Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Internal Medicine > GU > Flashcards

GU Flashcards

(72 cards)

Start Studying
1
Q

Defintion of nephritic syndrome (5)

A

Glomerulonephritis
Intrinsic form of AKI

HTN+ RBC casts in urine + Incr Creatinine + edema + dysmorphic RBCs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What two bacteria cause nephritic syndrome commonly

A

Staph
Strep viridans [ think kids; post strep GN]

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Immune causes of GN

A

SLE
IgA Nephropathy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Management with GN patients?

A

Salt and water restriction
Diuretics
ACE/ARBS

TXT if infection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What part of the kidney is effected in good pastures syndrome

A

Glomerular basement membrane

Anti-GBM Abs +

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

TXM Good Pastures Syndrome

A

Tx
1. Admit
2. Plasmapheresis (plasma exchange to remove circulating anti-GBM antibodies)
3. Prednisone
4. Cyclophosphamide

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is present in nephrotic syndrome

A

a. S/Sx: proteinuria, hypoalbuminemia, edema, hyperlipidemia, frothy urine

i. Edema predominant feature (d/t loss of proteins and albumin; fluid leaves blood)

b. Urinalysis: proteinuria > 3.5 g/day, urine dipstick protein 3+ or 4+, fatty casts, oval fat bodies

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

3 important characteristics of minimal change disease

A

Loss of podocytes on electron microscopy
Effects children 2-7 yrs
+ Hypercoagable = DVTs and PEs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Defintion of AKI

A

Defined as ↑ SCr by ≥ 0.3 mg/dL w/in 48 hrs or ↑ SCr ≥ 1.5x baseline or urine output < 0.5 mL/kg/hr for 6 hr

S/Sx: dark cola-colored urine, flank pain, low urine volume; uremia → N/V, malaise, anorexia, fatigue, pruritus,
AMS

Abrupt reduction in GFR

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Azotemia refers to

A

Abnormal levels of urea and creatinine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Pre Renal Azotemia :

A

Prerenal azotemia: impaired renal perfusion w/ resultant ↓ in glomerular capillary filtration pressure

i. MC cause of AKI

ii. BUN:Cr ratio often > 20:1

iii. Labs: ↑ SCr, ↑ BUN, metabolic acidosis, hyperkalemia, hyperphosphatemia, anemia, platelet dysfxn, ↓
GFR

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Causes of pre renal Azotemia (3)

A
  1. Hypovolemia
  2. NSAIDs + ACE-I
  3. Iodinated radiocontrast agents (↑ risk for pts w/ renal impairment, DM, HF)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Intrinsic Azotemia represents ___ and Causes

A

i. Hallmark = structure injury to kidney

ii. Causes
1. Acute tubular necrosis (ATN): MC cause of AKI d/t intrinsic renal dz; can be ischemic or
nephrotoxic
a. Ischemic is common in ICU pts w/ hypotension

b. Nephrotoxic: hemoglobin, myoglobin (rhabdomyolysis), medications, or ingested
poisons (ethylene glycol)

c. Muddy brown casts-granular-ATN

  1. Acute glomerulonephritis (AGN): characterized by inflammatory glomerular lesions
  2. Acute interstitial nephritis (AIN): drug rxn

iii. ↑ FeNa
= increase in fractional excretion of sodium. Due to DIRECT INJURY

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Triad of {physical exam findings} Intrinsic Azotemia

A

a. Triad: fever, transient maculopapular rash, arthralgias

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Think what causes for post renal Azotemia and labs?

A

Causes
1. BPH

  1. Urethral obstruction: clot, kidney stones, tumor, etc.

iii. Labs: ↑ osmolality, ↓ urine sodium (FeNa), ↑ BUN:Cr

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Indications for acute dialysis in patients with renal impairment?

A

Indications for acute dialysis

  1. Acidosis and refractory to HCO3
  2. Hyperkalemia > 6.5 mmol/L or w/ ECG changes (↑ t waves)
  3. Ingestion of lithium or ethylene glycol
  4. Uremia (may present w/ pericarditis or ↓ in mental status)

a. S/Sx: anorexia, nausea, vomiting, metallic taste
b. PE: asterixis, pericardial rub

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Alarming sxs in renal impairment

A

a. S/Sx: anorexia, nausea, vomiting, metallic taste
b. PE: asterixis, pericardial rub

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

2 common complications of post renal Azotemia

A

Hyperkalemia
Pulmonary edema

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Chronic kidney disease requires decreased GFR for how long

A

Greater 3 months

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Markers of kidney damage (3)

A

Markers of kidney damage:

proteinuria,

structural abnormalities on imaging,

abnml urinary sediment or
chemistries

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Decreased EPO assoc with CKD can lead to what?

A

Metabolic acidosis with anemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What is a kidney related reason to add ezetimibe if dyslipedmic and over the age of 50

A

GFR less 60

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Indications for dialysis in ESRD (7)

A

i. GFR < 10

ii. Fluid overload unresponsive to diuresis

iii. Refractory hyperkalemia

iv. Uremic sxs

v. Severe metabolic acidosis

vi. Neuro sxs

vii. BUN > 100

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Indications for dialysis in ESRD (7)

A

i. GFR < 10

ii. Fluid overload unresponsive to diuresis

iii. Refractory hyperkalemia iv. Uremic sxs

v. Severe metabolic acidosis

vi. Neuro sxs

vii. BUN > 100

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
What is Prehns sign in epididymitis
Raising the scrotal ; relieves pain
26
Management of epididymitis
viii. Labs: UA, culture, STI panel, +/- US to r/o torsion ix. Tx 1. STI: Ceftriaxone + Doxycycline 2. Non-STI: Ofloxacin or Levofloxacin 3. Viral or non-infxn: sx care → NSAIDs, ice packs, bed rest, scrotal elevation
27
Acute bacterial prostatitis is usually what 2?
E Coli Psuedomonas
28
TXM for prostatitis includes? Inpatient vs Outpatient
Labs: UA, pyuria, bacteriuria, hematuria, CBC, culture Transrectal US may be needed to ID a prostatic abscess if no response to abx w/in 24-48 hrs . Tx a. Outpt i. Empiric: FQ, double-strength TMP-SMX ii. Consider tx for STI for men < 35 y/o b. Inpt: pts who cannot tolerate PO or have major comorbidities i. IV FQ +/- aminoglycoside ii. IV beta-lactam w/ enteric coverage +/- aminoglycosides c. If urinary retention → catheter d. F/u w/ urine and prostatic secretion cultures → ensure eradication
29
Sxs of chronic bacterial prostatitis ; get what?
S/Sx: afebrile, irritative voiding sxs, urethral pain, and obstructive urinary sxs; low back and perineal pain; hx of UTIs Get a UA with Culture
30
Bacterial prostatitis with systemic signs [ADMITTED] treatment?
Inpt: pts w/ systemic signs i. IV therapy w/ broad-spectrum abx → Ampicillin + Gentamicin, 3rd gen Cephalosporin, or FQ
31
Labs: ↑ leukocytes in prostatic secretions, negative cultures ; think?
Non bacterial Prostatitis
32
TXM for prostate cancer
Tx 1. Localized: acute surveillance for older pts w/ low-risk cancer; pts w/ life expectancy > 10 yrs should be considered for with urology. [Gold Plates for Radiation/Chemo]
33
mean age for bladder cancer in males?
73 y/o
34
Over 40 with painless hematuria you’re thinking ; smoker
Bladder cancer
35
Painless hematuria smoker over 40 yrs old male;
Bladder cancer Confirmed by ; Cystoscopy and Bx
36
Painless hematuria smoker over 40 yrs old male;
Bladder cancer Confirmed by ; Cystoscopy and Bx
37
Triad of renal cell carcinoma + SMOKER
Hematuria Flank pain ABD/Renal Mass
38
3 common characteristics of testicular cancer
i. MC neoplasm in men 15-35 y/o (young man’s cancer) ii. Typical presentation: painless mass iii. RF: cryptorchidism, testicular trauma/torsion, infxn-related testicular atrophy, chemical exposure/pollutants
39
Treatment for testicular cancer
Radicle orchiectomy
40
Labs that are high in testicular cancer
HcG AFP LDH
41
RF and Protective Factors for Ovarian Cancer
RF = Advancing Age ; Early menarche ; Late menopause ; Nulliparity ; Fam Hx Protective = Contraceptive Use; Tubal Ligation; Hysterectomy
42
Young patients with HTN / CVDz / Flank Pain / ABD mass ; may result in ESRD ; think
Polycystic kidney disease
43
Reasons for renal artery stenosis @ (60-70yrs) and (20-30yrs)
60-70 yrs old = atherosclerosis 20-30 yrs old = fibromuscular dysplasia
44
If someone develops an AKI after starting an ACE think?
renal artery stenosis
45
Initial and Gold Standard test for Renal Artery Stenosis
Initial = Renal U/S Gold = CT renal A
46
MC pathogens in acute cystitis
E Coli Staph Saprophyticus
47
Workup for male cystitis (3)
ABD U/S Post void residual testing Cystoscope
48
TXM for acute cystitis ; first line ; pain ; and pregnant
Tx 1. Nitrofurantoin or TMP/SMX, Norfloxacin, Ciprofloxacin, Levofloxacin 2. Phenazopyridine (Pyridium): 200 mg TID 3. Pregnant: Amoxicillin, Cephalexin, Nitrofurantoin
49
Recurrent acute cystitis is defined as ; and treated with
Greater 3 episodes in a year: TMP / SMX Nitrofurantoin Cephalexin
50
Characteristics of interstitial cystitis
Pain with bladder filling; relieved by emptying
51
Chracteristics of interstitial cystitis
Painful bladder filling; relieved by emptying Negative UA/Culture Cystoscopy = Glommerulations / Hunters Lesion
52
TXM of interstitial cystitis
Tx: no cure → tx aimed at sx relief 1. 1st line: general relaxation / stress management, diet, pt education, behavioral modification, pain management 2. 2nd line: medications -- Amitriptyline, Hydroxyzine, Cimetidine, Intravesical dimethyl sulfoxide 3. 3rd line: Hydrodistention; intradetrusor botox
53
TXM of Pyelo
1. FQ or TMP-SMX 2. If inpt or pregnant: ampicillin/gentamicin or 3rd gen cephalosporin
54
Discuss the 4 common types of stones in kidney disease
i. MC caused by calcium oxalate ii. Struvite: staghorn calculi, urease-producing bacteria iii. Uric acid: radiolucent on XR, gout iv. Cystine: children w/ metabolic dz
55
Discuss txm based on kidney stone size
1. < 5 mm: likely to pass spontaneously 2. > 8 mm: unlikely to pass; lithotripsy
56
What are the obstructive vs irritative sxs in BPH
Obstructive sx: hesitancy, ↓ force and caliber of stream, sensation of incomplete bladder emptying, double voiding, straining to urinate, post-void dribbling Irritate sxs: frequency, urgency, nocturia, dysuria
57
Physical exam findings BPH vs Prostate Cancer/Prostatitis
f. PE: smooth, symmetric, firm yet elastic enlargement is c/w BPH g. If indurated or asymmetrical → further w/u to r/o cancer (TRUS) /prostatitis
58
Meds and definitive management of BPH
1. Alpha blockers (-osin) - ALLOW DILATION OF URETER TO IMPROVE FLOW 2. 5-alpha-reductase inhibitors (Finasteride/Dutasteride) -SHRINK THE PROSTATE 2 WEEKS ISH 3. Tadalafil: FDA approved for BPH and/or urinary tract sxs in pts w/ ED-IF ALSO HAVE ED ABSOLUTE = TURP ; may need a repeat TURP
59
5 CAUSES OF ED
i. Vascular: CV dz, HTN, DM, hyperlipidemia, smoking, major surgery, radiotherapy ii. Neurologic: spinal cord/brain injuries, Parkinson dz, Alzheimers dz, MS, stroke, major surgery, radiotherapy of prostate iii. Local penile factors: Peyronie’s dz, cavernous fibrosis, penile fX iv. Hormonal: hypogonadism, hyperprolactinemia, hyper/hypo hypothyroidism, hyper/hypocortisolism v. Drug Induced : anti-HTN; anti-psychs ; anti-depressives anti androgens; alcohol
60
Management of ED
Tx 1. Lifestyle changes: smoking cessation, wgt loss, gastric bypass, CPAP for sleep apnea 2. Phosphodiesterase-5 inhibitors: Sildenafil, Vardenafil, Tadalafil, Avanafil 3. 2nd line: vacuum-assisted erection devices, penile self-injection, intraurethral alprostadil 4. Surgery
61
Urge inconvenience think ; TXM
Overactive bladder -Detrusor Increased activity! W/ Nocturia TXM = anti Cholinergics
62
Stress incontinence ; description and treatment
i. MC caused by muscle weakness ii. S/Sx: small amount of urine loss when coughing, laughing, or sneezing iii. Tx 1. Kegel exercises (PFT) 2. Estrogen replacement 3. Surgery
63
Acididemia; Bicarbonate and CO2 levels
pH less than 7.35 Bicarbonate -less 24 = + CO2- greater 40 = +
64
Alkalemia Bicarbonate and CO2 levels
pH greater than 7.45 Bicarbonate - greater than 24 = + CO2 - less than 40 = +
65
MUDDY Brown Granular casts represent what?
Degenerating RBCs Acute Tubular Necrosis
66
Waxy casts represent what?
Severe urine stasis ; chronic renal f.
67
Waxy casts represent what?
Severe urine stasis ‘ Chronic renal f.
68
Broad casts represent what?
Dilated or atrophic renal tubules 2nd to parenychmal damage ; ESRD
69
Associated state with fatty casts
Nephrotic syndrome
70
White cell casts are more common in ___ than ___
Pyelonephritis ; than lower bladder tract infection
71
What it’s the hallmark kind of cast in glomerulonephritis
Red Cell Cast
72
2 types of casts found in acute tubular necrosis
1) Renal tubular epithelial cell cast 2) Granular Muddy Brown Cast

Internal Medicine (6 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions