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Nephro Flashcards

1
Q

Rx of anemia in CKD?

A

Iron then erythropoietin

If on dialysis IV iron > oral

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2
Q

Detrustor instability / urge incontinence classic

A

Intense urge to void patient overcomes with voluntary closure of sphincter

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3
Q

Stress incontinence

A

Weak sphincter

Leakage with coughing

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4
Q

Cause of acute interstitial nephritis?

A

Drugs:

  • NSAIDs
  • cephalosporins
  • penicillin
  • sulfonamide
  • aminoglycoside
  • rifampin
  • allopurinol
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5
Q

Epididymitis classic

A

Subacute scrotal pain
Prehn’s sign +ve
Mass above testis
Associated w/ STD = pyuria

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6
Q

Most common infection associated w/ epididymitis

A

STD (gonorrhea + chlamydia)

E. coli

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7
Q

How to lower the risk of contrast-induced nephropathy?

A

Hydration + Na HCO3

N-acetylcystine

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8
Q

Causes of erectile dysfunction

A 
Alcohol + smoking 
Age
DM
HTN
Hyperlipidemia
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9
Q

Urinary retention causes

A

Impaired bladder contractility (neuro)

Bladder outlet obstruction (Ca, BPH)

Detrusor-sphincter dyssynergia

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10
Q

Urinary retention classic

A

Frequency
Incontinence
Pain

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11
Q

Dx perinephric abscess

A

CT = big psoas muscle + perirenal gas + perirenal fluid

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12
Q

Sx of perinephric abscess

A

Fever + flank pain not responsive to 4days of Abx

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13
Q

Rx of stress incontinence

A

Kegel exercise
Surgical
Pessary
+/- estrogen

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14
Q

Rx of urge incontinence

A

Pelvic floor training (kegel)
Oxybutynin
Tolterodine

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15
Q

Types of urinary incontinence

A
  1. Functional: can’t move
  2. Stress: pelvic relaxation = involuntary loss of urine w/ coughing.
  3. Detrusor instability: overactive bladder, urge to urinate followed by loss of large amount of urine
  4. Neurologic: constant leakage of small amount.
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16
Q

Neurogenic bladder ass

A

DM
MS
Spinal cord injury

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17
Q

Rx of neurogenic bladder

A
  1. Strict ruination schedule
  2. Crede’s maneuver

+/- bethanecol

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18
Q

Dx of kidney stones

A

CT w/o contrast

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19
Q

Chronic bacteriuria

A

Short course Abx

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20
Q

Alternative to TMP-SMX in UTI

A

Cipro, Levo, nor or lemofloxacin

Not moxifloxacin

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21
Q

Use of moxifloxacin in UTI

A

Not recommended

Low urine concentration

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22
Q

Rx of DM nephropathy

A

ACEI / ARB + Na restriction

Nephroprotective

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23
Q

MCC of nephrotic

A

DM

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24
Q

When to adjust drugs dose / dosing intervals in CKD?

A

Based on GFR or creatinine clearance NOT creatinine serum level.

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25
Rx of epididymitis
Cefriaxone 250 mg IM + Doxycycline 100 mg BID for 10 days.
26
Rx in erectile dysfunction
Sildenafil Tadalafil Testosterone GnRH
27
Kidney stone classic
Flank pain Radiates to groin Costovertebral angle tenderness.
28
Rx of uric acid stones
Hydration | Alkalinize urine w/ K citrate or HCO3
29
Dx of glomerulonephritis
Dysmorphic RBC on cast
30
What never cause nephrotic syndrome
Inflammation reaction of glomerular cells
31
Dx polycystic kidney disease
US
32
Polycystic kidney disease classic
FHx Enlarge kidneys HTN +/- AKI
33
Organic vs psychological erectile dysfunction
morning erection = psychological
34
Drug contraindicated in HTN due to renal artery disease?
ACEI
35
Causes of urinary incontinence
Vaginal deliveries Chronic cough Estrogen deficiency Weak muscle of urethra NB: C-section isn't cause.
36
One cancer where biopsy is contraindicated?
Testicular Ca | Leads to seeding of tumor cells
37
Rx of hydronephrosis
Hydration Pain control +/- antibiotics Stones < 4mm pass spontaneously
38
Dx goodpasture
Anti-GBM ab
39
IgA nephropathy classic
- Recurrent gross hematuria after URTI Or - Microscopic hematuria and mild proteinuria Or - Rapidly progressive GN w/ HTN, edema.
40
Dx IgA nephropathy
Biopsy = IgA deposits
41
Dx AKI of hypovolemia
FENA <1% BUN:Cr >20 Urine Na <20 Hyaline cast
42
Dx Acute tubular necrosis
FENA >1% BUN:Cr <20 Urine Na >20
43
Best screening test for DM nephropathy?
Urine albumin/creatinine ratio to detect mucroalbuminuria
44
Dx renal artery stenosis
``` HTN (uncontrolled) Abdominal bruit US MRI Best = angiography ```
45
MCC of UTI
E. coli
46
Blood thinner needs adjustment w/ renal disease?
Enoxaparin
47
What BB don't need dose adjustment in renal disease? Why?
Carvedilol Metoprolol Metabolized by liver
48
Indication of drug-induced nephritis?
Eosinophilia
49
Pathophysiology of renal artery stenosis
Stenosis = hypo perfusion Activation of RAAS = Na + H2O retention Normal GFR in early disease.
50
When RBC in urine clinically significant?
If 3 RBC/hpf
51
Change in erection with age?
Increase time needed for arousal and decreased penile sensitivity Thus, increased need for direct contact stimulation Increased time between erections Less forceful ejection
52
Minimum sperm count to cause pregnancy?
> 1 million motile sperms
53
Pregnancy w/ oligospermia?
IVF
54
What medications cause urinary retention
Anti-cholinergic TCA Smooth muscle depressants Sympathomemtics
55
Interstitial Cystitis classic
``` Obstructive Sx Supra public pain Not responsive to Abx Negative cultures WBC + RBC in urine. ```
56
Dx cystitis
1st: Urine analysis Accurate: cultures => negative => cystoscope for interstitial cystitis
57
Rx of cystitis
TMP/SMX 3 days Nitrofurantoin 3 days Extend Rx to 5-7 days if complicated, resistant
58
Rx of overflow incontinence
Cholinergic; | Bethancol
59
Normal urine specific gravity
1.012 - 1.030
60
Causes of increased urine specific gravity
``` Glucosuri SAIDH Dehydration Adrenal insufficiency High protein diet ```
61
Low specific gravity
DI Diuretics Fluid intake
62
Most common nephropathy in AIDS
Focal glomerular sclerosis
63
Organisms in epididymitis
< 35 Y Gonorrhea Chamydia trachomatis ``` > 35 Y Pseudomonas Coli form (E.coli) ```
64
Drug causes erectile dysfunction
Sertraline (SSRI)
65
PSA level indicates prostate Ca?
> 2.0 ng/mL + prostate volume > 40 ml
66
Rx of prostatitis
Fluoroquinolone: cipro Slufa: TMS/MXZ

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