Nephrology

Question 1

Risk factors for urinary tract malignancy

Answer 1

Risk of urinary tract malignancy (eg, renal, bladder, or prostate cancer) include

• gross hematuria,
• age >40,
• male gender,
• smoking history.

Other potential risk factors include history of pelvic radiation or exposure to aniline dyes.

Question 2

Treatment abx of uncomplicated UTI?

Answer 2

Fluoroquinolones (-floxacin), sulfamethoxazole-trimethoprim (Bactrim), and nitrofurantoin

Question 3

Patients in diabetic ketoacidosis generally have blood glucose levels greater than?

Answer 3

250

Question 4

Ileus can be caused by this metabolic abnormality…

Answer 4

Hypokalemia (can be caused by loop diuretics, persistent vomiting)

Question 5

If concerned about refeeding syndrome be sure to follow this electrolyte…

Answer 5

Phosphorous (will decrease with subsequent insulin release)

Question 6

Acute poststreptococcal glomerulonephritis occurs greater or less than 10 days after URI?

Answer 6

Acute poststreptococcal glomerulonephritis follows a streptococcal throat/skin infection with a gap of more than 10 days between throat infection and onset of renal disease. Gross hematuria is uncommon. Patients are typically hypertensive. Urine sediment reveals RBCs and RBC casts. Complement levels are decreased.

If similar symptoms and history but less than 10 days, think IgA Nephropathy.

Question 7

Effects of Aldosterone

Answer 7

Aldosterone is released in response to Agiontensin II stimulating the adrenal cortex and posterior pituitary. Aldosterone then causes increased water absorption from aquapores in distal tubule of kidneys as well as increased Na and Cl reabsorption with excretion of K and net uptake of H2O.

Question 8

Management of uretral stone <10 mm

Answer 8

IV Hydration
Pain control
Alpha blockers (Tamsulosin x4 wks)
Strain urine

If no passage in 4-6 weeks consult urology for possible stone removal.

Question 9

Management of uretral stone >10mm

Answer 9

Urology consult, possible need for surgery

Question 10

SIRS criteria

Answer 10

occurrence of at least two of the following criteria: fever >38.0°C or hypothermia <36.0°C, tachycardia >90 beats/minute, tachypnea >20 breaths/minute, leukocytosis >12109/l or leukopoenia <4109/l [1,2].