

mesangial nodule
(kimmelstiel nodules disease)
tubulointersticial fibrosis
nephrotic syndrome avec low GFR

26

what can you have during mesangial expansion

HTA

27

quid of glomerulosclerosis

tubulointersticial fibrosis

28

hallmark of renal problem in diabetics patient

microangiopathy

29

risks factor for diabetics nephropathy

bad glycemia control
HTA
smoking
age
ethnicity

30

what nationality is a risk fector for diabetic nephropathy

mexican
african american

31

first cause of renal failure in north america

diabetes

32

management of uncomplicated pyelonephritis

blood culture
followed by empiric antibiotics

33

indication of MRI or US in pyelonephritis(2)

persistent fever
rulet out abcess or obstruction

34

persistent fever in pyelonephritis(2)

abcess
obstruction

35

indication of iv pyelogram in pyelonephritis

chronic pyelonephritis

36

complication of acute pyelonephritis(3)

abcess
papillary necrosis
emphysematous pyelonephritis

37

cause of bleeding in renal failure

platelet dysfunction

38

rx of bleeeding in renal failure

desmopressin(DDAVP)

39

what cause platelet dysfunction in renal failure

accumulation of guanidino succinic acid

40

red urine in patient taking anti tb

drug reaction(rifampicin)

41

clue for renal cell carcinoma(2)

blood in urine
left sided varicoceles

42

work up of renal cell carcinoma

abdominal CT

43

clue for varicocele

they fail to empty due to obstruction of gonadal vein by the the tumor when it entries in renal vein when the patient is in recumbent position

44

why erythrocytosis in renal cell carcinoma

high production of erythropoietine by the tumor

45

paraneoplastic syndrome in RCC(5)

anemia or erythrocytosis
hypercalcemia
thrombocytosis
cachexia
fever

46

patient whith tonic clonic seizure develops renal failure and high K+ why

rhabdomyolysis

47

why renal failure in rhabdomyolysis

tubular injury by myoglobin

48

cause of high K+

rein prroblem
medication
Metaboloic acidosis
hyperglycemia
tissue or cell destruction
pseudo hyperkaliemia

49

medication induced high K+(7)

amyloride
ACE inhibitor
ARBS
NSAIDS
K+sparing diuretics
non selectived B blocker
digoxin

50

secret to hyperkaliemie

all the time you block the SRAA --->high K+

51

quid of pseudo hyperkaliemia

hemolysed blood sample

52

why hyperglycemia causes high K+

K+ Movement out of the cells

53

why ACE inhibitor and ARB's causes high K+

block SRAA axis

54

why k+ sparing diuretics causes high K+

block receptor aldosterone

55

why NSAIDS causes high K+

because prostanglandin plays a key role in the activation of SRAA axis

56

why digoxin causes high K+

by blocking K+NA+ ATPASE PUMP

57

why B Blocker causes high K+

block uptake of K+ by cells

58

EKG finding of hyperkaliemia

peaked T waves

59

Patient with disk herniation develops retention of urine

2 possibilities
-severe pain plus HBP
cauda equina syndrome

60

Patient with disk herniation develops retention of urine sever pain and HBP

because of HBP valsalva maneuver will be perfrom strongly by the patient and more pain wil be produced if disk herniation because of high intra abdominal peressure
so retention can occur

61

clue of cauda equina syndrome

anal sphincter tone will decrease because of nerve root injury

62

cause of neurologic deficit in herniated disk

spinal nerve inpingement

63

why elderly is prone to dehydration(3)

decrease thirst response to dehydration
impaired renal Na+ conservation
impaired renal ability concentration

64

rx of dehydration

crystalloid

65

why you should rehydrate elderly with caution

because sodium loading can unmask subclinical heart failure in elderly

66

4 types of renal stones(4)

calcium oxalate/phosphate
acid uric
struvite or triple phosphate
cysteine

67

most common type of stone

calcium stone

68

most common cause of calcium stones(7)

idiopathic hypercalciuria
hyperuricosuria
hyperoxaluria
decrease urinary citrate
renal tubular acidosis
chronic decrease of urine output
hypercalciuria secondary to systemic disorder

69

quid idiopathic hypercalciuria(2)

hypercalciuria
normal calcemia

70

whaT's the most common cause of hypercalciuria

idiopathic hypercalciuria

71

systemic disorder causing hypercalciuria(2)

primary hyperparathyroidism
sarcoidosis

72

causes of hyperoxaluria(4)

high vit C intake
high green leafy vegetables intake
IBD
short bowel syndrome

73

finding in renal tubular acidosis

nephrocalcinosis

74

hypercalciuria in Men

> 300 mg /24 H

75

hypercalciuria in women

> 250 mg/24 h

76

rx of stones induced by idiopathic hypercalciuria(3)

fluid intake
dietary Na+ restriction
thiazide or amiloride

77

action of thiazide(2)

decrease urinary calcium excretion
precent precipitation of calcium in urine

78

rx of stones induced by hyperuricosuria(2)

purine restricted diet
allopurinol

79

recommandation for rx of calcium stone what to restrict

Na+
oxalate
proteins

80

restriction of na+ in calcium stones

81

source of oxalate (3)

dark roughage
chocolate
vit C

82

protein source to avoid in calcium stone(4)

beef
poultry
eggs
fish

83

what to increase in rx of calcium stone

fluid
normal or high calcium intake

84

fluid to take during rx of calcium stone

> 3 l day

85

intake of calcium in rx of calcium stone

1000 mg daily

86

why furosemide is contraindicated in calcium stone

it increase excretion of calcium

87

first thing in acute non complicated calcium stone(3)

fluid
observation
analgesique

88

nephrotic syndrome tetrad

proteinuria > 3-3.5 g par 24 h
hypoalbuminemia
edema
hyperlipidemia and lipiduria

89

the most common manif of SN

proteinuria

90

basic pathology of SN

altered permeability of basement glomerular membrane

91

disease causing SN(5)

Minimal change
Membranous glomerulopathy
mesangial proliferative glomerulonephritis
membranous proliferative glomerulonephritis
glomerulosclerose focale et segmentaire

92

cause of hypercoagulability in SN(5)

Loss of antithrombine 3
altered level of protein C et S
increased platelet aggregation
hyperfibrinogenemia
impaired fibrinolysis

93

why hyperfibrinogenemie

because of increase hepatic synthesis of fibrinogene

94

the most common manif of hypercoagulability in SN

renal vein thrombosis

95

why microcytic anemia in SN

because of loss of transferrin

96

complication of SN(5)

microcytic anemia
VIT D deficiency
low thyroxin level
infection
malnutrition

97

why low vit D in SN

because of increase excretion of cholecalciferol binding protein

98

why low thyroxin level in SN

loss of thyroxin binding protein

99

protein transporter of fer

transferrin

100

protein transporter of T3 T4

thyroxin binding globulin

101

protein tranporter of vit D

cholecalciferol binding protein

102

why acute renal failure in cocaine abuse

rhabdomyolisis

103

rhabdomyolisis in acute renal failure

myoglobin causes acute tubular necrosis

104

red flag for acute tubular necrosis in cocaine abuse

CPK >20000

105

differentiate drugs induced renal failure and drugs induced intersticial nephritis(2)

no wbc in the urinary sediment in drug u=induced renal failure
as the opposite of intersticial nephritis induced by drug

106

drugs causing renal failure

aminoglycoside

107

what to do during administration of aminoglycoside(2)

monitor renal fonction
monitor drug level

108

patient with CRAB cause of that(2)

paraproteinemia=
Bencejones

109

other name of Multiple myeloma

kahler disease

110

why renal inssuficiency in MM

obstruction of distal and collectig tubules by bence jones protein

111

simple renal cyst on ct (4)

black mass with no multilocular
no septae intra the mass
on thickened wall
ono enhancement on CT

112

management of simple renal cyst(2)

observation
reassurance

113

most common cause of SN in hogkin lymphoma

minimal change disease

114

the best way to remove K+ in the body in case of Hyperkaliemia(3)

kayexalate
dyalisis
diuretics

115

what's kayexalate(2)

cation exchange resin
Na+ entre K + sort

116

why amitryptiline can cause urinary retention(4)

anticholinergic effect
block detrusor contraction
prevent sphincter relaxation
no relaxation

117

why foley catheterization is important in urinary retention(2)

to provide symptomatic relief
to document retention

118

quid of priapism

painful and persistent erection

119

Med causing priapism(2)

trazodone
prazocin

120

disease causing priapism(2)

sickle cell disease
leukemia

121

quid of trazodone

it's a anti depressant

122

diabetic patient with proteinuria possibilities(2)

infection
glomerular basement changes

123

the 2 presentations of diabetic nephropathy

nodular glomerulosclerosis
diffuse glomerulosclerosis

124

most common cause of nephropathy in diabetic

diffuse glomerulosclerosis

125

clue for UTI in urinalysis(2)

leucocyte esterase positive
nitrites

126

quid of nitrites

presence of enterobacteriacea

127

quid of leucocyte esterase

pyuria

128

clue for chronic prostatitis(3)

voiding symptom

129

why in SN you have accelarated atherosclerosis(3)

hyperlipidemia
High LDL
Low HDL

130

risk in aptient with SN

MI
Stroke

131

prevention rx of hyperlipidemia in SN

statin

132

patient with HBP develops high creatine next step

abdominal US

133

what to do ig in HBP US shows hydronephrosis

foley is mandatory

134

how acyxclovir causes renal failure

renal tubular obstruction by crystalization of the drug in urine

135

what the main risk factor for acyclovir causing renal failure

inadequate hydration

136

specificity in urinalysis in colic nephretic(3)

wbc
rbc
no cast

137

indication of EPO(2)

anemia in renal failure
less than 10 g HB

138

side effect of EPO(4)

worsening HTA
headaches
flulike syndrome
red cell aplasia

139

how to prevent HTA worsening in EPO administration

slow raising of HMt with a goal of 30-35%

140

urinary retention with anticholinergic(4)

diphendramine
doxepin
hydroxyzine
chlorpheniramine

141

the earliest abnormality seen in diabetics

glomerular hyperfiltration rate

142

the earliest abnormality that can be quantified in diabetics

thickening of the basement membrane

143

role of ACE inhibitor in the prevention of nephropathy in diabetics

decrease intra glomerular HTA

144

prevention of acyclovir induced nephropathy

agressive hydration

145

after coronary stenting patient develops blue toe and high creat cause?

cholesterol emboli by disruption of plaques

146

clue cholesterol emboli inducing renal circulation problem and pedal circulation

elevated eosinophiles
low C3

147

patient taking NSAIDS develops high creat

analgesic nephropathy

148

physiopatho of analgesic nephropathy

papillary necrosis
chronic tubulointersticial nephritis

149

danger of analgesic(3)

premature aging
UT cancer
atherosclerotic vascular disease

150

HTA puls right sided renal bruit

stenose de l'artere renale

151

rx of stenose of renal artery

percutaneous angioplasty with placement

152

first cause of renal artery stenosis

fibro muscular disease

153

HIV black with SN cause of that

focal segmental glomerulosclerosis

154

2 causes of glomerular hematuria(2)

IGA nephropathy
GNA

155

clue for IGA nephropathy(3)

upper respiratory infection
later hematuria
complement is normal

156

painless hematuria in black

sickle cell trait

157

cause of hematuria in sickle cell disease

papillary necrosis

158

patient with HBP, gross and micro hematuria in smoker, next step

cystoscopy

159

why you should ask for cystoscopy even if you suspect HBP

any hematuria and risk factor of bladder cancer,cystoscopy is mandatory

160

what's the most important risk factor for bladder cancer

smoking

161

renal cause of hematuria(3)

CA
IGA nephropathy
GNA

162

ureteral cause of hematuria(2)

stones
stricture

163

bladder cause of hematuria(2)

ca
cystitis

164

prostate and uretral cause of hematuria(2)

ca prostate
uretritis

165

rsk factors for bladder cancer(6)

cigarette
cyclosporine
painter
chronic cystitis
metal worker
pelvic radiation

166

the most common cause of death in patient on dyalisis

cardiovascular

167

most common cause of death in renal transplant

cardiovascular

168

patient with SN develops acute flanck pain in the right DX

renal vein thrombosis

169

what the most comon disease causing SN

membranous glomerulonephritis

170

most common cause of painless hematuria in adults

bladder cancer

171

SRAA axis in hypovolemia(3)

angiotensine constrict efferent arterioles
prostaglandin dolate afferent arteriole
but if hypovolemia worsens this mechanism will fail and you will have damage in kidney

172

why elderly in nursing room can easily develops prerenal azatemia(3)

because they are taking
Aspirin
Ace inhibitor
diuretics

173

cause of epididymitis in elderly

E coli

174

cause of epididymitis in sexually active individual(2)

chlamydia
gonorrhea

175

symptom of epididimytis(2)

scrotal pain
irradiation in flank

176

name two improtant caus of pulmonary renal syndrome(2)

wegener
good pasture

177

rx in Wegener(2)

cycolphosphamide
steroids

178

rx in goodpasture (2)

plasmapheresis

179

why plasmapheresis in goodpasture

because of the presence of anti membrane basal antibody

180

rx of uncomplicated cystitis(4)

nitrofurantoin
TMS
phosphomycin
fluoquinolones

181

duration of rx of uncomplicated cystitis using TMS

3 jours

182

indication ofquinolones in uncomplicated cystitis

if you cannot use the 3 first drug listed above

183

meaning of complicated cystitis(3)

diabetes
immunosuppression
kidney disease

184

RX of complicated cystitis

fluoquinolones

185

indication of urine culture in uncomplicated cystitis

if rx fails

186

patient renal failure taking metformin risk

lactic acidosis

187

risk for metformin to induce lactic acidosis(3)

renal fialure
hepatic failure
sepsis

188

clue for chlamydial uretritis(3)

mucopurulent discharge
no bacteria
sexual active individual

189

clue for gonococcal uretritis

purulent discharge

190

tetrad of amyloidosis(4)

hepatomegaly
renal problem
heart problem S4
maladie inflammatoire sous jascente

191

finding in renal biopsy in amyloidosis ordinary microscopy

apple green birefringence under polarised light

192

stain coloration for amyloidosis

congo red stain

193

finding in renal biopsy in amyloidosis electronical microscopy

extra cellular or amyloid fibrils

194

most common type of renal stones

oxalate calcium 75/90%

195

cause of fat malabsortion

surgical ileal resection
chronic diarrhea
small bowel disease

196

condition predisposing for renal calcium stones

fat malsorption

197

why fat malabsortion causes renal oxalate calcium stones

because in fat mlabsorption, fat chelates calcium making oxalate free to be absorb

198

stone in parathyroidism

calcium stone

199

stone in chemo

acid uric stone

200

cause of cysteine stone

inborn error of metabolism in children

201

cause of struvite stone

proteus infection

202

quid of hepato renal syndrome

renal failure in patient with cirrhosis

203

rx of hepato renal syndrome

liver transplant

204

cause of death in hepato renal syndrome(2)

hemmorrahe
infection

205

most common cause of death in patient with hepatic failure

renal problem

206

patient with long term renal failure best long term measure in management

tranplantation renal from living related donor

207

what are the 2 options for end stage renal disease(2)

dyalisis
renal transplantation

208

advantage of transplantation over dyalisis(4)

good quality of living and survival
anemia bone disease and HTA are well controlled
autonomic neuropathy is improved
better survival rate

209

is dyalisis improves autonomic neuropathy in diabetics

no

210

clue for alport syndrome(3)

high creat
deafness
hematuria

211

biopsy finding in alport

foam cells

212

electron microscopy in alport

alternating areas of thinned and tickened capillary loopswith splitting GBM

213

cause of infertility in athlete

steroid abuse

214

why steroid abuse causes of infertility in athlete(2)

blockage of GNRH release
no LH and FSH

215

after renal transplantation patient develops oliguria
high BUN/CREAT DX(5)

acute rejection
ureteral obstruction
cyclosporine toxicity
ATN
vascular obstruction

216


after renal transplantation patient develops oliguria
high BUN/CREAT ,work up?(3)

US
biopsy
cyclosporine level

217

rx of acute rejection

steroids IV

218

biopsy in acute rejection

heavy lymphocyte infiltration and vascular involvementwith swelling of the intima

219

test to do after renalm transplantation(4)

radfio isotope scanning
MRI
US
Biopsie renale

220

prevention of contrast nephropathy(2)

hydration
or
acetylcysteine

221

action of aqcetyl cysteine in caseof contrast nephropathy rx

vasodilation
antioxydant

222

cause of painless hematuria(3)

analgesic
SCD
CA

223

[hysiopatho of analgesic induced nephropathy

papillary necrosis
caused by vasoconstriction of medullary blood vessel
(vasa recta)

224

most specific test to DX renal carcinoma

ct of abdomen

225

work up for patient with HBP symptomatic first step(2)

creat
urinalysis

226

work up for patient with HBP symptomatic creat and urinalysis anormal next step(2)

U/S
or
abdomen CT

227

clue to differentiate prostatis from cystitis(2)

systemic symptom
boggy and tender prostate

228

after urinalysis what's the next step for prostatitis

midstream urine sample culture

229

clue to differentiate acute from chronic prostatis

no systemic sympton in chronic prostatitis

230

rx of acute prostatitis

TMS

231

rx of chronic prostatitis

fluoquinolones

232

rx of acute pericarditis in qacute renal failure

hemodyalisis

233

clasic EKG findings in acute pericarditis(2)

ST and PR elevation in AVR
PR segment depression in other leads

234

the best test to DX renal calculi

ct of abdomen

235

xray of calcium stone

radioopaque

236

xray of acid uric stone

radioluscent

237

most beneficial next step in aptient with acid uric stone(2)

citrate de K+ to alkalinisation of the urine
or
bicarb K+

238

people at risk for acid uric stone

low pH urine

239

cause of low PH urine(2)

renal ammonia secretion deficit
hyperuricosuria

240

patient with classic renal colic and negative xray

acid uric stone
calcium stone 1-3 mm
non stone cause

241

nonstone cause of renal colic(2)

caillot
tumor

242

what's the target when alkalinisation of the urine

PH>6,5

243

terminal hematuria(2)

bladder disease
prostate disease

244

initial hematuria

uretritis

245

total hematuria(2)

renal disease
ureter

246

clue for renal hematuria

no clots

247

best test for bladder cancer

cystoscopy

248

clue for mixed essential cryoglobulinemia(3)

hematuria
proteinuria
palpable purpura

249

what infectious test should be done if you suspect cryoglonulinemia

HCV serology

250

why HCV serology in cryoglobulinemia

majority of patient have HCV infection

251

complement in cryo

low

252

most common cause of painlesss hematuria

bladder cancer

253

BPH treatment(3)

doxazocin or
tamsulosin Alpha 1 blockers plus
finasteride

254

quid of finasteride

5 alpha reductase inhibitor

255

zone of prostate touched by BPH

transitionnal zone

256

ALP in ca prostate

high

257

rapid rx in hyperkalemia even if renal failure

gluconate de calcium

258

next step after gluconate de calcium in hyperkalemia rx

remove calcium in the body

259

EKG in hyperkaliemia(4)

peaked T waves
wide RQS complex
bradycrdia
no P waves

260

cause of C3 levels(4)

immune complex reaction
GNA
cryoglobulinemia
membranous glomerulonephritis

261

Clue for GNA(3)

hta
skin infection
low c3

262

management of urolithiasis(3)

CT abdomen
analgesics
fluid > 2 l/jour

263

when to refer urolithiasis in urologic physician(3)

anuria
sepsis
acute ranl failure

264

grasseur of stone to be passed with hydration

less than 5 mm

265

clue for ATN(3)

BUN/CREAT2
urine osmolarity 300-350(never

266

what can cause ATN

prolonged hypotension

267

hallmark of ATN

muddy brown cast

268

quid of brown cast

renal tubular epithelial cells

269

mechanism of cystitis

ascending infection

270

role of sexual intercourse in cystitis(3)

massage uretral during sexual intercourse
entry of germs dans la vessie
honeymoon cystitis

271

RBC cast

GNA

272

WBC cast(2)

intersticial nephritis
pyelonephritis

273

fatty cast

SN

274

broad and waxy cast

chronic renal failure

275

patient at risk for contrast nephropathy(2)

diabetics
Creat> 1,5

276

what should be done to prevent contrast nephropathy(4)


nonionic contrast agent
acetylcysteine
good hydration

277

SN with focal glomerulosclerosis(4)

african american
HIV
heroin use
obesity

278

SN in hogkin(2)

minimal change
or
focal glomerulosclerosis

279

pyelonephritis unresponsive to rx after 48 h

ask for CT or US

280

why imagery in pyelonephritis unresponsive to rx after 48 h

rule out obstruction
or
abcess

281

vascular changes in HTA(2)

atherosclerotic changes of afferent and efferent artery renal arterioles and glomerular capillar tufs
narrowing of renal arterioles with sclerosisand intimal tickening

282

vascular changes in diabetics(4)

increased extra cellular matrix
basement membrane tickening
mesangial expansion
fibrosis

283

clue for drugs induced intersticial nephritis(4)

eosiniphilia
hematuria
sterile pyuria
eosinophiluria

284

in renal failure with platelet dysfunction ,bilan de coagulation

Pt,PTT normal
BT prolonged

285

action of desmopressin in renal failure with platelet dysfunction(2)

release of factor 8
and v willebrand

286

why platelet transfusion is not good in renal failure with platelet dysfunction

because transfused platelet will be inactivated

287

important clue for renal carcinoma

unilateral varicocele that fails to empty when the patient is in recumbent position

288

in rhabdomyolysis clue for myoglobinuria

large amount of blood in urinalysis with relative absence of RBC in microscopy(0-1 rbc)

289

differentiate myoglubunuria from Hemoglobinuria

large amount of blood in urinalysis with relative absence of RBC in microscopy(0-1 rbc)=myoglobin

290

rx of renla stone with hypercalciuria(3)

high fluid intake
sodium restriction
thiazide diuretic

291

indication of amikacin in pyelonephritis

multi drug resistant pyelonephritis

292

kahler disease(2)

plasma cells myeloma
Myelomatosis

293

clue for malignant cystic mass(2)

thick and irregular wall
multiple septae
presence of contrast enhancement

294

physical exam of urinary retention

tenderness and fulllness on palpation along the midline below the umbilicus

295

why patient with SN is at risk for MI and stroke(2)

hypercoagulable state
accelerated etherosclerosis

296

hallmark of diabetic nephropathy

nodular glomerulosclerosis

297

diabetes with proteiunuria and UTI you treat the UTI proteinuria still persist

glomerular basement membrane damage

298

drugs causing crystal induced nephropathy(5)

acyclovir
sulfonamides
methotrexate
ethyleneglycol
protease inhibitor

299

anemia in renal insufficiency(2)

normochromic
normocytic

300

cause of hematuria in AF

papillary necrosis

301

any hematuria with no glomerular involvement plus risk factor of bladdder cancer

cystoscopy

302

when to avoid nitrofurantoin in the rx of uncomplicated cystitis

clearance creat

303

contraindication of metformin(2)

sepsis
renal failure
hepatic failure

304

clue for chlamydial uretritis(3)

Multiple sexual partners
absent bacteriuria
mucopurulent discharge

305

finding in amyloidosis

renal amyloid deposit showing apple green birefringence under polarised light after congo red stain ing

306

clue for hepatorenal syndrome(2)

high creat in patient with cirrhosis
no improvement of creat value after fluid resuscitation

307

indication of hemodyalisis(7)

refractory hyperkaliemia
volume overload or pulmonary edema unresponsive to diuretics
refractory metabolic acidosis
uremic pericarditis
uremic encephalopathy or neuropathy
caogulopathy due to renal failure

308

first in hyoerkaliemia(2)

gluconate de calcium
later use insulin and/orsodium polystyrene sulfonate

309

first episode of renal stone management

hydration
no further metabolic work up is required

310

mady having sex for the first time ,days later develops urinary symptom

honeymoon cystitis

311

cause of honey moon cystitis

sexual intercourse introduces bugs directly in bladder

312

size of kidney in HTA

small size