Nephrology/GU Flashcards
(125 cards)
1
Q
What is hematuria?
A
5+ RBC in urine
2
Q
What dz can cause hematuria?
A
BAPI HUH Benign familial Alport Post strep glemerulonephritis IgA - Berger Hemolytic uremic UTI Hypercalcuria
3
Q
What is benign familial hematuria?
A
RBC in urine
d/t family gene - autosomal dominant
4
Q
Benign familial hematuria - sx?
A
normal:
- exam
- renal fxn
5
Q
Adult smokes + painless hematuria = ?
what can this lead to?
A
transitional cell carcinoma
6
Q
Benign familiar hematuria - PE?
A
prerenal: dark
renal: casts
post renal: bright red
7
Q
What is Alport sx?
A
can lead to ESRD
autosomal recessive
8
Q
What are the genetic caused hematuria dz?
A
benign familial hematuria
Alport sx
9
Q
Hematuria + hearing loss + vision loss = ?
A
Alport sx
10
Q
Alport sx - dx?
A
renal bx
11
Q
What is post strep glomerulonephritis?
A
d/t a strep infxn: throat or skin
12
Q
When does post strep glomerulonephritis occur?
A
1-2 days after strep infxn
13
Q
Which hematuria dz can cause HTN?
A
post strep glomerulonephritis
IgA
HUS
14
Q
How to differentiate between post strep glomerulonephritis and IgA?
A
get ASO titers to r/o post strep glomerulonephritis
15
Q
Post strep glomerulonephritis - tx?
A
control HTN
supportive
fluid balance
16
Q
Baby had URI 1-2 days ago + hematuria + RBC casts = ?
A
IgA nephropathy
17
Q
Post strep glomerulonephritis - labs?
A
increased BUN/Cr
UA: hematuria + RBC casts
18
Q
IgA nephropathy - tx?
A
prednisone
ACE inhibitors
19
Q
Athletic child w/ fever comes in with brown urine?
A
myoglobinuria/rhabdomyloysis
20
Q
Myoglobinuria/rhabdomylosis - UA?
A
NO RBC
21
Q
Myoglobinuria/rhabdomylosis - tx?
A
mannitol to flush it all out
rehydrate
22
Q
HUS - sx?
A
rash
dark urine
HTN
bloody diarrhea
23
Q
HUS - labs?
A
high PTT
high BUN/Cr
RBC + casts
24
Q
What dz have RBC + casts?
A
HUS
post strep glomerulonephritis
IgA
25
HUS - dx?
stool: EHEC
26
HUS - what to be careful of?
abx
27
HUS - tx?
supportive
28
Henoch schonlein purpura?
IgA mediated
rash waist down
arthritis
abdominal pain
29
Baby has abdominal pain + arthritis + rash waist down =?
henoch schonlein purpura
30
Henoch schonelin purpura - labs?
CBC - check for non thrombocytopenia
31
What is proteinuria?
child: >30-40mg/kg/day
adult: >3-3.5g
protein: Cr > 0.2
32
What is the gold standard to check for protein?
24 hr urine
33
Orthostatic proteinuria?
protein in urine when sitting/standing
34
Orthostatic proteinuria - dx?
morning first void > 24 hr urine
35
Orthostatic proteinuria - tx?
benign
36
Minimal change dz?
COMMON CX OF PROTEINURIA IN KIDS
37
Minimal change dz - prognosis?
does NOT lead to ESRD
38
Baby comes in with sudden onset of edema?
minimal change dz
39
What kidney dz can be treated w/ ACE?
IgA
| minimal change dz
40
Minimal change dz - dx?
renal bx
41
Bug for UTI?
e coli
| adenovirus
42
female comes in w/ fever but NO URI?
UTI
43
RF for UTI?
female
male not circumcised
constipation
44
UTI can lead to ESRD if?
recurrent 3x
45
UTI sx?
```
vomit
diarrhea
abdominal pain
strong smelling urine
NO CVA tenderness in kids
suprapubic pain
```
46
What to look out for in babies w/ systemic sx?
pyleo
47
Baby <12 mo has fever w/ no source?
UA
48
Gold standard for clean catch in babies?
catheter b/c bag is not clean catch
49
Dx for UTI in babies?
clean catch UA C&S
50
If urine culture comes back with flora?
prob not UTI
51
UTI - tx?
cover for e coli
| 7-14days
52
UTI - admit if?
suspicious for sepsis, stones
unable to stay hydrated
<3 mo w/ fever
53
When to US for UTI?
<2 yo
boy w/UTI
recurrent UTI (3x)
GU anamolies
54
When to VCUG for UTI?
fails to respond in 2days
<2yo with 2nd UTI
recurrent UTI
55
How to dx reflux neuropathy?
VCUG
56
How many grades are there for reflux neuropathy and when do you do surgery?
Grade I - V
| Grade V - surgery
57
What is enuresis?
wetting the bed at night
58
What is concerning enuresis?
able to potty but now wetting the bed - secondary enuresis
59
What are the categories of enuresis?
nocturnal
diurnal
primary enuresis
secondary enuresis
60
What is dirunal?
peeing during the day and night
61
What is primary enuresis?
NEVER been potty trained
62
What is secondary enuresis?
potty trained for >6mo but starting to wet the bed
63
Cx of enuresis?
UTI
anatomical prob
social probs at home
64
Enuresis - PE check for?
spinal bifida
65
Enuresis - tx?
1) bed wetting alarms
| 2) drugs (antidiuretic)
66
What is polycystic kidney dz?
polyps on the kidney
67
What are the types of polycystic kidney dz?
autosomal dominant
| autosomal recessive
68
Why is autosomal recessive not that important?
does not live very long
69
Autosomal dominant polycystic kidney - PE?
flank pank
| recurrent UTI
70
Autosomal dominant polycystic kidney - dx?
2 cysts in 1 kidney
1 cyst in EACH kidney
FMAILY hx
71
Autosomal dominant polycysit kidney - tx?
manage HTN
| transplant
72
What is CAH 21 Hydroxylase deficiency?
salt wasting sydndrome d/t too much androgen and coritosl
73
CAH 21 hydroxylase deficiency - labs?
```
hyponatremia
hyperkalemia
hypoglycemia
metabolic acidosis
hypovolemia
```
74
What happens when you are hypovolemic?
too much renin produced --> dehydration, vomit, shock
75
Hydroxylase deficiency - females?
amiguous genitalia and virilization
76
Hydroxylase deficiency - males?
bilateral cryptorchidism (absence of a testes)
77
What is phimosis?
inability to pull back prepuce (foreskin) over the glans
78
What is phimosis at risk for?
```
UTI
urinary retension
urinary reflux
STI
penile cancer
```
79
Phismosis - timeline?
3yo: normal retraction of foreskin
3yo+: gentle retraction + topical hydrocortisone
DO NOT forcefully retract foreskin
80
What is paraphismosis?
phimotic foreskin is retracted past the cornoal suclus and becomes trapped --> tight ring that impairs blood flow
MEDICAL EMERGENCY
81
Parphismosis- PE?
fussy
82
Paraphismosis -cx?
forceful retraction
83
Parphismosis - tx?
refer
84
Balanoposthitis?
inflammation of glans
penile edema
phismosis
85
Posthitis?
inflammation of prepuce and penile skin
86
Balanoposthitis - bugs?
candida
| strep
87
Balanoposthitis - tx?
antifungal cream
| +/-abx
88
What is buried penis?
small penis but normal structures
89
Buried penis - population?
obese
90
Buried penis - complication?
skin irritation d/t pee pooling
91
Bured penis - tx?
wt loss
92
Microphallus?
penile length is below average/mean
93
Microphallus can cause?
hypogonadotropic hypogonadism
| primary testicular failure
94
Undescended testes types?
retractile testes
| cryptorchidism
95
When does testes drop?
by the end of 6mo
96
What is retractile testes?
testicles pull down into inguinal canal when exposed but settles down in warm bath
most descend by 2yo
97
What is cryptorchidism?
true undescended testes
98
Cryptorchidism - risk?
infertility
| germ cell tumor
99
Cryptorchidism - tx?
orchidopexy 6-12mo
100
How to palpate for testes?
begin high in inguinal canal --> nothing? US
| found? --> monitor
101
What is varicocele?
enlargement of the veins in the scrotum
| "boggy enlargement"
102
Varicocele - PE?
left side
full testes
"bag of worms"
increase in size when standing
103
Varicocele - cx?
obstruction of increase pressure of abdomen
104
Varicocele-complication?
infertility
105
Hydrocele?
non painful swelling of scrotum d/t fluid buildup
106
Hydrocele - tx?
resolves in 6mo (common in newborns)
too big - surgery
does NOT affect infertility
107
What is testical torsion?
twisting of the spermatic cord
108
Testical torsion - PE?
painful and acute abdominal pain radiating to groin
N&V
swollen testes
NO relief when testes are elevated - negative Prehn sign
Negative cremasteric reflex
109
Testicular torsion - dx?
scrotal doppler w/ flow doppler
110
Epididymitits?
inflammation of epididymitis
111
Epidimyitis - bugs?
bacterial: chlaymdia
112
Epididymitis - PE?
painful and swollen testes
NO N&V
RELIEF when testes are elevated - positive Prehn sign
positive cremasteric reflex (drawing of the scrotum)
113
Torsion of appendix testes-PE?
```
acute pain of upper pole testes
small swelling of testes
NO FEVER
NO N&V
"blue dot"
```
114
Torsion of appendix testes-labs?
testicular doppler: normal or decreased blood flow
115
Torsion of appendix tests- tx?
pain control
| self resolves
116
Orchitis?
mumps
| rare
117
Orchitis - PE?
fever
HA
unilateral parotid gland swelling
bilateral testes pain
118
Orchitis - timeline?
4-6days after parotiditis
119
Orchitis - complication?
infertility
| aseptic meningitis
120
What is inguinal hernia?
protrusion of abdominal contents through inguinal canal
121
Inguinal hernia -gender?
boys>girls
122
Inguinal hernia - PE?
R>L
| increase in size w/ valsalva
123
Inguinal hernia - unincarcerated vs incarcerated?
un: not painful
in: painful --> ER
124
What scrotal swelling is painful?
```
epididymitis
orchitis
testicular torsion
torsion of appendix testes
incarcerated inguinal hernia
```
125
What scrotal swelling is NOT painful?
```
hydrocele
varicocele
inguinal hernia
nephrotic syndrome
testiuclar tumors
macro-orchidism
micro-orchidism
```
