GU Renal Comp Flashcards
(143 cards)
1
Q
EKG changes: Name the electrolyte disorder which causes prolonged PR interval widened QRS.
A
Hypermagnesemia
2
Q
EKG changes: Name the electrolyte disorder which causes long QT.
A
Hypocalcemia
3
Q
EKG changes: Name the electrolyte disorder which causes flattened T waves U waves.
A
Hypokalemia
4
Q
EKG changes: Name the electrolyte disorder which causes short QT.
A
Hypercalcemia
5
Q
EKG changes: Name the electrolyte disorder which causes tall T waves.
A
Hypomagnesemia
6
Q
EKG changes: Name the electrolyte disorder which causes peaked T waves.
A
Hyperkalemia
7
Q
Which electrolyte abnormality do spironolactone and ACE inhibitors predispose a patient to?
A
Hyperkalemia
8
Q
What does the “S” in MUDPILES (causes of metabolic acidosis) stand for?
A
S : salicylates
9
Q
What does the “E” in MUDPILES (causes of metabolic acidosis) stand for?
A
E : ethylene glycol
10
Q
What does the “L” in MUDPILES (causes of metabolic acidosis) stand for?
A
L: lactic acidosis
11
Q
What does the “I” in MUDPILES (causes of metabolic acidosis) stand for?
A
I : idiopathic
12
Q
What does the “P” in MUDPILES (causes of metabolic acidosis) stand for?
A
P : paraldehyde
13
Q
Which disorder has oval fat bodies in the urine?
A
Nephrotic syndrome
14
Q
Is the FENa (fractional excretion of sodium) low normal or high in acute tubular necrosis?
A
High
15
Q
Is the FENa (fractional excretion of sodium) low normal or high in pre renal failure?
A
Normal
16
Q
What are the CT findings expected with pyelonephritis?
A
Perinephric stranding
17
Q
What procedures can assist in confirming the diagnosis of interstitial cystitis?
A
Urodynamics - Cystoscopy with hydrodistention of bladder
18
Q
What is a blue dot sign associated with?
A
Torsion of the appendix testis (paratesticular nodule superior aspect of testicle)
19
Q
How are pain and cremasteric reflex different in testicular torsion vs. torsion of the appendix testis?
A
Torsion has diffuse pain and absent cremasteric - Appendix testis has superior testicle pain and + cremasteric
20
Q
What modality should be used to diagnose testicular torsion?
A
Ultrasound with Doppler
21
Q
What is a + transillumination of the scrotum associated with?
A
Hydrocele
22
Q
What disorder is likely with severe testicular pain and a negative Prehn’s sign?
A
Testicular torsion (Elevation of the testicle does not change the pain)
23
Q
Describe a positive Prehn’s sign.
A
Elevation of the testicle relieves the pain
24
Q
What disorder is Prehn’s sign associated with?
A
Epididymitis
25
What GU disorder is LeRiche syndrome associated with?
Erectile dysfunction
26
What procedures can assist in confirming the diagnosis of interstitial cystitis?
Urodynamics - Cystoscopy with hydrodistention of bladder
27
What other electrolyte must be corrected in the treatment of hypokalemia?
Magnesium
28
What is the most common electrolyte abnormality with furosemide or bumetanide?
Hypokalemia
29
What electrolyte abnormality potentiates the cardiac toxicity of digoxin?
Hypokalemia
30
List dietary modifications for chronic kidney disease.
Restrict protein sodium potassium and fluid intake
31
What urinalysis findings are consistent with acute tubular necrosis?
Muddy casts and renal tubular cells
32
What is the most likely cause of acute tubular necrosis in a patient who has recently used cocaine?
Rhabdomyolysis
33
Which type of acute renal injury is most likely following injection of radio contrast dye?
Acute Tubular Necrosis (ATN)
34
What is the most common cause of prerenal failure?
Dehydration
35
What is the most likely underlying disorder in a patient who develops acute renal failure after initiation of an ACE inhibitor?
Renal artery stenosis
36
What are the two most common long term complications of polycystic kidney disease?
Hypertension and renal failure
37
What renal disorder is linked to cerebral aneurysm?
Polycystic kidney disease
38
What type of tumor is the most common renal cancer found in children?
Wilms Tumor
39
What are flank pain hematuria and a palpable abdominal/renal mass hallmark signs of?
Renal cell carcinoma
40
What is the most common causative factor for bladder cancer?
Smoking
41
What non-infectious disorder causes cystitis in response to specific foods?
Interstitial cystitis
42
What is the most common type of incontinence?
Mixed (both stress and urge)
43
What type of incontinence results from an over active detrusor muscle?
Urge incontinence
44
What type of incontinence results from activity such as laughing or coughing?
Stress incontinence
45
Sudden onset of severe testicular pain which does not alleviate with elevation of the testicle?
Testicular torsion
46
Name two disorders which may cause orchitis in children?
Mumps and brucellosis infections
47
What hematological disorder may cause priapism?
Sickle cell crisis
48
What medication classes can not be taken with PDE5 inhibitors?
Nitrates or alpha blockers (May result in hypotension)
49
What are the most common causative agents for prostatitis in an 15-30 year old male?
Chlamydia and/or gonorrhea
50
What is the most common causative agent for prostatitis in an elderly male?
E. Coli
51
What surgical procedure is most commonly used in patients with BPH who fail pharmacological treatment?
Transurethral Resection of the Prostate (TURP)
52
What counseling must be given to a patient who is started on doxazosin terazosin or prazosin?
Take while sitting on bed prior to sleep to avoid orthostatic hypotension
53
What is the most common type of renal calculus in children?
What is the most common type of renal calculus in children?
54
Which type of renal calculus is highly associated with chronic infection?
Struvite
55
What are the 3 electrolyte abnormalities which occur with tumor lysis syndrome?
Hyperkalemia -Hyperuricemia - Hyperphosphatemia
56
What nephropathy is associated with lupus?
Membranous nephropathy
57
Most common histology of bladder cancer?
Transitional cell carcinoma
58
What is the Dx? Hematuria flank pain and a palpable flank mass.
Renal cell carcinoma
59
What is the Dx? Eosinophils in the urine sediment.
Allergic interstitial nephritis
60
What are the 2 most common types of nephrotic syndrome?
Focal Segmental Glomerulosclerosis (FSGS) - Membranous glomerulonephritis
61
What is the most common type of nephrolithiasis?
Calcium oxalate
62
Most common causes of hypercalcemia?
Malignancy and hyperparathyroidism
63
What is the Dx? Hypernatremia and azotemia.
Most likely dehydration
64
Doughy skin with skin tenting may represent which electrolyte abnormality?
Hypernatremia
65
The recommended age to start annual prostate screening?
White male average risk: 50 years old - Black male, + FMHX or + BRCA mutations: 40 years old
66
Inability to retract the foreskin from the penis?
Phimosis
67
What is the Dx? Gram stain of penile discharge reveals gram-negative intracellular diplococci.
Gonorrhea
68
Where is the most likely initial distant site for prostate cancer to metastasize?
Bone
69
Inability to replace the foreskin back over the glans in an uncircumcised male?
Paraphimosis
70
Describe a + Chvostek's sign. What does it indicate?
The facial muscle contracts in response to tapping of the facial nerve. Sign of hypocalcemia
71
What is the treatment for asymptomatic hyponatremia?
Fluid restriction
72
Enlarged prostate with a firm nontender discrete mass?
Prostatic carcinoma
73
Peaked T waves on EKG?
Hyperkalemia
74
Bag of worms in scrotum?
Varicocele
75
Most common presentation for bladder carcinoma?
Painless hematuria
76
Most likely organisms causing acute epididymitis in young males?
Chlamydia and Neisseria gonorrhoeae
77
Definitive treatment for a 3 year old with an undescended testicle?
Orchiopexy
78
Most likely organisms causing epididymitis in an older male?
E. Coli - Klebsiella - Pseudomonas
79
What is the Dx? Male patient presents with fever chills dysuria perineal pain and decreased stream.
Acute prostatitis (Do not massage the prostate = bacteremia)
80
What factors are associated with increased risk of infertility in males?
Cryptorchidism - Hypogonadism - Orchitis Hx - Testicular torsion
81
Most common cause of dysuria in an adult male?
Urethritis
82
What is the Dx? UA shows pyuria white blood cell casts and hematuria.
Pyelonephritis
83
What may correcting a patients hyponatremia too quickly cause?
Pontine crenation which may lead to central pontine myelinolysis
84
Organism most likely to cause urethritis in males under 30?
Neisseria gonorrhoeae (Note: 30% have concurrent Chlamydia infection)
85
Risk factors for stress incontinence?
Age - Obesity - Vaginal deliveries
86
Drug of choice for treatment of BPH?
1st line: alpha-1-blockers - 2nd line: 5-alpha-reductase inhibitors
87
What are the hallmark manifestations of acute hypernatremia?
Lethargy - Weakness - Muscle twitching
88
What are the three hemodynamic factors that influence renal perfusion?
Cardiac output - Blood pressure - Systemic vascular resistance
89
Hemolysis of red blood cells may cause increased serum levels of what electrolyte?
Potassium
90
What drug may slow the progression of diabetic nephropathy?
ACE inhibitors and angiotension II receptor blockers (ARBs)
91
What is the Dx? Proteinuria and fatty casts in urine.
Nephrotic syndrome
92
What is the Dx? RBC casts in the urine.
Glomerulonephritis
93
What is the most common form of nephrotic syndrome?
Membranous glomerulonephritis
94
What is the serologic marker for Wegener's granulomatosis?
Anti Neutrophilic cytoplasmic autoantibodies (ANCA)
95
What are the hallmark signs of nephrotic syndrome?
Upper and lower extremity edema with normal jugular venous pressure
96
What is the most common type of renal cell carcinoma?
Clear cell
97
Acid-base disorder associated with renal failure?
Metabolic acidosis with increased anion gap
98
Diagnostic tests for renal artery stenosis?
Initial: Renal artery Doppler US - CT or MRI angiography to confirm
99
What is the Dx? Proteinuria hypoalbuminemia hyperlipidemia lipiduria and edema.
Nephrotic syndrome
100
What is the Dx? Hematuria hypertension oliguria with worsening azotemia.
Nephritic syndrome
101
Most common cause of acute renal failure?
Prerenal
102
What two diagnoses should be considered with hematuria and red blood cell casts after URI?
IgA nephropathy (<5 days) - Post-streptococcal glomerulonephritis (10-21 days)
103
What is the Dx? Paresthesia muscle cramping and agitation in a patient who has received multiple transfusions.
Hypocalcemia (Citrate in the transfused blood chelates calcium)
104
What must be ruled out in a patient with polycystic kidney disease and the worst headache of their life?
Cerebral aneurysm rupture
105
Common extrarenal manifestation of polycystic Kidney disease?
Cerebral aneurysm - Hepatic and pancreatic cysts
106
List the symptoms of interstitial nephritis.
Arthralgias - Rash - Renal failure - Fever - Eosinophilia - Eosinophiluria
107
Hyperkalemia in a patient receiving chemotherapy is indicative of what syndrome?
Tumor lysis syndrome
108
What type of nephropathy is associated with Hodgkin's lymphoma?
Minimal change nephropathy
109
What type of nephropathy is associated with carcinomas?
Membranous nephropathy
110
Most common type of kidney damage associated with HIV?
Focal Segmental Glomerulosclerosis (FSGS) presenting as nephrotic syndrome
111
What is the treatment for acute, symptomatic hyperphosphatemia?
Phosphate binders - Acetazolamide - Dialysis
112
What is treatment for hypophosphatemia?
Oral phosphate replacement
113
Bones, stones, groans and psychiatric overtones is the mnemonic for what electrolyte disorder?
Hypercalcemia
114
Trousseau and Chvostek sign are associated with what abnormality?
Hypocalcemia
115
A patient with preeclampsia is given magnesium IV. She develops hypotension, bradycardia. What is the recommended treatment?
She is hypermagnesemic, treatments are: Calcium gluconate - Insulin& glucose - Furosemide - Dialysis if these are unsuccessful
116
What electrolyte will not correct with supplementation until hypomagnesemia is corrected?
Hypokalemia
117
Digoxin and what potassium abnormality leads to increased digoxin toxicity and ventricular arrhythmia?
Hypokalemia
118
What is the endocrine disease that leads to hypernatremia?
Diabetes insipidus
119
Correction of hyponatremia too quickly with 3% saline IV fluid will lead to what brain abnormality?
Pontine crenation
120
Nephrotic syndrome is associated with protein loss in excess of how many grams per day?
3.5 g of protein or more
121
A fraction of excreted sodium that is greater than 2% is associated with what renal condition?
Acute tubular necrosis
122
Red blood cell casts on urinalysis are associated with what kidney condition?
Nephritic
123
What is the treatment for anemia due to chronic renal failure?
Erythropoietin analogs (epoetin alfa, darbepoetin alfa)
124
What is the most common cause of nephrotic syndrome in non-diabetic adults?
Membranous
125
A 18 year old male presents with hematuria, hypertension and pedal edema after a recent viral infection. What antibody will be noted on lab work?
IgA (IgA nephropathy)
126
What are the four main causes of acute tubular necrosis?
Prerenal (#1 cause) - Contrast dye - Drugs - Rhabdomyolysis
127
What are the three components of prerenal failure?
Volume loss: bleed, dehydration - Weak cardiac pump: heart attack, CHF - Loss of SVR: sepsis, neuro injury, anaphylaxis
128
A 65 year old male presents with suprapubic pain, anuria and a palpable bladder. What is the first step in the evaluation?
Foley catheterization
129
A 65 year old female presents with painless hematuria. She has a 50 year smoking history. What underlying condition do you suspect?
Bladder cancer
130
What is the treatment of choice for renal cell carcinoma without metastasis?
Radical nephrectomy
131
A patient with polycystic kidney disease suddenly develops the worst headache of his life. What do you suspect?
Subarachnoid hemorrhage due to a ruptured cerebral aneurysm
132
What is the gold standard for evaluating a patient with renal artery stenosis?
Angiography of the renal arteries
133
A 30 year old female presents with persistant hypertension. She has an abdominal bruit on exam. What do you suspect is the underlying cause of her hypertension?
Renal artery stenosis
134
A 17 year old male presents with hypertension and azotemia. What is his most likely diagnosis?
Polycystic kidney disease
135
What is the most common renal cancer in children, presenting with a unilateral abdominal mass?
Wilms tumor
136
Flank pain hematuria and palpable right abdominal renal mass is associated with what condition?
Advanced renal cell cancer
137
What is the most common type of bladder cancer?
Transitional cell
138
An untreated urinary tract infection leads to a high fever, chills, flank pain, nausea and vomiting. What condition do you suspect?
Pyelonephritis
139
What class of medication can often help patients with interstitial nephritis?
Tricyclics such as amitriptyline
140
What is the most common cause of urinary tract infection?
E. Coli
141
Bilateral hydronephrosis leads to what type of renal failure?
Post renal failure due to obstruction
142
Untreated pyelonephritis can lead to what kidney condition?
Hydronephrosis
143
White blood cell casts on urinalysis are associated with what condition?
Pyelonephritis
