Test Two Flashcards
(193 cards)
1
Q
What are the three defining criteria of Acute Kidney Injury?
A
> creatinine 0.3 mg/dL
> 50% increase in creatinine
drop of urine output of 500 mL over 24 hours
2
Q
A serum creatinine of 3 corresponds to a GFR of what value?
A
25 mL/day
3
Q
A serum creatinine of 2 corresponds to a GFR of what value?
A
50 mL/day
4
Q
What is more accurate, BUN or creatinine?
A
creatinine
5
Q
What is the FENa of pre-renal azotemia?
A
less than one
6
Q
What can prolonged pre-renal azotemia lead to?
A
ATN
7
Q
What is the FENa of ATN?
A
> 2%
8
Q
What is the most common cause of AKI?
A
ATN
9
Q
What zone of the prostate does BPH come from?
A
transitional zone
10
Q
Which zone of the prostate does cancer come from?
A
peripheral
11
Q
What two nutrients for sperm cells are secreted by the prostate?
A
fructose and citrate
12
Q
What is the function of PSA?
A
liquify semen
13
Q
Can hematuria be a sign of BPH?
A
yes
14
Q
Which alpa1- receptor is located in the vasculature?
A
A1B
15
Q
How long does it take for 5α Reductase Inhibitors to work?
A
3 months
16
Q
What is the gold standard surgical procedure for treating BPH?
A
TURP
17
Q
Are there symptoms with early prostate cancer?
A
no
18
Q
Will antibiotics increase or decrease PSA levels?
A
decrease
19
Q
PSA density greater than what gets a biopsy?
A
> 0.15
20
Q
Does Smith say that patients with prostate cancer have a higher or lower percentage of complexed PSA?
A
higher
21
Q
Greater than what percent of suspicious prostate exams are cancerous?
A
50%
22
Q
Is imaging recommended for detection of prostate cancer?
A
no
23
Q
What are the two indications for prostate biopsy?
A
abnormal DRE
abnormal PSA
24
Q
What type of cancer are the majority of prostatic cancers?
A
adenocarcinoma
25
Which two treatment modalities for prostate cancer have the same outcomes at ten years?
prostatectomy
external beam radiation
26
When is hormone therapy used for prostate cancer?
metastatic palliation
27
What is the treatment for metastatic prostate cancer?
androgen deprivation
28
External spermatic fascia arises from what abdominal muscle?
external oblique
29
Cremasteric muscle arises from what abdominal muscle?
internal oblique
30
Internal spermatic fascia arises from what abdominal muscle?
transversalis fascia
31
Does high or low fixation of tunica vaginalis to testes predispose to torsion?
high
32
What is the most sensitive sign for testicular torsion?
absent cremasteric reflex
33
What reduces pain during epididymitis?
elevation of testicle
34
Within what structure does fluid collect during hydrocele?
tunica vaginalis
35
How is an adult hydrocele treated?
drainage
36
What structure does a spermatocele arise from?
epididymitis
37
What structure breaks during a testicular rupture?
tunica albuginea
38
What are the three markers for testicular cancer? Obtained when?
AFP/B-HCG/LDH
39
Does PDE5 inhibitors function in the absence of sexual stimulation?
no
40
What is the diastolic pressure greater than during a HTN emergency?
120
41
What does a hypertensive urgency not have?
end organ damage
42
Arteriolar narrowing would correspond to what degree of HTN retinopathy?
grade one
43
What grade does AV nicking begin?
grade two
44
Below what index of ABI is concerning for vascular disease?
0.90
45
What is the gold standard for ascertaining Renovascular Hypertension?
renal arteriography
46
How much does Carney say brachial pulses need to differ by to Dx Coarc?
> 20 mm Hg
47
Does hypothyroidism result in an increase in diastolic or systolic pressure?
diastolic
48
Does hyperthyroidism result in an increase in diastolic or systolic pressure?
systolic
49
What type of treatment do all patients with HTN receive?
lifestyle modifications
50
What is normal pCO2 value?
40 mm Hg
51
For every gram of albumin below four, what must be done to the anion gap?
increase by 2.5
52
According to Carney, if a patient has a creatinine clearance above 30, which diuretic do they get for HTN?
thiazide
53
According to Carney, if a patient has a creatinine clearance below 30, which diuretic do they get for HTN?
loop
54
What type of anti-HTN does not work well in blacks?
ACE-I
55
Which ARB can exacerbate gout?
losartan
56
What is a severe side-effect of sudden clonidine withdrawl?
severe refractory hypertension
57
Two drugs for black person with HTN that doesnt have kidney disease?
CCB or thiazide
58
Two drugs for non-black person with HTN that doesnt have kidney disease?
ACE/ARB
CCB
thiazide
59
Drug for HTN for all races with kidney disease?
ACE/ARB
60
At what blood pressure should two anti-HTN drugs be started?
160/100
61
Carney says to avoid what type of drug in older patients if blood pressure can be controlled with other drugs?
β-blocker
62
Carney says to decrease the blood pressure by what percentage during a hypertensive emergency?
25%
63
According to Carney, which anti-hypertensive 'can increase cardiac work'?
hydralazine
64
Does blood pressure increase or decrease during acute cerebral ischemia?
increase
65
What does the blood pressure have to be below to begin lytic therapy?
less than 185/110
66
During an ischemic stroke, bp should be treated at what value?
> 220/120
67
All patients with diabetes need to have a bp below what?
140/90
68
All patients above 60 w/o renal disease need to have a bp below what?
150/90
69
All patients below 60 w/o renal disease need to have a bp below what?
140/90
70
Bacteria other than E. coli can do what to the kidney?
scarring
71
Are white or black kids more likely to get a UTI?
white
72
According to Clor, can one properly culture urine from a bag?
no
73
Do term or preterm kids have a higher risk of UTI?
preterm
74
What is the best method for culturing urine in a neonate?
suprapubic asppiration
75
Which two bacteria are the most common in preterm neonatal UTI?
klebsiella
coagulase negative staph
76
Are preterm neonatal UTIs more common ascending or hematogenous?
hematogenous
77
Which bacteria is the most common in term neonatal UTI?
E. coli
78
Are term neonatal UTIs more common ascending or hematogenous?
ascending
79
Who gets kidney stones more often, men or womens?
men
80
What three drugs are known to cause kidney stones?
prednisone
topiramate
acetozolamide
81
What ion is lost during removal of an ileum? What does this do to the urine?
bicarb
acidify
82
Which diuretic could cause a kidney stone?
triamterene
83
What are the three drugs for testicular cancer?
Bleomycin
Etoposide
Cisplastin
84
What two ways does Clor say to do in order to get a urine sample from a non-toilet trained kid with a suspected UTI?
cath or aspiration
85
At what age does Clor say hospitalize for a UTI?
less than two months
86
Clor says to get LP for a neonate with a UTI if what?
ill appearing
87
What two drugs does Clor say to use for a suspected hospitalized UTI?
ampicillin and gentamicin
88
Does Clor say VUR is more common in girls or boys?
girls
89
Does Clor say VUR is more common in those younger or older than two?
younger
90
Why does fat malabsorption cause an increase in kidney stone formation?
fat binds calcium and leaves oxalate free
91
What is the definition of oliguria?
less than 500 per day
92
What is the definition of anuria?
less than 50 per day
93
Are kidney stones recurrent?
yes
94
What is more common, calcium oxalate or calcium phosphate?
oxalate
95
What is the most common cause of hyper-calciuria?
idiopathic
96
If there is more sodium in the urine, there is more what kind of ion in the urine?
calcium
97
Which protease inhibitor can cause stones?
indinavir
98
Which two kidney stones are radiolucent?
cystine and urate
99
Is VUR more common in whites or blacks?
white
100
Under what age is VUR more common?
less than two
101
Will AKI have signs of uremia?
no
102
What does Tadalafil do to the prostate?
relax prostate smooth muscle
103
Which age group has the highest indications for PSA screening?
55-69
104
Do younger guys get prostatectomies or radiation?
radiation
105
Is Extra or Intra-testicular almost always cancer?
intra
106
How long is infant hydrocele surgery delayed?
1-2 years
107
What is the most common cause of infertility in men?
varicocele
108
What is the marker for advanced seminoma?
LDH
109
Does an orchicetomy get a low or high ligation of spermatic cord?
high
110
Can anti-hypertensives exacerbate ED?
yes
111
What grade of HTN Retinopathy does optic disc swelling occur?
grade four
112
According to Carney, does nocturia more often occur in males or females with OSA?
females
113
According to Carney, what is the first step in treating someones BP if it is under 160/100?
life style changes
114
According to Carney, are aplha blockers used as monotherapy?
no
115
Dementia and cognitive impairment occur more commonly in patients with what CV disease?
HTN
116
What percentile does the BP have to be to Dx HTN in adolescents?
above 95th percentile
117
Where do casts in the urine come from?
glomerulus
118
Where do dysmorphic blood cells in the urine come from?
glomerulus
119
What correlates with glomerular damage during glomerulonephritis?
protein in urine
120
What does Pauci-immune mean?
lack of IF deposition
121
Why can nephrotic syndrome produce iron deficient anemia?
loss of transferrin
122
FSGS can be confused with what other disease if a large enough biopsy sample isnt taken?
MCD
123
Patients over the age of 50 with nephrotic syndrome should be evaluated for what?
malignancy
124
What three malignancies may result in MCD/FSGS?
hodgkins
leukemia/lymphoma
solid tumors
125
Why does HTN produce mesangial matrix growth?
intraglomerular pressure is a growth stimulus
126
Regarding the glomerulus, what is proteinuria a marker for?
intraglomerular pressure
127
How long do symptoms need to be around to diagnose CKD?
three months or longer
128
Decreased kidney function has a GFR below what value?
60
129
What ratio of Americans has CKD?
1/10
130
ESRD qualifies you for what?
medicare
131
Over what age does CKD prevalence increase?
65
132
Who has a higher liklihood for ESRD, blacks or whites?
blacks
133
What gene is implicated in ESRD? Inheritance pattern?
Apoprotein L1
autosomal recessive
134
Which molecule is the gold standard for GFR?
inulin
135
What is the definition for Glomerular Hyperfiltration?
compensatory increases of GFR in remaining nephrons
136
What cell is demaged in a hyperfiltration injury?
endothelial
137
What molecule can exacerbate CKD?
protein
138
What two parameters are measured annually in patients with CKD?
albumin and GFR
139
What organ system is the number one caused of death in patients with kidney disease?
cardiovascular
140
What is calciphylaxis?
extraosseus calcification of arterioles
141
What does Mutneja say the bp should be for all diabetics with less than 30 mg/24 hours?
140/90
142
What does Mutneja say the bp should be for all diabetics with more than 30 mg/24 hours?
130/80
143
What is the target A1C in CKD?
144
When should anemia be addressed in a CKD patient with a GFR greater than 60?
as needed
145
When should anemia be addressed in a CKD patient with a GFR of between 30-59?
annually
146
When should anemia be addressed in a CKD patient with a GFR less than 30?
twice per year
147
What should the goal HCT be in a CKD patient with anemia?
10-11
148
Does hyperphosphatemia occur early or late in CKD?
early
149
What kind of toxin is PTH as it relates to CKD?
uremic toxin
150
What should the calcium phosphate product be kept under in CKD?
55
151
Patients with a GFR of under what value should be monitored if exposed to radiocontrast dye?
GFR
152
What can gadolinium dye do to patients with CKD?
nephrogenic systemic fibrosis
153
Is the ECF increased or decreased in its osmolarity during SIADH?
decreased
154
Is SIADH clinically hypovolumic, hypervolumeic or euvolumic?
euvolumic
155
What condition can cause Cerebral Salt Wasting?
subarachnoid hemorrhage
156
What is UNa above for hypervolemia?
20
157
What structure do cysts develop from in the kidney?
tubules
158
Does ARPKD have variable or complete penetrance?
variable
159
What chromosome is Polycystin 1 located on?
16
160
What chromosome is Polycystin 2 located on?
4
161
According to Belz, what structure in the brain is pathogonomic for Tuberous Sclerosis?
cortical brain tubers
162
What are three manifestations of Medullary Cystic Disease?
sodium wasting
Anemia
Renal Insufficiency
163
Which cystic kidney disease cant make acidic urine?
medullary sponge kidney
164
What is the Gold Standard for diagnosing Acute Interstitial Nephritis?
biopsy
165
What are the three most common cause of Acute Interstitial Nephritis?
analgesics
NSAIDs
antibiotics
166
What is the most common kind of blindness in develop countries?
diabetic retinopathy
167
What is the most common cause of HTN in preadolescent patients?
renal disease
168
Which has a high false positive rate, serum or urine metanephrines?
serum
169
Would a nephrotic syndrome present with a high or low thyroid hormone levels?
low
170
Can dialysis produce hypertension or hypotension?
hypo
171
What are the two most common causes of death in pt's on dialysis?
cardiovascular and infection
172
Orthostatic hypotension is a clinical indicator of a deficiency in what electrolyte?
sodium
173
What is less expensive, transplant or dialysis?
dialysis
174
Which immune response mediates hyperacute rejection? What type of necrosis?
preformed ABs against HLA
fibrinoid
175
What is the most common viral infection post-renal transplant?
CMV
176
What drug is used to treat CMV in renal transplant patients?
valgangciclovir
177
What drug can be used to treat BK Virus?
leflunomide
178
Which class of drug is used to treat renal transplant HTN?
calcium channel blockers
179
In terms of potassium, what drug can act like amiloride?
TMP
180
What organ system most commonly kills people post renal transplant?
cardio
181
Which four immunosuppressives are safe during pragnancy?
tacrolimus
cyclosporine
azathioprine
prednisone
182
Which antibiotic is used as prophylaxis in renal transplant patients?
bactrim
183
What is AEIOU for dialysis?
acidosis
electrolytes
ingested substances
overload (fluid)
uremia
184
What if GFR for Stage 3 CKD?
30-59
185
What if GFR for Stage 4 CKD?
15-29
186
What if GFR for Stage 5 CKD?
below 15
187
What proinflamatory cytokine does Mutneja say can exacerbate CKD?
MCP-1
188
Patients with a GFR below what during CKD are at increased risk of expansion of what compartment? What type of diuretic in these pts?
ECF
loop
189
What three drugs are the most common immunosuppressants after kidney transplant?
tacrolimus
mycophenolate
prednisone
190
What two things does dialysis do?
remove substances
remove fluids
191
According to student, is nephrotic more common in males or females?
males
192
According to student, is nephrotic syndrome more common in whites or minorties?
whites
193
According to the student, what is the stain for membranous nephropathy?
methenamine
