amboss 7/1 renal Flashcards
what type of cast is found in nephrotic syndrome
fatty casts
pregnant women with pyelonephritis should be what
admitted and given IV cefotaxime
what is the treatment of choice for complicated pyelonephritis
IV ciprofloxacin 10-14 days`
what is the likely culprit organism for a UTI with an indwelling catheter and + LE. patient has a history of stones
proteus mirabilis
what else will you find with a proteus infection
alkalized urine pH >7
what is the most common cause of UTI
ascending infection
what is a contraindication for foley
suspected urethral injury
what is the preferred method for evaluating urethral injury
retrograde urethrogram
what is a characteristic finding of uric acid crystals
low urine pH (which is characteristic of calcium oxalate, cystine as well), radiolucent stones on Xray (cannot be seen),
what are bipyramidal crystals
calcium oxalate
what are hexagon shaped crystals in the urine
cystinuria
what stones form in alkaline pH
calcium phosphate and struvite stones
which stones are found on x ray
calcium phosphate and struvite stones
what is the treatment of choice for unilateral fibromuscular dysplasia
ramipril and percutaneous angioplasty without stent
what is the treatment of choice for a real stone larger than 10mm
lithotripsy
what is a relative contraindication to lithotripsy
obesity
what is the alternative to lithotripsy
ureterenoscopy
what is the proper treatment for a large stone obstructing the ureter causing hydroneophrosis with concomitant infection (UTI/pyelo)
nephrostomy tube to decompress the ureter
what is the cause of analgesic nephropathy
Prostacyclins enhance renal blood flow by dilating renal capillaries, most prominently in the medulla of the kidney. By inhibiting prostacyclin production, nonsteroidal anti-inflammatory drugs (NSAIDs) decrease renal blood flow. After prolonged exposure to analgesics, especially analgesics used in combination, as is the case here, patients develop renal papillary necrosis and subsequent analgesic nephropathy (chronic kidney disease).
what is the presentation of analgesic nephropahty
features of kidney dysfunction: fatigue, anemia, uremia, and elevated creatinine. He also has sterile pyuria (WBCs in the urine with negative cultures) and ultrasonography shows changes associated with chronic kidney disease. Along with these findings, his long-term use of naproxen and the aspirin-caffeine combination
what are the characterstics to watch out for in renal cell carcinoma vs bladder cancer
signs of increased renin production –facial plethora, hypertension, blurry vision, signs of polycythemia
Patients with hematuria should generally be evaluated for
urinary tract infections (urinalysis, urine culture), kidney function (creatinine, BUN), and glomerular disease (urine microscopy). Furthermore, patients > 35 years or with risk factors for urothelial malignancy regardless of age should undergo cystoscopy to evaluate the lower urinary tract and CT urography to evaluate the upper urinary tract.
where does blood that presents initially in the stream of urine and then becomes normal before the stream ends typically originate from
the urethra
where does blood that presents throughout the stream or terminal blood come from in the urinary system
the bladder or above