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Renal/GU JB Flashcards

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1
Q

acute prostatitis MCC

A

<35yo: chlamydia and gonorrhea
>35yo: E. coli

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2
Q

Acute prostatitis dx

A

DRE
UA/culture (+ in acute)
transrectal US

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3
Q

ATN labs

A

epithelial cell casts
muddy brown casts
waxy/granular casts
low specific gravity
hyperK, hyperP

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4
Q

ATN tx

A

Volume depletion: IV fluids
Volume overload: diuretics (furosemide)
metabolic acidosis, hyperP: dialysis if pH <7.1

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5
Q

Postrenal azotemia lab

A

elevated BUN/Cr

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6
Q

pre-renal azotemia labs

A

elevated BUN/Cr
hypovolemia

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7
Q

BPH lab

A

DRE
increased PSA
urine cytology

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8
Q

BPH monitor

A

mild: monitor annually
avoid antihistamine/anticholinergics

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9
Q

BPH tx

A

5 a reductase: finasteride, dutasteride
a 1 blocker: tamsulosin, doxazosin –> sx relief

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10
Q

MC type of bladder cancer

A

transitional cell carcinoma

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11
Q

bladder cancer highest risk factor

A

smoking

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12
Q

bladder cancer dx

A

cystoscopy w/ bx

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13
Q

bladder injury dx

A

ureteral contrast study w/ pelvic fx

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14
Q

bladder outlet obstruction tx

A

BPH: tamsulosin
Detrusal muscle atony: cholinergic (bethanechol)

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15
Q

chronic renal failure labs

A

proteinuria
broad waxy casts
small kidneys on US

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16
Q

MCC ESRD

A

DM

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17
Q

give before surgical procedures for chronic renal insufficiency patients

A

desmopressin

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18
Q

cystitis tx

A

uncomplicated: Macrobid, FQ, bactrim
complicated: FQ, amino glycoside, gentamicin

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19
Q

Pyridium AE

A

turns urine orange, do not use more than 48h

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20
Q

mannitol AE

A

pulmonary edema

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21
Q

acetazolamide AE

A

hyperchloremic metabolic acidosis
sulfa allergy
kidney stones

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22
Q

Loop diuretics AE

A

hypoK, hypoCa
hyperglycemia
sulfa allergy

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23
Q

thiazide AE

A

hypoNa, hypoK, hyperCa, hyperlipidemia
hyperuricemia, hyperglycemia
sulfa allergies
metabolic alkalosis

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24
Q

K sparing AE

A

hyperK
metabolic acidosis
gynecomastia

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25
Enuresis childhood nocturnal tx
DDAVP TCA (imipramine) anticholinergics
26
glomerulonephritis hallmark
azotemia
27
glomerulonephritis dx
UA: RBC casts, dysmorphic RBC, proteinuria, high SG, increased BUN Cr, hematuria renal bx: gold standard
28
goodpastures dz dx
Bx: crescent formation + anti-GBM ab (kidney and alveoli) linear IgG deposits
29
goodpastures dz tx
high dose CS + cyclophosphamide + plasmapheresis
30
HUS tx
hemodialysis
31
HUS sx
triad: thrombocytopenia, microangiopathic hemolytic anemia, kidney failure kid w/ renal failure and diarrhea prodrome
32
HUS tx
observation and IV fluids plasmapheresis
33
hydronephrosis dx
UA CBC BUN/Cr Bladder catheter Renal US --> CT
34
hyperkalemia tx
EKG changes: calcium to protect heart (calcium gluconate) bicarb/insulin/dextrose kayexalate/dialysis
35
hypocalcemia labs
increased P decreased Mg
36
hypovolemic shock sx
pale cool mottled skin decreased CO prolonged capillary refill, decreased turgor no severe respiratory depression
37
IgA nephropathy lab
+ IgA mesangial deposits on immunostaining
38
impotence tx
PDE5: sildenafil, tadalafil, vardenafil PGE1 injection vacuum pump, revascularization, prosthetics testosterone if low
39
interstitial nephritis sx
AKI w/ increased eosinophils F, maculopapular rash, arthralgia WBC casts pathognomonic urine eosinophils
40
simple kidney cyst dx
US: echoic round mass w/ smooth and sharply demarcated wall CT
41
Lactic acidosis labs
increased RR/K/anion gap decreased pH, CO2, and bicarb
42
metabolic alkalosis labs
prolonged vomiting increased bicarb/pH/CO2
43
Minimal change disease dx
MC in nephrotic syndrome in kids no visible cellular changes in simple light microscopy
44
minimal change dz tx
prednisone TOC cytotoxic therapy w/ cyclosporine if refractory
45
nephrolithiasis labs
US: hematuria, nitrites if infectious non contrast CT abd/pelvis BIT renal US if CT CI IV pyelography gold standard
46
pH of stones in nephrolithiasis (calcium oxalate, phosphate, uric acid, cystine, struvite)
pH 5.5-6.8: calcium oxalate/phosphate pH <5: uric acid, cystine pH >7.2: struvite
47
stones seen on radiograph (radiopaque)
calcium and struvite
48
nephrolithiasis tx
<7mm pass on its own shock wave lithotripsy proximal: ureteroscopy + stents distal: percutaneous nephrolithotomy (usually for >10mm stones)
49
nephrotic syndrome sx
proteinuria, hypoalbuminemia, hyperlipidemia, edema
50
MCC nephrotic syndrome in adults
DM
51
nephrotic syndrome dx
24h urine protein collection gold standard UA: proteinuria, oval fat bodies "Maltese cross shaped" hypoalbuminemia, hyperlipidemia renal bx
52
nongonococcal urethritis dx
chlamydia nucleic acid amplification: for chlamydia and gonorrhea
53
paraphimosis tx
emergency manual reduction, cool compress granulated sugar, hyaluronidase injection dorsal slit
54
Peyronie associated w/
vitamin E deficiency, BBs, increased serotonin levels Dupuytren contracture and HLA-B27
55
Peyronie tx
Vit E and potassium aminobenzoate colchicine injection surgery
56
phimosis tx
circumcision
57
PKD sx
abdominal/flank pain, palpable flank mass HTN, hematuria berry aneurisms, MVP colonic diverticula
58
PKD dx
renal US 1st line genetic testing CT/MRI more sensitive
59
PKD tx
simple cyst: observe, reevaluation. ACE for HTN multiple cyst: supportive, increase fluid intake, ACE for HTN
60
postop hypovolemia tx
IV fluids or blood products
61
premature ejaculation tx
topical desensitizing agents (lidocaine, benzocaine, prilocaine) SSRI PDE5 inhibitor (sildenafil, tadalafil) pindolol, tramadol
62
priapism tx
low flow (ischemic): phenylephrine intracavernous injection 1st line. Turbutaline PO/SQ if <4h, needle aspiration if >4h. Shunt surgery if not responsive to other tx high flow: observation
63
Prostatitis tx
Acute: >35yo FQ or bactrim outpt, IV FQ +/- aminoglycoside or ampicillin +/- gentamicin if inpt <35yo: ceftriaxone + doxycycline or azithromycin chronic: FQ, bactrim, TURP
64
pyelonephritis dx
UA: pyuria, leukocyte esterase, WBC casts (hallmark), nitrites urine culture definitive
65
pyelonephritis tx
FQ (PO/IV), amino glycoside (gent), bactrim, cephalosporin admit for IV fluids + IV abx if severe/complicated
66
pyelonephritis sx
F, tachycardia, back/flank pain + CVA tenderness, N/V
67
renal calculi tx
pain control (NSAIDS) antiemetics alpha blocker (tamsulosin) for large stones
68
renal cell carcinoma sx
triad: hematuria, flank/abd pain, palpable mass malaise, L sided varicocele, HTN, hypercalcemia
69
renal cell carcinoma dx
CT 1st line renal US MRI
70
renal cell carcinoma tx
Stage 1-3: nephrectomy, IL2 therapy. usually resistant to chemo/rad bilateral or pt w/ one kidney: partial nephrectomy
71
respiratory alkalosis labs
from hyperventilation increased pH decreased PCO2
72
Testicular torsion PE
negative preens sign absent cremasteric reflex blue dot sign
73
MCC UTI
E. coli
74
varicocele PE
bag of worms dilation decreases if supine or testicular elevation worse w/ upright or valsalva
75
varicocele tx
observation surgery
76
wilms tumor (nephroblastoma) sx
painless palpable abdominal mass, does not cross midline hematuria, HTN, anemia
77
wilms tumor (nephroblastoma) dx
abdominal US BIT CT w/ contrast or MRI more accurate

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