Renal and Urologic Flashcards Preview

Differential Diagnosis Test 2 > Renal and Urologic > Flashcards

Flashcards in Renal and Urologic Deck (18):
1

What is the pain distribution for the upper urinary tract?

  • T10-L1 dermatomes
  • Renal- subostal and costovertebral
  • Ureteral- groin and genital
  • Lower abdominal quadrant
  • Generalized- nausea, vomitting
  • Hip OA- groin pain

2

What is the pain distribution for lower urinary tract?

  • Suprapubic-low abdomen
  • Low back- UTI (common)

3

What could you possibly find in the history of someone with a renal or urinary disorder?

  1. HTN
  2. Diabetes- Kidneys are first organs affected
  3. Age- especially if male and  over 45 y/o. Screen for prostate invlovement
  4. Gender- Lower urinary most affected for women
  5. Sexual Activity- UTI (STD's)
  6. Obstructive disorders- prostate enlargement
  7. Common symptoms: alteriation in flow, nausea and vomitting, dysuria (burning pain)

4

Signs and symptoms of Upper urinary tract

  1. Flank and ipsilateral shoulder pain
  2. fever and chills
  3. Hyperesthesia of dermatomes
  4. Hematuria,bacteriuria
  5. Pyuria

5

What is Murphy's percussion test? Reason? How to treat?What is positive?

  • Test for costovertebral tenderness
  • Reason: Previous hx of kidney infection
  • Treatment: We don't treat. Requires immediate referral
  • Positive= reproduction of back and/or flank pain

6

Predictor for renal Colic:

  • Urinalysis-hematuria
  • Presence of renal tenderness
  • <12 hours of pain
  • Normal Appetite
  • Gender- male 2x more likely

7

Signs and Symptoms of lower urinary Tract:

  1. Urinary frequency or urgency
  2. Dysuria, Pyuria, Dyspareunia
  3. Hematuria,bacteriuia
  4. LBP, pelvic or lower ab pain

8

What is the difference between Upper urinary obstructive disorders and lower urinary obstructive disorders?

  • Upper urinary- pain is excruciating, spasmodic, and radiating with nausea and vomiting
  • Lower urinary- more related to tumors, prostatic hypertrophy, nocturia, hesitancy

9

What are some mechanical/neuromuscular disorders?

Incontinence, Infection, Endocrine disorders

10

What are some meds that cause incontinence?

  • Antichoinergic
  • calcium channel blocker
  • diuretics
  • sedatives
  • alpha-antagonists
  • alpha-agonists

11

Signs and symptoms of renal impairment:

  • HTN
  • decreased urinary output
  • dependent edema
  • unusual weakness
  • dyspnea
  • Headache
  • Proteinuria

12

What is the difference between acute and chronic renal failure?

  • Acute-reversible
  • Chronic- ends in End stage renal failure

13

What are some other characteristics of Renal failure?

  • Multiple systems involvement
  • Signs and symptoms are the same as renal impairment but more severe
  • Severe bilateral pitting edema

14

Things to note in patients with ESRD:

  • typically medically fragile
  • areas in clinic must stay as sanitary as possible
  • cannot take pain meds

15

What results in an increase of creatine?

Renal impairment (increase normal in elderly)

16

What causes abnormal BUN value?

  • hepatic or renal disease; dehydration, infection, GI bleed, steroid use (increase BUN)
  • secere hepatic damage (increase BUN)
  • Malnutrition (decrease BUN)

17

What causes an abnormal BUN/Creatine ratio?

  • dehydration (increase)
  • malnutrition (decrease)

18

Types of imaging:

  1. Ultrasound- looking for enlargement of kidneys (indicates blockage) or prostate
  2. MRI-tumor
  3. Cystoscopy-visualize lining of bladder