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Flashcards in Nephro Deck (66):
1

Rx of anemia in CKD?

Iron then erythropoietin
If on dialysis IV iron > oral

2

Detrustor instability / urge incontinence classic

Intense urge to void patient overcomes with voluntary closure of sphincter

3

Stress incontinence

Weak sphincter
Leakage with coughing

4

Cause of acute interstitial nephritis?

Drugs:
- NSAIDs
- cephalosporins
- penicillin
- sulfonamide
- aminoglycoside
- rifampin
- allopurinol

5

Epididymitis classic

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

6

Most common infection associated w/ epididymitis

STD (gonorrhea + chlamydia)

E. coli

7

How to lower the risk of contrast-induced nephropathy?

Hydration + Na HCO3

N-acetylcystine

8

Causes of erectile dysfunction

Alcohol + smoking
Age
DM
HTN
Hyperlipidemia

9

Urinary retention causes

Impaired bladder contractility (neuro)

Bladder outlet obstruction (Ca, BPH)


Detrusor-sphincter dyssynergia

10

Urinary retention classic

Frequency
Incontinence
Pain

11

Dx perinephric abscess

CT = big psoas muscle + perirenal gas + perirenal fluid

12

Sx of perinephric abscess

Fever + flank pain not responsive to 4days of Abx

13

Rx of stress incontinence

Kegel exercise
Surgical
Pessary
+/- estrogen

14

Rx of urge incontinence

Pelvic floor training (kegel)
Oxybutynin
Tolterodine

15

Types of urinary incontinence

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.

16

Neurogenic bladder ass

DM
MS
Spinal cord injury

17

Rx of neurogenic bladder

1. Strict ruination schedule

2. Crede's maneuver

+/- bethanecol

18

Dx of kidney stones

CT w/o contrast

19

Chronic bacteriuria

Short course Abx

20

Alternative to TMP-SMX in UTI

Cipro, Levo, nor or lemofloxacin

Not moxifloxacin

21

Use of moxifloxacin in UTI

Not recommended

Low urine concentration

22

Rx of DM nephropathy

ACEI / ARB + Na restriction
Nephroprotective

23

MCC of nephrotic

DM

24

When to adjust drugs dose / dosing intervals in CKD?

Based on GFR or creatinine clearance NOT creatinine serum level.

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