Exam 3: Renal Diagnostics

Question 1

What can increase BUN?

Answer 1

Dehydration, GI bleed, and certain meds (tetracycline and steroids)

Question 2

What is used to track the progression of kidney disease and to dose medications?

Answer 2

GFR

Question 3

What is PSA?

Answer 3

Prostate specific antigen, a glycoprotein found in high concentrations in the prostatic lumen

Question 4

PSA levels are detected in every male, but are increased in what conditions?

Answer 4

Prostate cancer, BPH, prostatitis, and following prostate manipulation

Question 5

What is the treatment for men with abnormal PSA?

Answer 5

Referral to urology

Question 6

What lab finding is the earliest clinically detectable stage of diabetic nephropathy?

Answer 6

Microalbuminemia

Question 7

What can a KUB help diagnose?

Answer 7

• Calcification of the urinary tract (identify calcium containing struvite and cystine stones but will miss smaller stones and radiolucent stones (uric acid))
• Prostatic calculus
• Bladder distention

Question 8

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

Answer 8

Renal US

Question 9

What can a renal Doppler US help identify?

Answer 9

Renal vein thrombosis, renal infarction, renal artery stenosis, intrarenal vascular disease, and arteriosclerosis

Question 10

You see a hypodense mass with internal echoes on US. What are you concerned about?

Answer 10

Pyelonephritis

Question 11

What is the diagnostic chest of choice for nephrolithiasis?

Answer 11

Non-Con CT

Question 12

You see triangular, hypodense streaks spreading from the renal pelvis to cortex on CT. What are you concerned about?

Answer 12

Pyelonephritis

Question 13

What is the gold standard for renal vein thrombosis?

Answer 13

MRI

Question 14

Gadolinium increases the risks of *** in patients with chronic renal failure.

Answer 14

Nephrogenic systemic fibrosis

Question 15

You see a “string of pearls” sign on angiography? What are you concerned about?

Answer 15

Fibromuscular dysplasia

Question 16

What does a renal biopsy help diagnose?

Answer 16

Unexplained acute renal failure, nephrotic syndrome, acute nephritic syndrome, renal mass, and assessment for rejection following transplant

Question 17

What are cystourethrograms used to diagnose?

Answer 17

Vesicoureteral reflux, distortion of the bladder, fistula, and perforation

Question 18

What are the indications to use a prostate US and biopsy?

Answer 18

Detection of prostate cancer in patients with elevated PSA

Question 19

What are the indications for a cystoscopy?

Answer 19

• Assess bladder and ureteral involvement due to malignancies
• evaluate urogynecologic conditions ( Incontinence, recurrent infection, hematuria)
• Diagnose intrinsic bladder disease (Bladder tumor, interstitial cystitis, bladder stones, and bladder scarring)

Question 20

What conditions are urine eosinophils most commonly seen in?

Answer 20

Acute interstitial nephritis

Question 21

You see radiopaque, branched staghorn calculus filling the collecting systems on KUB. What are you concerned about?

Answer 21

Nephrolithiasis