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AANP Study Cards > GU > Flashcards

GU Flashcards

1
Q

What is the function of the kidneys

A

-function to regulate the body’s electrolytes and fluids which effects BP

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2
Q

What hormones affect H20 Reabsorption

A

ADH and Aldosterone

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3
Q

What is considered average urine output?

A

1,500mL/day

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4
Q

What is the definition of oliguria

A

<400ml/day

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5
Q

What is normal values for creatinine

A

Males 0.7-1.3mg/dL

Females 0.6-1.1mg/dL

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6
Q

What affects creatinine levels

A
  • gender (males)
  • race (Black people have more muscle mass)
  • Muscle mass
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7
Q

What does the creatinine clearance (24 hour urine) evaluate

A

Microalbuminuria, albuminuria, proteinuria

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8
Q

What is the best test of kidney function

A

eGFR

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9
Q

How is the eGFR calculated

A

creatinine, age and gender

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10
Q

What makes an eGFR less reliable

A
  • pregnancy
  • muscle wasting
  • elderly
  • lower extremity amputee
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11
Q

What is a normal eGFR

A

> 90mL/min

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12
Q

What is CKD Stage 1

A

> 90mL/min; damage but normal function

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13
Q

What is CKD Stage 2

A

60-89mL/min

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14
Q

What is CKD Stage 3a

A

45-59mL/min

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15
Q

What is CKD Stage 3b

A

30-44mL/min

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16
Q

What is CKD Stage 4

A

15-30mL/min

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17
Q

What is CKD Stage 5

A

<15mL/min

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18
Q

What is BUN

A

measurement of the kidney’s ability to excrete urea (which is a waste product of protein metabolism)

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19
Q

What are causes of increased BUN

A
  • AKI
  • High protein diet
  • Hemolysis
  • CHF
  • Drugs
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20
Q

What are causes of decreased BUN

A

liver damage or disease

21
Q

What is the BUN: Creatinine ratio useful for

A

Classifying the type of renal failure

If there is a decreased blood flow to the kidneys then there will be an increased BUN: Creatinine ratio

22
Q

What does proteinuria indicate?

A

Kidney damage

23
Q

What is the most common bacteria to cause a UTI

A

E. Coli

24
Q

What are sx of a UTI

A
  • Dysuria
  • Urgency
  • Frequency
  • Hematuria
  • Foul-smelling urine
  • Sensation of incomplete emptying, scant voiding
  • Lower abdominal pain
  • Back pain* think pyelo
25
Q

What is the colony count of a midstream urine that indicates a UTI

A

> 100,000 CFU

26
Q

Urine Cultures should be done on:

A
  1. Recurrent or refractory infections
  2. Children and pregnant women
  3. 65+
27
Q

What is the most reliable indicator of UTI in a UA

A

WBC

28
Q

What DDx should you consider for frequency and urgency of urine with a normal UA

A
  • Pregnancy
  • Vaginitis
  • STI
  • Herpes
  • UTI but diluted sample
  • Overactive sample
29
Q

What antibiotic is recommended for uncomplicated UTI

A

1) Nitrofurantonin (Macrobid) 100mg BID *Not in 3rd trimester of pregnancy

30
Q

How long should you treat a UTI in:

  • men
  • individuals with co-morbid conditions
  • Complicated UTIs
A

7-10 days

31
Q

How long should you treat an uncomplicated UTI

A

-3 days

32
Q

What other medications should you consider in UTIs

A

-Antispasmodics: Phenazopyridine (Pyridium) or Flavoxate

33
Q

What health promotion should you initiate in UTI

A
  • Hydration
  • Avoid Carbonation, ETOH and Caffeine
  • Void after Sex
34
Q

What is a side effect of Phenazopyridine (Pyridium)

A

Will discolor urine (orange) and stain contact lenses

35
Q

What are causes of hematuria in adults

A
  • Cancer (renal/bladder)
  • Infection
  • Stones
  • Coagulopathy
  • Glomerular Disease
  • Hydronephrosis
  • Polycystic kidney
  • Trauma
  • Meds
  • Exercise
36
Q

Risk factors for Bladder Cancer

A
  • Smoking
  • Age >40
  • Occupational exposure
  • Chronic cystitis
  • History of pelvic irradiation
  • History of analgesic abuse
37
Q

A patient presents with classic symptoms of a kidney stone what lab abnormality is most likely to be present?

A

-Hematuria

38
Q

What medications can help with passing kidney stones?

A
  • Alpha blockers

- CCB

39
Q

What are risk factors for pyleonephritis

A
  • Untreated or undertreated UTI
  • Urinary tract abnormalities
  • Elderly
  • Fecal Incontinence
  • Pregnancy
40
Q

What findings may be present in a patient with pyleo

A
  • CVA tenderness
  • Fever
  • Pyuria
  • WBC in urine
  • Casts
41
Q

What diagnostic studies are indicated in suspected pyelonephritis

A
  • UA (pyuria, hematuria and maybe mild proteinuria)
  • C&S
  • CBC (Leukocytosis)
  • CVA tenderness
  • ESR
42
Q

What is mgmt of pyelonephritis

A

-Quinolones: Only oral Abx recommended for outpatient tx

43
Q

What is the significance of WBC cast

A

-Pyleonephritis

44
Q

What are the types of incontinence

A

1) Urge- detrusor instability
2) Stress- sphincter incompetence
3) Mixed (most common)

45
Q

What lifestyle changes are indicated in incontinence

A
  • ETOH
  • Carbonation
  • Coffee or tea
  • Citrus
  • weight loss
  • regular voiding (but not frequent)
  • minimize fluids after dinner
46
Q

Overactive Bladder Management

A
  • Anticholinergics
  • Mirabegron (less S/E)
  • Estrogen for post-menopausal women
  • Biofeedback
  • Pelvic floor PT
47
Q

What is the ODE to anticholinergics

A 
Oh this drug it makes me pink, 
Sometimes I can't think or even blink
I cant see
I cant pee
I cant spit 
I cant sh*t
48
Q

What findings suggest pyleo over UTI

A
  • fever >100.4
  • Back/flank pain
  • CVA tenderness
  • WBC casts
49
Q

Use of spermicides can ____ risk of UTI

A

increase

AANP Study Cards (20 decks)

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