GU

Question 1

What is the function of the kidneys

Answer 1

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

Question 2

What hormones affect H20 Reabsorption

Answer 2

ADH and Aldosterone

Question 3

What is considered average urine output?

Answer 3

1,500mL/day

Question 4

What is the definition of oliguria

Answer 4

<400ml/day

Question 5

What is normal values for creatinine

Answer 5

Males 0.7-1.3mg/dL

Females 0.6-1.1mg/dL

Question 6

What affects creatinine levels

Answer 6

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

Question 7

What does the creatinine clearance (24 hour urine) evaluate

Answer 7

Microalbuminuria, albuminuria, proteinuria

Question 8

What is the best test of kidney function

Answer 8

eGFR

Question 9

How is the eGFR calculated

Answer 9

creatinine, age and gender

Question 10

What makes an eGFR less reliable

Answer 10

• pregnancy
• muscle wasting
• elderly
• lower extremity amputee

Question 11

What is a normal eGFR

Answer 11

> 90mL/min

Question 12

What is CKD Stage 1

Answer 12

> 90mL/min; damage but normal function

Question 13

What is CKD Stage 2

Answer 13

60-89mL/min

Question 14

What is CKD Stage 3a

Answer 14

45-59mL/min

Question 15

What is CKD Stage 3b

Answer 15

30-44mL/min

Question 16

What is CKD Stage 4

Answer 16

15-30mL/min

Question 17

What is CKD Stage 5

Answer 17

<15mL/min

Question 18

What is BUN

Answer 18

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

Question 19

What are causes of increased BUN

Answer 19

• AKI
• High protein diet
• Hemolysis
• CHF
• Drugs

Question 20

What are causes of decreased BUN

Answer 20

liver damage or disease

Question 21

What is the BUN: Creatinine ratio useful for

Answer 21

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

Question 22

What does proteinuria indicate?

Answer 22

Kidney damage

Question 23

What is the most common bacteria to cause a UTI

Answer 23

E. Coli

Question 24

What are sx of a UTI

Answer 24

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

Question 25

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

Answer 25

>100,000 CFU

Question 26

Urine Cultures should be done on:

Answer 26

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

Question 27

What is the most reliable indicator of UTI in a UA

Answer 27

WBC

Question 28

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

Answer 28

- Pregnancy - Vaginitis - STI - Herpes - UTI but diluted sample - Overactive sample

Question 29

What antibiotic is recommended for uncomplicated UTI

Answer 29

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

Question 30

How long should you treat a UTI in: - men - individuals with co-morbid conditions - Complicated UTIs

Answer 30

7-10 days

Question 31

How long should you treat an uncomplicated UTI

Answer 31

-3 days

Question 32

What other medications should you consider in UTIs

Answer 32

-Antispasmodics: Phenazopyridine (Pyridium) or Flavoxate

Question 33

What health promotion should you initiate in UTI

Answer 33

- Hydration - Avoid Carbonation, ETOH and Caffeine - Void after Sex

Question 34

What is a side effect of Phenazopyridine (Pyridium)

Answer 34

Will discolor urine (orange) and stain contact lenses

Question 35

What are causes of hematuria in adults

Answer 35

- Cancer (renal/bladder) - Infection - Stones - Coagulopathy - Glomerular Disease - Hydronephrosis - Polycystic kidney - Trauma - Meds - Exercise

Question 36

Risk factors for Bladder Cancer

Answer 36

- Smoking - Age >40 - Occupational exposure - Chronic cystitis - History of pelvic irradiation - History of analgesic abuse

Question 37

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

Answer 37

-Hematuria

Question 38

What medications can help with passing kidney stones?

Answer 38

- Alpha blockers | - CCB

Question 39

What are risk factors for pyleonephritis

Answer 39

- Untreated or undertreated UTI - Urinary tract abnormalities - Elderly - Fecal Incontinence - Pregnancy

Question 40

What findings may be present in a patient with pyleo

Answer 40

- CVA tenderness - Fever - Pyuria - WBC in urine - Casts

Question 41

What diagnostic studies are indicated in suspected pyelonephritis

Answer 41

- UA (pyuria, hematuria and maybe mild proteinuria) - C&S - CBC (Leukocytosis) - CVA tenderness - ESR

Question 42

What is mgmt of pyelonephritis

Answer 42

-Quinolones: Only oral Abx recommended for outpatient tx

Question 43

What is the significance of WBC cast

Answer 43

-Pyleonephritis

Question 44

What are the types of incontinence

Answer 44

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

Question 45

What lifestyle changes are indicated in incontinence

Answer 45

- ETOH - Carbonation - Coffee or tea - Citrus - weight loss - regular voiding (but not frequent) - minimize fluids after dinner

Question 46

Overactive Bladder Management

Answer 46

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

Question 47

What is the ODE to anticholinergics

Answer 47

``` 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 ```

Question 48

What findings suggest pyleo over UTI

Answer 48

- fever >100.4 - Back/flank pain - CVA tenderness - WBC casts

Question 49

Use of spermicides can ____ risk of UTI

Answer 49

increase