Urology/Renal

Question 1

Inflammation of the foreskin and head of the penis

pain, redness, and a foul-smelling discharge from under the foreskin

Answer 1

Balanitis

Question 2

Balanitis Tx

Answer 2

topical antifungals BID x 1-3 weeks (clotramazole 1%, miconazole 2%)

Question 3

Drugs to avoid in BPH…

Answer 3

anticholinergics and antihistamines

Question 4

BPH Tx to decrease prostate size…

Answer 4

finasteride (5 alpha reductase inhibitors)

Question 5

discharge from the penis or vagina, painful or more frequent urination, cervicitis, PID, lymphogranuloma venereum, or infertility

Answer 5

Chlamydia

Question 6

Chlamydia Dx?

Answer 6

NAAT

Question 7

Tx of chlamydia?

Answer 7

azithromycin 1 g PO + ceftriaxone 250 mg IM x 1

or

doxycycline BID x 7 days + IM ceftriaxone

Question 8

UTI Tx in pregnancy

Answer 8

macrobid 100 mg PO BID x 7 days

OR

Keflex 500 mg BID x 7 days

Question 9

dysuria, unilateral dull aching scrotal pain that can radiate up the ipsilateral flank

(+) Prehn’s sign

Answer 9

epididymitis

Question 10

Dx of epididymitis…

Answer 10

UA

Question 11

Tx of epididymitis over 35…

Answer 11

supportive care + levaquin 500mg QD x 10 days

Question 12

Tx of epididymitis UNDER 35…

Answer 12

doxycycline 100 mg PO BID x 10 d

PLUS

ceftriaxone 250mg IM x 1 dose

Question 13

edema + HTN + hematuria + RBC Casts/dysmorphic RBCs + proteinuria 1-3.5 g/day + azotemia

Answer 13

Nephritic Syndrome

Question 14

Severe proteinuria > 3.5 g/day

Massive edema

Fatty casts with “maltese cross” sign

Hypoalbuminemia, hyperlipidemia, and lipiduria

Oval fat bodies

Answer 14

Nephrotic Syndrome

Question 15

MC cause of acute glomerulonephritis…

Answer 15

IgA Nephropathy

Question 16

What type of nephritic glomerulonephritis?

Young males

Hx of URI/GI Infx 24-48 hours ago

Answer 16

IgA nephropathy

Question 17

What type of nephritic glomerulonephritis?

10-14 days after infection - diagnosed with ASO titers and low serum complement - treatment is supportive + antibiotics

Answer 17

Post-strep

Question 18

What type of nephritic glomerulonephritis?

due to SLE, viral hepatitis

Answer 18

membranoproliferative

Question 19

What type of nephritic glomerulonephritis?

(+) anti-GBM antibodies, dx linear IgG deposits

Answer 19

goodpasture’s syndrome

Question 20

Tx for goodpastures syndrome

Answer 20

high dose steroids

plasmapheresis

cyclophosphamide

Question 21

What type of nephritic glomerulonephritis?

lack of immune deposits (+) ANCA antibodies

Answer 21

vasculitis

Question 22

(+) C ANCA

Answer 22

Granulomatosis with polyangiitis / Wegener’s

Question 23

(+) P ANCA + nephritic sxs

Answer 23

microscopic polyangitis

Question 24

urinary excretion of > 3 g of protein in a 24-hour urine sample due to a glomerular disorder plus edema and hypoalbuminemia…

Answer 24

Nephrotic syndrome

Question 25

MC nephrotic syndrome in non-diabetic adults, a/w malignancy...

Answer 25

Membranous nephropathy (immune complex formation in glomerulus)

Question 26

What cause of nephrotic syndrome? most common cause in kids. child with sudden onset idiopathic nephrotic syndrome 2 weeks after illness, improves after treatment with corticosteroids.

Answer 26

minimal change disease

Question 27

What cause of nephrotic syndrome? obese patients, heroin, and HIV+ black males.

Answer 27

focal segmental glomerulosclerosis

Question 28

Most common secondary causes of glomerulonephritis? (3)

Answer 28

Lupus DM (nephrotic) Pre-eclampsia

Question 29

Dysuria, urinary frequency, and purulent yellow-green discharge post-coital bleeding at cervical os

Answer 29

Gonorrhea

Question 30

Dx of gonorrhea

Answer 30

NAAT of first voided urine

Question 31

Gram negative diplococci on urine Cx

Answer 31

gonorrhea

Question 32

Tx of gonorrhea...

Answer 32

250 mg IM Ceftriaxone + 1g oral azithromycin

Question 33

Passage of intestine through the external inguinal ring at Hesselbach triangle, rarely enters the scrotum

Answer 33

direct inguinal hernia

Question 34

Passage of intestine through the internal inguinal ring down the inguinal canal, may pass into the scrotum

Answer 34

indirect inquinal hernia (MC)

Question 35

Gold standard for nephrolithiasis...

Answer 35

Non-contrast CT

Question 36

Stones < ___mmm have an 80% chanace of spontaneous passage...

Answer 36

5mm

Question 37

Tx for kidney stones 5-10mm

Answer 37

elective lithotripsy

Question 38

Tx for kidney stones > 10mm

Answer 38

nephrostomy (gold standard) or ureteral stent

Question 39

Unilateral swollen testicle/tenderness with erythema and shininess of the overlying skin, fever/tachycardia

Answer 39

Orchitis

Question 40

What is orchitis usually seen in presentation with?

Answer 40

epididymitis

Question 41

If no epididymitis, but orchitis, what is often the etiology?

Answer 41

mumps

Question 42

Sudden onset of fever, chills, and low back pain combined with urinary frequency, urgency, and dysuria Tender prostate on DRE

Answer 42

Prostatitis

Question 43

If prostatitis is suspected, what can happen if prostate is massaged?

Answer 43

sepsis

Question 44

Tx of prostatitis in men < 35 yo

Answer 44

GC tx

Question 45

Tx of prostatitis in men > 35 yo

Answer 45

FLQ or Bactrim x 6 weeks

Question 46

Outpatient Tx of Pyelonephritis

Answer 46

cipro/levaquin or bactrim x 1-2 weeks

Question 47

Inpatient tx of pyelonephritis

Answer 47

IV FLQ, 3/4th gen ceph, extended spectrum PCN

Question 48

firm, painless, non-tender testicular mass and a feeling of heaviness in the scrotum

Answer 48

testicular CA

Question 49

MC type of testicular CA?

Answer 49

Seminoma

Question 50

Tumor markers for testicular CA?

Answer 50

AFP, b HCG

Question 51

painful, burning, or frequent urination or a discharge from the urethra Positive leukocyte esterase on urine dipstick or having ≥ 10 WBC/HP

Answer 51

Urethritis (G/C)