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USLME > FARR Renal/Geniourinary > Flashcards

FARR Renal/Geniourinary Flashcards

1
Q

Renal tubular acidosis (RTA) associated with abnormal H+ secretion and nephrolithiasis.

A

Type I (distal) RTA.

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2
Q

RTA associated with abnormal HCO3– and rickets.

A

Type II (proximal) RTA.

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3
Q

RTA associated with aldosterone defect.

A

Type IV (distal) RTA.

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4
Q

“Doughy” skin

A

Hypernatremia.

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5
Q

Differential of hypervolemic hyponatremia.

A

Cirrhosis, CHF, nephritic syndrome.

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6
Q

Chvostek’s and Trousseau’s signs.

A

Hypocalcemia.

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7
Q

The most common causes of hypercalcemia.

A

Malignancy and hyperparathyroidism.

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8
Q

T-wave flattening and U waves.

A

Hypokalemia.

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9
Q

Peaked T waves and widened QRS.

A

Hyperkalemia.

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10
Q

First-line treatment for moderate hypercalcemia.

A

V hydration and loop diuretics (furosemide).

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11
Q

Type of ARF in a patient with FeNa < 1%.

A

Prerenal.

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12
Q

A 49-year-old man presents with acute-onset flank pain and hematuria.

A

Nephrolithiasis.

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13
Q

The most common type of nephrolithiasis.

A

Calcium oxalate.

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14
Q

A 20-year-old man presents with a palpable flank mass and hematuria. Ultrasound shows bilateral enlarged kidneys with cysts. Associated brain anomaly?

A

Cerebral berry aneurysms (autosomal-dominant PCKD).

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15
Q

Hematuria, hypertension, and oliguria.

A

Nephritic syndrome.

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16
Q

Proteinuria, hypoalbuminemia, hyperlipidemia, hyperlipiduria, and edema.

A

Nephrotic syndrome.

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17
Q

The most common form of nephritic syndrome.

A

Membranous glomerulonephritis.

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18
Q

The most common form of glomerulonephritis.

A

IgA nephropathy (Berger’s disease).

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19
Q

Glomerulonephritis with deafness.

A

Alport’s syndrome.

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20
Q

Glomerulonephritis with hemoptysis.

A

Wegener’s granulomatosis and Goodpasture’s syndrome.

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21
Q

Presence of red cell casts in urine sediment.

A

Glomerulonephritis/nephritic syndrome.

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22
Q

Eosinophils in urine sediment.

A

Allergic interstitial nephritis.

23
Q

Waxy casts in urine sediment and Maltese crosses (seen with lipiduria).

A

Nephrotic syndrome.

24
Q

Drowsiness, asterixis, nausea, and a pericardial friction rub.

A

Uremic syndrome seen in patients with renal failure.

25
Q

A 55-year-old man is diagnosed with prostate cancer. Treatment options?

A

Wait, surgical resection, radiation and/or androgen suppression.

26
Q

Low urine specific gravity in the presence of high serum osmolality.

A

Diabetes insipidus.

27
Q

Treatment of SIADH?

A

Fluid restriction, demeclocycline.

28
Q

Hematuria, flank pain, and palpable flank mass.

A

Renal cell carcinoma (RCC).

29
Q

Testicular cancer associated with β-hCG, AFP.

A

Choriocarcinoma.

30
Q

The most common type of testicular cancer

A

Seminoma, a type of germ cell tumor.

31
Q

The most common histology of bladder cancer.

A

Transitional cell carcinoma.

32
Q

Complication of overly rapid correction of hyponatremia.

A

Central pontine myelinolysis.

33
Q

Salicylate ingestion occurs in what type of acid-base disorder?

A

Anion gap acidosis and 1° respiratory alkalosis due to central respiratory stimulation.

34
Q

Acid-base disturbance commonly seen in pregnant women.

A

Respiratory alkalosis.

35
Q

Three systemic diseases that lead to nephrotic syndrome.

A

DM, SLE, and amyloidosis.

36
Q

Elevated erythropoietin level, elevated hematocrit, and normal O2 saturation suggest?

A

RCC or other erythropoietin-producing tumor; evaluate with CT scan.

37
Q

A 55-year-old male presents with irritative and obstructive urinary symptoms. Treatment options?

A

Likely BPH. Options include no treatment, terazosin, finasteride, or surgical intervention (TURP).

38
Q

Hypernatremia causes—

A

The 6 D’s
Diuresis Dehydration Diabetes insipidus Docs (iatrogenic) Diarrhea
Disease (e.g., kidney,
sickle cell)

39
Q

Hypervolemic hyponatremia is caused by

A

“nephrOSIS, cirrhOSIS, and cardiOSIS.”

40
Q

Hyperkalemia HISTORY/PE

A

May be asymptomatic or may present with nausea, vomiting, intestinal colic, areflexia, weakness, flaccid paralysis, and paresthesias.

41
Q

Treatment of hyperkalemia—

A

C BIG K

Calcium Bicarbonate Insulin Glucose Kayexalate

42
Q

Hypokalemia HISTORY/PE

A

Presents with fatigue, muscle weakness or cramps, ileus, hypotension, hyporeflexia, paresthesias, rhabdomyolysis, and ascending paralysis.

43
Q

Causes of hypercalcemia—

A

CHIMPANZEES
Calcium supplementation
Hyperparathyroidism/ Hyperthyroidism
Iatrogenic (e.g., thiazides, parenteral nutrition)/Immobility
Milk-alkali syndrome Paget’s disease Adrenal insufficiency/
Acromegaly Neoplasm
Zollinger-Ellison syndrome
(e.g., MEN 1) Excess vitamin A Excess vitamin D Sarcoidosis and other
granulomatous disease

44
Q

Loops

A

(furosemide) Lose calcium.

Avoid thiazide
diuretics, which ↑ tubular reabsorption of calcium.

45
Q

↑ anion gap caused by—

A

MUDPILES
Methanol Uremia
DKA Paraldehyde Intoxication Lactic acidosis Ethylene glycol Salicylates

46
Q

Symptoms of uremia include

A

malaise, fatigue, confusion, oliguria, anorexia, and nausea.

47
Q

Exam of remia may show

A

a pericardial rub, asterixis, hypertension, ↓ urine out- put, and an ↑ respiratory rate (compensation of metabolic acidosis or from pulmonary edema 2° to volume overload)

48
Q

Indications for urgent dialysis—

A

AEIOU
Acidosis
Electrolyte abnormalities
(hyperkalemia) Ingestions (salicylates,
theophylline, methanol, barbiturates, lithium, ethylene glycol)
Overload (fluid) Uremic symptoms
(pericarditis, encephalopathy, bleeding, nausea, pruritus, myoclonus)

49
Q

CHRONIC KIDNEY DISEASE (CKD)

Most commonly due to

A

diabetes mellitus (DM), hypertension, and glomerulo- nephritis.

50
Q

Autosomal dominant (ADPKD):

A

I Most common.
I Usually asymptomatic until patients are > 30 years of age.
I One-half of ADPKD patients will have ESRD requiring dialysis by age 60.
I Associated with an ↑ risk of cerebral aneurysm, especially in patients with a

51
Q

Autosomal recessive (ARPKD):

A

Less common but more severe. Presents in infants and young children with renal failure, liver fibrosis, and portal hypertension; may lead to death in the first few years of life.

52
Q

Differential for hematuria—

A

S2I3T3
Strictures Stones Infection Inflammation Infarction Tumor Trauma
TB

53
Q

Testicular cancer

DIAGNOSIS

A

I Testicular ultrasound.
I CXR and abdominal/pelvic CT to evaluate for metastasis.
I Tumor markers are useful for diagnosis and in monitoring treatment re-
sponse.
I β-hCG is always elevated in choriocarcinoma and is elevated in 10% of
seminomas.
I α-fetoprotein (AFP) is often elevated in nonseminomatous germ cell tu-
mors, particularly endodermal sinus (yolk sac) tumors. It is also elevated in hepatocellular carcinoma, hepatoblastoma, and neuroblastoma.

USLME (41 decks)

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