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CD 3305 > Genioutinary #2 > Flashcards

Genioutinary #2 Flashcards

1
Q

big 3 kidney function tests

A

serum creatinine
blood urea nitrogen (BUN)
glomerular filtration rate (GFR)

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2
Q

acute kidney injury (AKI) definition

A

Abrupt decline in renal function leading to increased nitrogenous waste products normally excreted by the kidney

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3
Q

acute kidney injury characterized by (2)

A

azometmia (increased BUN and creatinine)

abnormal urine volume (can manifest as anuria or oliguria)

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4
Q

etiology of hyponatreamia (serum Na+ <135 mmol/L)

A

diuretics (especially THIAZIDES)
diarrhea
excessive sweating

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5
Q

etiology of hypernatremamia + what is it

A

reduced fluid intake, increased fluid loss

serum (NA+) >145 mmol/L

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6
Q

hypokalemia etiology (serum K <3.5 mEq/L)

A 
limited dietary intake
GI losses (diarrhea, laxatives)
hyperaldosteronism (e.g Conn's syndrome)

DIURETICS (FUROSEMIDE, HYDROCHLOROTHIAZIDE)

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7
Q

big sign and symptom change of hypokalemia

A

arrythmias, found on ECG CHANGES**

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8
Q

hyperkalemia etiology (serum K >5.0 mEq/L(

A

factitious (sample hemolysis)
renal failure

MEDS - NSAIDs, ACEI, Angiotensin 2 receptor blockers, heparin, spironolactone

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9
Q

symptoms of hyperkalemia

A

usually asymptomatic, but will see ECG changes and cardiotoxcity

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10
Q

what is key aspect of nephrotic syndrome

A

protienuria > 3.5g/day

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11
Q

Hallmark of NEPHRITIC syndrome

A

(RBCs in urine) aka hematuria

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12
Q

clinical features of nephritic syndrome (3)

A

Proteinuria (<3.5g/day)
Hematuria
Azotemia (increased creatine and urea)

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13
Q

Post Streptococcal Glomerulonephritis (PSGN) cause? + age

A

group A beta hemolytic streptococci (strep pyogenes)

5-15years old

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14
Q

PSGN hallmark sign

A

Gross hematuria (coca-cola or tea colored, brown, smoky) urine

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15
Q

important investigation (aside from urinalysis and kidney function) for PSGN

A

Elevated Antistreptolysin O (ASO) titer

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16
Q

NSAIDs and vasomotor acute kidney injury, what do NSAIDs cause

A

renal ischemia (sad!)

tx: discontinue NSAIDs

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17
Q

NSAIDs and Acute Interstitial Nephritis (AIN) – what primarily does this?

A

Fenoprofen (60%), ibuprofen, naproxen

tx: discontinue NSAIDs!

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18
Q

symptoms of Acute Interstiail Nephritis (AIN)

A

fever and rash shortly after first dose of medication

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19
Q

What is Chronic Interstitial Nephritis caused by with meds

A

excessive antipyretics (PHENACETIN or ACETOMINOPHEN) in combination WITH NSAIDs!!!

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20
Q

Chronic Interstitial Nephritis clinical symptoms

A

gross hematuria, flank pain, declining renal function

21
Q

Actue tubular necrosis is caused by what med?

A

acetaminophen

22
Q

symptoms and investigation for Acute Tubular Necrosis

A

mental status change, edma, fatigue, nausea + vomiting

Urinalysis, MUDDY BROWN CASTS***(dead tubular cells)

23
Q

treatment for acute tubular necrosis

A

dialysis..

24
Q

what is def of chronic kidney disease (2)

A

Progressive decrease of kidney function >3m

Decreased GFR <60ml/min

25
Q

What is end stage kidney disease and what is needed at that point

A

Stave V= GRF<15

dialysis and transplantation will be required

26
Q

end stage renal disease presentatiojn (4)

A

volume overload - weight gain + edema

electrolyte abnormalities (High K, PO4, uric acid: LOW, ca2, hco3)

retention of urine

anemia, normocytic anemia due to decreased EPO and treatrment will be EPO replacement

27
Q

normocytic anemai treatment for end stage renal disease

A

erythropoietin replacement therapy

28
Q

2 types of cystic kidney disease

A

simple cysts (50% at 50)

polycistic kidney disease –> 2 types, autosomal recevessive leads to renal failure in kids, while autosomal dominant causes renal failure in adults

29
Q

most common adult kidney neoplasm?

A

renal cell carcinoma

30
Q

what are the 3 subtypes of renal cell carcinomas + % + which are in pros tuvule

A
  1. Clear cell renal cell carcinoma (70-75%)
  2. Papillary renal cell carcinoma (10-16%)
    ^both in prox tubule^
  3. Chromophobe renal cell carcinoma (%)
31
Q

hereditary renal cell carcinoma is related to?

A

Von Hippel_lindau (VHL) syndrome (and hereditary papillary renal carcinoma)

32
Q

Von Hippel Lindau disease manifested by?

A

retinal angiomas, central nervous system hemangiomas, and ccRCC

33
Q

VHL gene does what?

A

under hypoxic conditions or if inactivated the number of proangiogenic and growth factors are produced with increase tumor and endothelial cellular proliferation and angiogenesis

34
Q

classic too late triad in renal cell carinoma

A

gross hematuria, flank pain, palpable mass

35
Q

most common sites of renal cell carcinoma metastases

A

bone, brain, lung, and liver (1/3 of cases do)

36
Q

investigations for renal cell carcinoma (aside from CBC, ESR, Urine)

A

contrast-enhanced CT: highest sensitivity

renal biopsy

37
Q

treatment for renal cell carcinoma (3)

A

radical nephrectomy

patrial nephrectomy

tyrosine kinase inhibitors for metastatic disease (Sunitinib, sorafenib)

38
Q

Prognosis at diagnosis for renal cell carcinoma (T1, T2/3, metastasis)

A

STAGE = Most important prognostic factor

T1: 90% 5 yr survival
T2: 60% 5 yr survival
Mets: <5% 10 yr survival ):

39
Q

main risk factor for bladder carcinoma

A

smoking (implicated in 60% of cases)

40
Q

bladder classification (most common?)

A

Urothelial carcinoma (>90%)

41
Q

Clinical features of bladder carcinoma

A

Hematuria is KEY SYMPTOM
85-90% of the time at diagnosis
pain 50% of time

42
Q

bladder cancer gold standard investigation

A

Transurethral resection of bladder tumor (TURBT)

2nd best- cystoscopy with biopsy

43
Q

Benign prostatic hyperplasia - what will you find on digital rectal exam

A

prostate is smooth, rubbery, and symmetrically enlarged

44
Q

investigations for BPH

A

PSA <4 (normal)
PSA>10 (consider prostate cancer)

between 4 and 10 is grey zone

-physical exam (DRE)

45
Q

Prostate Cancer - Digital Rectal Exam finding

A

hard, irregular asymmetrical nodule

46
Q

MC cause of prostatitis

A

E. Coli

47
Q

Lower urinary symptoms (as they relate to prostatitis) are?

A

Storage symptoms (Frequency, Urgency, Nocturia, Dysuria) & Voiding Symptoms (Stream changes, Hesitancy, Incomplete Emptying, Dribbling

48
Q

Etiology of chronic Prostatitis bolded term

A

Recurrent UTI with same organism

CD 3305 (15 decks)

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