Renal and Urologic Flashcards Preview

Differential Diagnosis Test 2 > Renal and Urologic > Flashcards

Flashcards in Renal and Urologic Deck (18):

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


What is the pain distribution for lower urinary tract?

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


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)


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


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


Predictor for renal Colic:

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


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


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


What are some mechanical/neuromuscular disorders?

Incontinence, Infection, Endocrine disorders


What are some meds that cause incontinence?

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


Signs and symptoms of renal impairment:

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


What is the difference between acute and chronic renal failure?

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


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


Things to note in patients with ESRD:

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


What results in an increase of creatine?

Renal impairment (increase normal in elderly)


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)


What causes an abnormal BUN/Creatine ratio?

  • dehydration (increase)
  • malnutrition (decrease)


Types of imaging:

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