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Clinical Med II > Exam 3 - Renal Diagnostics > Flashcards

Exam 3 - Renal Diagnostics Flashcards

1
Q

What is serum creatinine used for in clinical practice?

A
  • Used to measure renal function and approximate the GFR

- Helpful to know when choosing or dosing medications

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2
Q

When is BUN typically elevated?

A

Dehydration, GI bleed, or use with certain meds such as steroids or tetracyclines

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3
Q

What is GFR used for in clinical practice?

A
  • Gives rough measure of the number of functioning nephrons

- Used to track progression/regression of disease and to dose medications

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4
Q

What defines chronic kidney disease?

A

Presence of kidney damage or decreased kidney function for 3 or more months

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5
Q

If you suspect SLE, what lab study should you order?

A

ANA

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6
Q

If you suspect GPA, what lab study should you order?

A

C-ANCA and P-ANCA

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7
Q

If you suspect Goodpasture Syndrome, what lab study should you order?

A

Anti-GBM

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8
Q

If you suspect forms of glomerulonephritis, what lab study should you order?

A

Hep B, Hep C, HIV, VDRL, complement

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9
Q

If you suspect post-streptococcal glomerulonephritis, what lab study should you order?

A

Antistreptolysin O

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10
Q

If you suspect Multiple Myeloma, what lab study should you order?

A

Serum and urine protein electrophoresis (SPEP, UPEP)

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11
Q

What can be used as a screening method for early detection of prostate cancer and to monitor the disease after treatment?

A

Prostate-Specific Anitgen (PSA)

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12
Q

PSA levels are detected in every male but are elevated in what conditions?

A
  • Prostate cancer
  • BPH
  • Prostatitis
  • Following prostate manipulation (U/S, biopsy, sexual activity, prostate exam)
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13
Q

When should we start to screen with PSA?

A
  • Recommended to start the conversation around 50 years old
  • For high risk men (African Americans, family hx of prostate cancer), begin conversation around 40-45
  • No benefit in screening men > 70
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14
Q

If RBC casts are found in UA, what should you be concerned for?

A

Glomerulonephritis

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15
Q

If WBC casts are found in UA, what should you be concerned for?

A

Pyelonephritis

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16
Q

If hyaline casts are found in UA, what should you be concerned for?

A

Dehydration

17
Q

What is the earliest clinically detectable sign in the urine of diabetic nephropathy or other early kidney damage?

A

Microalbumin

18
Q

What is urine eosinophils most commonly associated with?

A

Acute interstitial nephritis (associated with allergic rxn)

19
Q

What is a 24-hour urine collection used for?

A

Provides a better quantitative measurement for proteinuria or GFR determination

20
Q

What will be seen on UPEP in Multiple Myeloma?

A

Bence Jones protein

21
Q

While KUB x-rays can identify calcium-containing, struvite, and cystine stones, what will they likely miss?

A

Miss smaller stones, radiolucent stones (uric acid) or stones overlying bony structures

22
Q

What is meant by staghorn calculi which can be associated with cases of nephrolithiasis?

A

Stones involving the renal pelvis and extending into 2 or more calyces

23
Q

What is the appropriate initial test to obtain in patients with renal failure of unknown etiology?

A

Renal Ultrasound

24
Q

What is the test of choice to exclude urinary tract obstruction?

A

Renal Ultrasound

25
Q

When would a Renal Doppler Ultrasound be used?

A

If concerned about blood flow as it will evaluate renal vascular flow

26
Q

What is the diagnostic test of choice for evaluating nephrolithiasis?

A

Non-contrast CT

27
Q

If a patient is taking Metformin, what should you instruct your patient to do after receiving a CT with contrast?

A

Hold Metformin for 48 hours as it can increase nephrotoxicity

28
Q

What is the gold standard for diagnosis of renal vein thrombosis?

A

MRI

29
Q

What are some contraindications to an MRI/A?

A

Renal failure/GFR < 30 as Gadolinium may increase risk for nephrogenic systemic fibrosis

30
Q

If you observe a “string of pearls” on renal angiography, which should you be concerned about?

A

Fibromuscular Dysplasia

31
Q

What study is best to evaluate for Vesicoureteral reflux?

A

Voiding Cystourethrogram

32
Q

What study is best to evaluate for distortion of the bladder (due to tumor)?

A

Voiding Cystourethrogram

33
Q

What study is best to evaluate for a fistula?

A

Voiding Cystourethrogram

34
Q

What study is best to evaluate for bladder perforation?

A

Voiding Cystourethrogram

35
Q

What are indications to using cystoscopy?

A
  • Assess bladder and ureteral involvement due to malignancies
  • Evaluate urogynecologic conditions (recurrent infection, hematuria, incontinence)
  • Diagnose intrinsic bladder disease
36
Q

If you are ordering a testicular ultrasound, what else should you order?

A

Make sure to get a doppler to look at blood flow

37
Q

What is the test of choice for a male presenting with severe/acute testicular pain?

A

Testicular Ultrasound

38
Q

What is a prostate ultrasound and biopsy helpful for?

A

In detection of prostate cancer in patients with elevated PSA

Clinical Med II (17 decks)

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