Urology/Renal

Question 1

Hesitation, dribbling, straining, nocturnal urination, incomplete emptying

Answer 1

BPH

Question 2

Ascending infxn - gram neg rods
UA: pyuria
Swollen, tender prostate

Answer 2

Bacterial prostatitis

Question 3

Bacterial prostatitis tx

Answer 3

Abx (culture 1 wk after abx)

Question 4

Why avoid vigorous prostate exam for bacterial prostatitis?

Answer 4

Can cause sepsis

Question 5

Causes of resp acidosis? (acute vs. chronic)

Answer 5

Chronic: COPD
Acute: narcotics, benzos, alcohol, barbiturates

Question 6

Causes of resp alkalosis?

Answer 6

Anxiety, PE, salicylates, cirrhosis/ascites

Question 7

Metabolic compensation is (fast/slow)

Respiratory compensation is (fast/slow)

Answer 7

Metabolic compensation: slow

Respiratory compensation: fast

Question 8

Causes of WAGMA

Answer 8

MUDPILES

Question 9

Causes of WAGMA:
\+ Blindness?
\+ Kidney problems?
\+ Calcium oxalate crystals?
\+ Hearing prob/tinnitus?

Answer 9

Methanol: blindness
Uremia: kidney problems
Ethylene glycol: calcium oxalate crystals
Salicylate OD in elderly: hearing prob/tinnitus

Question 10

How to calculate anion gap

Answer 10

AG = Na - (bicarb + Cl)

Question 11

Causes of NAGMA

Answer 11

Diarrhea

Renal tubular acidosis

Question 12

Peaked T waves, long PR

Answer 12

Hyperkalemia

Question 13

Hyperkalemia tx

Answer 13

C BIG K Drop A (lot)

• Calcium
• Bicarb
• Isulin
• Glucose
• Kayexalate
• Diuretics
• Albuterol

Question 14

Causes of ARF (pre, renal, post)

Answer 14

Pre: NSAID, hypoTN, ACEI/ARB
Renal: GN, ATN
Post: obstructive

Question 15

Stages of CKD (GFR)

Answer 15

1: GFR >90
2: 60-90
3: 30-60
4: 15-30
5: <15

Question 16

CKD stages 1-4 tx

Answer 16

ACEI, diuretic, BP control, glycemic control

Question 17

Indications for dialysis

Answer 17

AEIOU

• Acidosis
• Electrolytes
• Intoxication
• Overload
• Uremia

Question 18

Hematuria, RBC casts, azotemia, cola urine, HTN, some proteinuria

Answer 18

Nephritic syndrome

Question 19

Nephritic syndrome tx

Answer 19

Fluid restriction

May need diuretics, dialysis, steroids

Question 20

Hematuria following URI

Answer 20

IgA nephropathy

Question 21

Lungs and kidneys (nephritic syndrome)

Answer 21

Goodpasture’s

Question 22

Proteinuria (>3.5 g), HLD, edema, HTN, azotemia

Answer 22

Nephrotic syndrome

Question 23

Nephrotic syndrome tx

Answer 23

ACEI, diuretics, fluid restriction, statin, steroids

Question 24

Nephrotic syndrome

Enlarged glomeruli, thickened capillaries

Answer 24

Membranous nephropathy

Question 25

Nephrotic syndrome Sclerosis in some glomeruli, others appear normal HIV, heroin

Answer 25

Focal segmental glomerulosclerosis

Question 26

Nephrotic syndrome Normal biopsy appearance Kids

Answer 26

Minimal change dz

Question 27

Patchy, irregular interstitial infiltration with inflam cells

Answer 27

ATN

Question 28

Irritative sx: freq, urgency, dysuria

Answer 28

UTI

Question 29

UTI 1st line tx

Answer 29

Bactrim

Question 30

Signs of UTI on UA

Answer 30

+ nitrites + leukocytes + bacteria

Question 31

Unilateral colicky flank pain

Answer 31

Nephrolithiasis

Question 32

Kidney stone tx | What size is likely to pass spontaneously?

Answer 32

<5 mm: likely to pass | >5 mm: less likely - lithotripsy, ureteroscopy, nephrostomy

Question 33

Triple struvite (Mg, ammonium, phosphate) Proteus Increased urine pH (ammonia)

Answer 33

Staghorn calculi

Question 34

Palpable nodular kidney | Causes kidney failure

Answer 34

Polycystic kidney dz

Question 35

Causes of unilateral vs. bilateral hydronephrosis

Answer 35

Bilateral: BPH Unilateral: ureter obstruction

Question 36

ED tx

Answer 36

PDE-5 inhibitor (sildenafil, tadalafil)

Question 37

Swollen testicle | Transilluminates

Answer 37

Hydrocele

Question 38

Bag of worms | Does not transilluminate

Answer 38

Varicocele

Question 39

Which side is varicocele more likely? Why?

Answer 39

Usually on left, testicular joins renal vein at right angle

Question 40

Absent cremaster reflex | Blue dot sign

Answer 40

Testicular torsion

Question 41

Positive Prehn sign

Answer 41

Epididymitis

Question 42

Epididymitis causes in young vs. old

Answer 42

Young: chlamydia, gonorrhea Older: e. coli

Question 43

Painless hematuria

Answer 43

Bladder cancer

Question 44

Triad: hematuria + flank pain + palpable mass (only seen in 10%)

Answer 44

Renal cell carcinoma

Question 45

Uncontrolled HTN + pulm edema + worsening renal fxn

Answer 45

Renal artery stenosis

Question 46

Resting tachy + orthostatic hypoTN

Answer 46

Hypovolemia (dehydration)