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Nephrology/Urology Flashcards

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1
Q

Nephrotic syndrome includes what manifestations?

A
  • Proteinuria
  • Hypoalbunemia
  • Hyperlipidemia
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2
Q

Acute Glomerulonephritis (Nephritic Syndrome) includes what pt manifestations

A
  • Hematuria (RBC casts)
  • HTN
  • Edema /Azotemia (High nitrogen in blood)
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3
Q

Nephrotic syndrome includes what 3 etiologies?

A

Minimal Change
Focal Segmental Glomerulosclerosis
membranous nephropathy

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4
Q

MC Nephrotic syndrome etiology occurring in children: Effacement of podocytes: Tx is Prednisone

A

Minimal change Disease

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5
Q

Nephrotic syndrome etiology Involves AA, HTN and fibrosis of glomerulus: “Not Steroid responsive”

A

Focal Segmental Glomerulosclerosis

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6
Q

Nephrotic syndrome etiology Involves thickening of the glomerular basement membrane: 2T immune complex depositions

A

Membranous Nephropathy

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7
Q

Nephritic Syndrome (AGN) includes what etiologies?

A
  • IgA Nephropathy (Berger’s Disease)
  • Post infectious
  • Rapidly Progressive GN
  • Good Pasture’s
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8
Q

Nephritic Syndrome (AGN) MC after GABHS or Impetigo: Facial Edema: Post-Strep: coca cola urine

A

Post Infectious GN

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9
Q

Nephritic Syndrome (AGN): Linear IgG depositis, hemoptysis and kidney failure (Hematuria

A

Good Pasture’s

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10
Q

Nephritic Syndrome (AGN) progresses to ESRD in weeks due to fibrin and protein deposition:

Crescent formation biopsy Tx:

A

Rapid Progression GN

CS and Cyclophosphamide

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11
Q

MC Nephritic Syndrome (AGN) in adults WW: post URI or GI infection; IgA mesangial deposits: Tx: ACE/ CS

A

IgA Nephropathy (Berger’s Disease)

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12
Q

Acute Kidney Injury Types

A

Prerenal (MC). Intrinsic, and post renal.

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13
Q

MCC of prerenal AKI is _______: which leads to_______ if not corrected ? BUN:Cr is?

A

Hypovolemia (NSAID/IV contrast): Leads to ATN

B:Cr 20:1

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14
Q

Intrinsic types of AKI?

A

Acute Tubular necrosis (ATN MC type)

Acute tubulointerstitial nephritis (AIN)

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15
Q

Intrinsic AKI caused by hypo/ tension-volemia or aminoglycosides: UA= Muddy Brown casts/Epithelial cell

A

ATN

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16
Q

AIN is caused by a ________–> to ________ casts?

A

Hypersensitivity (PCN, NSAID Sulfa: WBC Casts

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17
Q

RBC casts are pathognomonic for ?

A

Acute Glomerulonephritis

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18
Q

FeNa >2 you think what AKI?

A

ATN

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19
Q

Low FeNa< 2 you think what type of AKI?

A

Prerenal

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20
Q

Autosomal Dominant D/O: Abdominal Flank pain /palpable mass, recurrent infections, Hematuria, HTN

Dx: Tx:

A

Adult Polycystic Kidney Disease

Dx: Renal US Tx: ACEi/ renal transplant

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21
Q

Adult Polycystic Kidney Disease is associated with what Extrarenal common abnormalities

A

Berry Aneurysms and MVP

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22
Q

MCC and 2nd MCC of ESRD

A

1st MCC DM-II

2nd MCC HTN

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23
Q

what is the single best predictor of Chronic Kidney Disease?

A

Proteinuria

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24
Q

Best Diagnostic tool for CKD?

A

Spot Albumin/U creatinine Ratio (ACR)
“preferred over 24 hour collection”

(ACR <2 Normal; 2-20 micro: >20 nephropathy)
(Albuminuria 24H <30mg=Normal: 30-300mg: >300 neph)

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25
What are the GFR CKD stages?
``` Stage 0= >90 Stage 1= 60-90 Stage 2= 30-59 Stage 3= 15-30 Stage 4= <15 ```
26
Non-physiologic excess of ADH from pituitary or ectopic 2T stroke, trauma CNS tumor, ecstasy: Hyponatremia Na < 120: Isovolemic- no edema: Dx: Tx:
Syndrome of Inappropriate ADH Dx: Concentrated urine Tx: H2O restriction < 800ml/day Hyponatremia - hypertonic saline/Lasix
27
ADH (vasopressin) deficiency or insensitivity: Large amounts of urine 20L /day: Hypernatremia: Polydipsia Dx Tx:
Diabetes Insipidus Dx: Fluid deprivation--> dilute urine Desmopressin--> reduces urine (central) Tx: Desmopressin or carbamazepine
28
Drugs that can cause Diabetes insipidus --> partial or complete insensitivity to ADH?
Lithium or Amphotericin B
29
Electrolyte imbalance that causes Increased DTRs and prolonged PR and QT interval--> _____?
hypomagnesemia : Torsades
30
Hypermagnesemia treatment
-Calcium Gluconate
31
Electrolyte imbalance that causes muscle weakness/ cramps, palpitations, T wave flattening or U waves ECG
Hypokalemia
32
Hyperkalemia treatment (Wide QRS in ECG)
1. Calcium Gluconate 2. Insulin 3. B2 Agonists
33
MCC of epididymitis in <35 and >35?
< 35 Chlamydia or Gonorrhea >35 E.coli or Klebsiella Mumps
34
Orchitis manifestations?
Scrotal- pain redness, swelling UA- Pyuria/bacteruria (+) Phrens (+) Cremasteric reflex
35
Orchitis Treatment?
<35 Doxy + Ceftriaxone (Chlamydia/Gono) >35 Levo or Ofloxacin (Cephalexin/amoxicillin children) Chronic- 4-6 week trial
36
Abrupt scrotal/inguinal pain: < 6 hours NV, 10-20 yo: Negative phrens, negative cremasteric, Blue Dot Sign Dx: Tx:
Testicular Torsion Dx: Doppler US Tx: Orchiopexy w/I 6 hours
37
Orchiopexy tx for Cryptorchidism is recommended as early as ______, until then observation can be done?
6 months (ideally prior to 1 year)
38
Sx repair for hydrocele persistent or communicating can be done if not resolved by what age?
1 year of age or electively
39
Cystic testicular mass worsened when patient is upright or Valsalva: MC sx correctable infertility cause
Varicocele
40
Varicocele MC involves what vessels?
Pampiniform venou Plexus and internal spermatic vein
41
Left sided varicocele in older man= ________ | Right sided varicocele in < 10 yo= _________
Older man L side= Renal cell carcinoma < 10 yo R side = Retroperitoneal malignancy
42
Fever, tachycardia, back/flank pain CVA tenderness, NV UA= WBC?
Pyelonephritis
43
suprapubic discomfort, hematuria, dysuria, in creased frequency and urgency?
Acute Cystitis
44
Definitive Dx for acute cystitis/Pyelonephritis? Tx: for pyelonephritis
Urine Cx= WBC >100,000 Fluoroquinolone or Aminoglycoside X 14 days
45
Acute Cystitis complicated Tx?
Fluoroquinolone or Aminoglycoside IV 7-10 days
46
Acute Cystitis uncomplicated?
Nitrofurantoin- 100 bid X 7days Ciprofloxacin 250 mg BID X 3 days TMP- DS BID X3 days
47
Acute Cystitis pregnant Tx?
Amoxicillin (Augmentin) or cephalexin 7-14 days Nitrofurantoin
48
Foreskin becomes trapped behind corona of glans?
Paraphimosis (Phimosis retract over glans)
49
fever/ chills, Increased frequency/urgency, dysuria, peri anal pain, LBP exquisitely tender, hot, boggy prostate
Acute prostatitis
50
Recurrent UTIs, obstruction sx, LBP non-tender, boggy prostate
Chronic Prostatitis
51
Prostatitis Tx?
>35 Fluoroquinolone or TMP (E.coli) | <35 Doxycycline + Ceftriaxone (Chlamydia/Gonorrhea)
52
Obstructive and irritative urinal symptoms: Uniformly enlarged, firm, "Rubbery prostate":
Benign Prostatic Hyperplasia (BPH)
53
Benign Prostatic Hyperplasia (BPH) Dx; Tx:
Dx: PSA < 4 Tx: 5-A reductase Inh. (Finasteride Dutasteride) "Androgen Inhibitors" (suppresses growth) A-1 blockers Tamsulosin, Terazosin, -zosin (m. relaxation) "Only relieves symptoms"
54
MC cancer on prostate cancer ?
Adenocarcinoma
55
Prostate cancer highlights?
- Urethral obstruction - Back/bone pain - PSA> 4ng (>10 ng = METS)
56
Painless gross or microscopic hematuria, irritative s/sx
Bladder cancer
57
MC cancer in bladder cancer ?
Transitional Cell cancer
58
Hematuria, flank/abdominal pain, palpable mass, malaise, weight loss, HTN, Hypercalcemia, L varicocele,
Renal Cell Carcinoma (95 originate in kidney)
59
in 1st 5 yo life: Hematuria, HTN, painless palpable abdominal mass, anorexia, and anemia?
Wilms Tumor (Nephroblastoma)
60
Sudden constant upper/lateral back pain radiating to groin/ anteriorly: NV, restless position, hematuria
Nephrolithiasis
61
Urinary pH >7.2 stone formation is associated with what stone
Struvite Nephrolithiasis
62
MC type of Nephrolithiasis ?
Calcium Oxalate
63
Calculi formed 2T urea-splitting organism proteus or Klebsiella, pseudomonas?
Struvite Calculi (--> Staghorn)
64
Narrowest point of urinary tract?
Ureterovesicular joint
65
Tx of stone less than ______mm in diameter that have a 80% chance of spontaneous passage?
5mm Tx: Iv fluids: Analgesic, antiemetic Tamsulosin A-1 blocker
66
Tx for large stones >8mm
Lithotripsy (Uretoscopy w stent)
67
Erectile dysfunction treatment phosphodiesterase 5 Inh | that works 30 min.-4 hours before sexual activity
Sildenafil (Viagra)
68
Erectile dysfunction treatment phosphodiesterase 5 Inh | that works within 30 min. with no regard of sex timing
Tadalafil (Cialis)
69
Erectile dysfunction treatment phosphodiesterase 5 Inh | that works 60 minutes prior to sexual activity
Vardenafil (Levitra)
70
Priapism management?
``` Phenylephrine (intracavernous injection) Terbutaline (Orally or sub Q) Needle aspiration (Blood removal) ```
71
Urethritis Dx: and Tx:
Dx: Nucleic acid amplification Tx: Gono: Ceftriaxone (250mg) X1 or Azythromycin 2 G Non-Gono: Azithromycin 1G or Doxy 100 BID X 10
72
Atherosclerotic MC in elderly: HTN onset <20 or >50 or HTN resistant to 3 drugs: AKI post ACEi; Abd. Bruit Tx:
Renovascular Hypertension (Renal Artery stenosis) Tx: Stent definitive
73
Enuresis Tx:
Desmopressin Imipramine (Alarm or behavioral)
74
Incontinence marked by overactive bladder Detrusor muscle? Tx:
Urge incontinence Tx: Oxybutynin or Tolterodine (Anticholinergics) TCA-Mirabregon
75
Incontinence marked by increased abd. pressure, ;laxity of pelvic floor muscle: laughing, sneezing, coughing Tx:
Stress Incontinence Tx: Midodrine
76
Incontinence marked by urinary retention (incomplete emptying). underactive detrusor muscle: Dx:
Overflow Incontinence Dx: Post void residual .200 ml Tx: Tamsulosin (A-1 b)

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