Buzzwords - Renal & GU Flashcards
delay from radial to femoral pulse
coarctation of aorta
small flattened villi in bx of small intestine
celiacs
sentinel loop or colon cutoff sign
inflam in the area - pancreatitis or appendicitis (depends on area)
podocyte damage on electron microscope
minimal change disease (nephrotic syndrome)
periorbital edema (esp in children) usually worse in morning, +/- scrotal edema
minimal change disease (nephrotic syndrome)…could also be glomerulonephritis/nephritic (if blood in urine)
HTN, hematuria (RBC casts), dependent edema (protienuria), azotemia
acute glomerulonephritis (nephritic syndrome)
berger’s disease
IgA nephropathy (mc cause of acute glomerulonephritis)
crescent formation (bowman’s capsule) on biopsy
rapidly progressive glomerulonephritis (rpgn) poor prognosis
goodpasture’s disease
autoimmune AB attack basement membrane of alveoli and glomerulus (= type of acute glomerulonephritis)
azotemia
increased BUN
sx: proteinuria, hypoalbuminemia, edema, hyperlipidemia
nephrotic syndrome
fatty casts, oval fat bodies “maltese cross”
nephrotic syndrome (think of pt seen w/ natalie)
cellular cast formation
intrinsic AKI
bence-jones proteins
multiple myeloma
muddy brown casts or epithelial cell casts
acute tubular necrosis
WBC casts, pyruia
acute tubulointerstitial nephritis or pyelonephritis
-also fever, eosinophilia, maculopapular rash, arthralgias, inc serum IgE for AIN
waxy casts (acellular w/ sharp edges)
narrow waxy casts: chronic ATN / glomerulonephritis
broad waxy casts: end-stage renal dz
hyaline casts
nonspecific (may be normal)
-Tamm-Horsfall proteins secreted by tubular epith cells
UA: hematuria & pyuria (no red cell casts)
UTI mc
-may be acute intertitial nephritis (AIN), glomerular dz, vasculitis
UA: pyuria alone
UTI mc
small kidneys on US
CKD
rapid correction of hypoNa concern
central pontine myelinolysis
no faster than 0.5 mEq/L per hour
polyuria (up to 20L/d), polydipsia, nocturia (clinically symptomatic w/ decreased oral free water intake)
diabetes insipidus
aldosterone
causes Na retention
peripheral and presacral edema pulmonary edema jugular venous distension hypertension (decreased hct, serum protein, and BUN:Cr)
HYPERvolemia
poor skin turgor dry mucus membranes flat neck veins hypotension (increased hct, serum protein & BUN:Cr ratio)
HYPOvolemia
chvostek sign
tap face and get spasm if hypocalcemia
trousseau sign
carpal spasm w/ BP cuff = hypocalcemia
perioral numbness
hypocalcemia
calcium elevated AND phosphate elevated
renal failure (other types hyperCa should be opposite)
hyponatremia
increased free water
- due to impaired kidney ability to excrete free water (unable to make dilute urine)
- risk of CNS dysfunction due to cerebral edema
“salt and pepper” appearance of skull and brown tumors in long bones
Osteitis fibrosa cystica (due primary hyperparathyroidism)
piriformis syndrome
compression of sciatic nerve
bone pain, kidney stones, abdominal pain, lethargy, psychosis
bones, stones, groans, psychotic moans –> HYPERcalcemia
anion gap metabolic acidosis causes
MUDPILES: methanol, uremia, DKA, paraldehyde, iron, lactic acidosis, ethylene glycol, salicylates
scrotal pain, erythema & swelling mc unilateral (no N/V)
epididymitis / orchitis
+/- fever
positive prehn’s sign
normal (pos) cremasteric reflex
relief of pain w/ elevation of affected scrotum
epididymitis / orchitis
abrupt onset of scrotal, inguinal or lower abdominal pain (usually <6 hrs) +/- N/V
testicular torsion
negative prehn’s sign
absent (neg) cremasteric reflex
no pain relief w/ elevation of scrotum
testicular torsion
“blue dot sign” at the upper pole
torsion of appendix of testis
painless testicular nodule, solid mass or enlargement (can’t seperate from testicle) +/- hydrocele
testicular cancer
painless scrotal swelling + transillumination
hydrocele
mc surgically correctable cause of male infertility
varicocle (increased temp from increased venous blood flow inhibits spermatogenesis)
“bag of worms” superior to testicle
varicocle - dilation worsens when upright or valsalva
recurring UTI in sexually active women (not e.coli)
staph saprophyticus
perineal pain (w/ F/C, urinary sx)
acute prostatitis
exquisitely tender, normal or hot, boggy prostate
acute prostatitis
nontender, boggy prostate
chronic prostatitis
uniformly enlarged, rubbery, firm prostate
BPH
hematuria, flank/abdominal pain, palpable mass
renal cell carcinoma
- malaise, WL
- L-sided varicocele
- HTN & hypercalcemia common (inc PTH)
painless, palpable, abdominal mass (doesn’t cross midline) hematuria, HTN, anemia (MC in children 1-5 yo)
wilms tumor / nephroblastoma
incontinence from sneezing, coughing, laughing
stress incontinence
small volume voids, post-void residual >200
overflow incontinence
urgency, frequency, small volume voids, NOCTURIA
urge incontinence
yellow-green discharge, strawberry cervix, vaginal pH > 5 and motile trichomonads
trichomonas
off-white, thin, and homogeneous vaginal discharge with “fishy” odor
bacterial vaginosis - change in the vaginal flora brought about by the reduction in concentration of lactobacilli
-Gardnerella vaginalis, Ureaplasma sp., and Mycoplasma sp
balanitis
inflammation of glans penis
- balanoposthitis inflammation of foreskin (uncircumcised)
- MC cause is candida
radio translucent stones (don’t show up on xray)
uric acid stones (show up on US or CT scan)
painful genital ulcers and inguinal bubo (unilateral painful node)
Haemophilus ducreyi
painless chancre
syphilis
painless genital ulcers, highly vascular, beefy red appearance and bleeding on contact
Klebsiella granulomatis
Priapism after cervical spine injury (fracture where?)
C5 fracture
bell clapper deformity
testicular torsion, the testis on the affected side sits higher with the long axis of the testis orienting horizontally instead of vertically due to shortening of the spermatic cord
elongated face, prominent jaw, large ears, macro-orchidism, and a range of behavioral anomalies and cognitive deficits
fragile x syndrome
additional X chromosome in males (47, XXY)
small testes with hypogonadotropic hypogonadism and gynecomastia, infertile.
Klinefelter syndrome
elevated CA19-9
pancreatic cancer, gallbladder cancer, bile duct cancer, and gastric cancer.
elevated CA-125
maybe ovarian cancer
elevated carcinoembryonic antigen
colorectal cancer and breast cancer
painful, shallow, tender, genital lesions
+ low fever, myalgias (2-7 day incubation)
genital herpes
-lesions last 2-4 weeks
asymmetric areas or induration or nodules of prostate
prostate cancer
