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Flashcards in Urologic disorders Deck (37)
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1

Acute polynephritis

subpubic, R/LLQ tenderness, burning w/ urination, CVA tenderness, concentrated urine, TNTC bacteria, WBC casts, left shift, pyuria, hematuria, possible blood culture positive

2

Acute polynephritis treatment

first line: cipro 500 mg BID 7-10 days, could also use bactrim, macrolid+pyridium, do sensitivity test

3

Complicating factors of acute polynephritis

pregnancy, age, high WBC, positivie culture, hydronephrosis

4

Cystitis

bladder infection, common in women, dysuria, abd pain, nausea, irrative voiding, bacturia might not show up if entercoccus

5

Treatment of cystitis

bactrim, Cipro, macrobid, pyridium

6

Acute prostatitis

fever, irrative voiding, perineal/ subpubic pain, severe tenderness on rectal exam, leucocytosis, pyuria, bacteriuria, hematuria, ecoli and pseudomonas most common, could also be STD

7

Acute prostatitis treatment

if high fever/ in severe pain, admit to hospital and give ampicillin and gentamycin until organism identified, if afebril, Levaquin 500 mg daily 4 wks, doxycycline may also be used, do not cath, suprapubic tube required to drain

8

Orchitis

25% due to mumps, fever tachycardia, testicular swelling and tenderness is unilateral, pyuria, bacteriuria, pos cultures

9

Treatment of Orchitis

if mumps- ice and analgesic, if bacteria- Cipro 500 mg BIDx12 days

10

Epididymitis

retrograde infection through vas deferens, heaviness/dull/ache in scrotum, pain in scrotum, inguinal area and into flank on affected side, epididymis markedly swollen and tender to palpation, scrotal mass, phrehn's sign

11

Treatment of epididymitis

Ceftriaxone 250 mg IM, plus doxycyclin 100 mg bidx10 days, cipro 500 mg bidx14 days, ejaculation

12

UTI preventative measures

urinate after sex, drink plenty of water, urinate often, dec caffiene, protected sex, wipe front to back

13

Glomerulonephritis

damage to glomeruli by protein being deposited into glomerular membranes, 60% are 2-12yo, can be focal involves

14

Focal causes

benign hematuria, henoch-schonlein, purpura, mild postinfections GN, Adults: IgA nephropathy, hereditary nephritis, IgA nephropathy, hereditary nephritis, SLE

15

Diffuse causes

postinfections GN, membranoproliferative GN; Adults: SLE membranoproliferative GN, rapidly progressive GN, postinfectious GN, vasculitis

16

GN symptoms

blood in urine or tea colored urine, dec or no urine output, swelling of face and eyes in morning and of feet and ankles in pm, HTN common, dec complement, abnormal RBCs

17

GN treatment

steroids and immunosuppressive therapy, abx if due to PSGN, dietary management (dec Na and fluid), dialysis, ACEI, treat other medical conditions

18

Nephrotic syndrome

excretion of 3.5g of protein per 1.73m in 24hr, manifests- hypoalbuminemia, lipiduria, hypercholesterolemia, edema, predisposing factors- thrombosis

19

Causes of nephrotic syndrome

primary renal disease, secondary disease-drugs

20

Nephrotic syndrome

malaise, bloating, anorexia, facial edema/puffy eyelids, dec urination, scrotal swelling, dyspnea, wt gain, ascites, edema, HTN, orthostatic hypoTN, retinal sheen, skin striae, foamy urine, proteinuria, hyperlipidemia

21

Nephrotic syndrome treatment

dependent on cause and complications, usually use ACEI and diuretics, otherwise treatment of cause

22

Acute tubular necrosis

AKI due to tubular damage, approx 85% of intrinsic AKI, caused by ischemia or nephrotoxin, P and K elevated, UA- brown, granular casts

23

Nephrotoxins

Exogenous: aminoglycosides, amphotericin B, Vanco, IV acyclovir, cephalosporins, contrast; Endogenous: heme containing products, uric acid, paraproteins, myoglobinuria, bence jones protein

24

Renal cell carcinoma

most common type of renal malignancy, more common in men, >55, black, unknown cause, linked to smoking, gross or microscopic hematuria, pain or abd mass, normocytic anemia, ESR inc

25

What is diagnostic modality of choice for RCC

CT scan

26

Treatment of RCC

radical nephrectomy based on furman grading, radiation therapy for palliation in pts w/ metastatic lesions

27

Bladder CA

irritative voiding, painless hematuria, do cytoscopy, treatment- transurethral resection

28

Nephrolithiasis

more common in males, calcium stone most common, unilateral back pain, renal colic that waxes and wanes, hematuria, dysuria, urinary frequency, fever, chills, nausea, vomiting; spiral CT w/out contrast

29

Treatment of nephrolithiasis

stones10 impatient, ureteral stent or percutaneous nephrostomy

30

5 classifications of incontinence

Urge, stress, overflow, functional, an dmixed