Genitourinary Flashcards
1
Q
finding in renal biopsy in MPGN
A
dense deposit in glomerular basement membrane
2
Q
quid of dense deposit
A
C3
3
Q
Physiopatho in MPGN
A
persistent activation of alternative pathway of complement
4
Q
quid of nephritic factor
A
IGG against c3 convertase
5
Q
clue for MPGN
A
Hematuria and SN
6
Q
action of cyclosporin
A
inhibits interleukin 2 transcription
7
Q
what s the most common side effect of cyclo
A
nephrotoxicity
8
Q
how nephrotoxicity induced by cyclo manifest
A
hyperkalimia
Hus sometimes
9
Q
side effect of cyclo to remember(5)
A
nephrototoxycity tremor hta gum hypertrophy hyperkaliemia
10
Q
Mycophenolate side effect
A
marrow suppression
11
Q
azathioprine side effect(3)
A
diarhee
leukopenia
hepatotoxicity
12
Q
patient with autosomal dominant polykystic renal disease with intracerebral hemorrrage,why
A
rupture of berry aneurism
13
Q
most common extra renal manif of ADPKD
A
Hepatic cyst
14
Q
other extra renal manif of ADPKD(3)
A
Mitral valve prolapse/aortic regurgitation
colonic diverticula
abdominal wall hernia or inguinal hernia
15
Q
urinalysis sign of nephritis
A
WBC cast
16
Q
patient on cephalexin develops dark urine
A
drug induced intersticial nephritis
17
Q
hallmark of drugs induced intersticial nephritis(2)
A
eosiniphiluria
hypereosniphilie
18
Q
treatment of drug induced intersticial nephritis
A
stop the offending agent
19
Q
the first phenomenon occuring in diabetic
A
glomerular hyperfiltration
20
Q
why GFR increases in diabetics patient
A
because of glomerular hypertrophy
21
Q
perio to have high GFR in diabetic patient
A
0-5 ans
22
Q
laps of time to have microalbuminuria
A
5-10 years
23
Q
why you will have microalbuminuria
A
mesangial expansion
24
Q
quid of arterial hyalinosis
A
thickening of the basement membrane=mesangial expansion
25
what will happen after ten years in diabetics patient(2)
mesangial nodule
(kimmelstiel nodules disease)
tubulointersticial fibrosis
nephrotic syndrome avec low GFR
26
what can you have during mesangial expansion
HTA
27
quid of glomerulosclerosis
tubulointersticial fibrosis
28
hallmark of renal problem in diabetics patient
microangiopathy
29
risks factor for diabetics nephropathy
```
bad glycemia control
HTA
smoking
age
ethnicity
```
30
what nationality is a risk fector for diabetic nephropathy
mexican
| african american
31
first cause of renal failure in north america
diabetes
32
management of uncomplicated pyelonephritis
blood culture
| followed by empiric antibiotics
33
indication of MRI or US in pyelonephritis(2)
persistent fever
| rulet out abcess or obstruction
34
persistent fever in pyelonephritis(2)
abcess
| obstruction
35
indication of iv pyelogram in pyelonephritis
chronic pyelonephritis
36
complication of acute pyelonephritis(3)
abcess
papillary necrosis
emphysematous pyelonephritis
37
cause of bleeding in renal failure
platelet dysfunction
38
rx of bleeeding in renal failure
desmopressin(DDAVP)
39
what cause platelet dysfunction in renal failure
accumulation of guanidino succinic acid
40
red urine in patient taking anti tb
drug reaction(rifampicin)
41
clue for renal cell carcinoma(2)
blood in urine
| left sided varicoceles
42
work up of renal cell carcinoma
abdominal CT
43
clue for varicocele
they fail to empty due to obstruction of gonadal vein by the the tumor when it entries in renal vein when the patient is in recumbent position
44
why erythrocytosis in renal cell carcinoma
high production of erythropoietine by the tumor
45
paraneoplastic syndrome in RCC(5)
```
anemia or erythrocytosis
hypercalcemia
thrombocytosis
cachexia
fever
```
46
patient whith tonic clonic seizure develops renal failure and high K+ why
rhabdomyolysis
47
why renal failure in rhabdomyolysis
tubular injury by myoglobin
48
cause of high K+
```
rein prroblem
medication
Metaboloic acidosis
hyperglycemia
tissue or cell destruction
pseudo hyperkaliemia
```
49
medication induced high K+(7)
```
amyloride
ACE inhibitor
ARBS
NSAIDS
K+sparing diuretics
non selectived B blocker
digoxin
```
50
secret to hyperkaliemie
all the time you block the SRAA --->high K+
51
quid of pseudo hyperkaliemia
hemolysed blood sample
52
why hyperglycemia causes high K+
K+ Movement out of the cells
53
why ACE inhibitor and ARB's causes high K+
block SRAA axis
54
why k+ sparing diuretics causes high K+
block receptor aldosterone
55
why NSAIDS causes high K+
because prostanglandin plays a key role in the activation of SRAA axis
56
why digoxin causes high K+
by blocking K+NA+ ATPASE PUMP
57
why B Blocker causes high K+
block uptake of K+ by cells
58
EKG finding of hyperkaliemia
peaked T waves
59
Patient with disk herniation develops retention of urine
2 possibilities
-severe pain plus HBP
cauda equina syndrome
60
Patient with disk herniation develops retention of urine sever pain and HBP
because of HBP valsalva maneuver will be perfrom strongly by the patient and more pain wil be produced if disk herniation because of high intra abdominal peressure
so retention can occur
61
clue of cauda equina syndrome
anal sphincter tone will decrease because of nerve root injury
62
cause of neurologic deficit in herniated disk
spinal nerve inpingement
63
why elderly is prone to dehydration(3)
decrease thirst response to dehydration
impaired renal Na+ conservation
impaired renal ability concentration
64
rx of dehydration
crystalloid
65
why you should rehydrate elderly with caution
because sodium loading can unmask subclinical heart failure in elderly
66
4 types of renal stones(4)
calcium oxalate/phosphate
acid uric
struvite or triple phosphate
cysteine
67
most common type of stone
calcium stone
68
most common cause of calcium stones(7)
```
idiopathic hypercalciuria
hyperuricosuria
hyperoxaluria
decrease urinary citrate
renal tubular acidosis
chronic decrease of urine output
hypercalciuria secondary to systemic disorder
```
69
quid idiopathic hypercalciuria(2)
hypercalciuria
| normal calcemia
70
whaT's the most common cause of hypercalciuria
idiopathic hypercalciuria
71
systemic disorder causing hypercalciuria(2)
primary hyperparathyroidism
| sarcoidosis
72
causes of hyperoxaluria(4)
high vit C intake
high green leafy vegetables intake
IBD
short bowel syndrome
73
finding in renal tubular acidosis
nephrocalcinosis
74
hypercalciuria in Men
> 300 mg /24 H
75
hypercalciuria in women
> 250 mg/24 h
76
rx of stones induced by idiopathic hypercalciuria(3)
fluid intake
dietary Na+ restriction
thiazide or amiloride
77
action of thiazide(2)
decrease urinary calcium excretion
| precent precipitation of calcium in urine
78
rx of stones induced by hyperuricosuria(2)
purine restricted diet
| allopurinol
79
recommandation for rx of calcium stone what to restrict
Na+
oxalate
proteins
80
restriction of na+ in calcium stones
< 100 meq /dl/ jour
81
source of oxalate (3)
dark roughage
chocolate
vit C
82
protein source to avoid in calcium stone(4)
beef
poultry
eggs
fish
83
what to increase in rx of calcium stone
fluid
| normal or high calcium intake
84
fluid to take during rx of calcium stone
> 3 l day
85
intake of calcium in rx of calcium stone
1000 mg daily
86
why furosemide is contraindicated in calcium stone
it increase excretion of calcium
87
first thing in acute non complicated calcium stone(3)
fluid
observation
analgesique
88
nephrotic syndrome tetrad
proteinuria > 3-3.5 g par 24 h
hypoalbuminemia
edema
hyperlipidemia and lipiduria
89
the most common manif of SN
proteinuria
90
basic pathology of SN
altered permeability of basement glomerular membrane
91
disease causing SN(5)
Minimal change
Membranous glomerulopathy
mesangial proliferative glomerulonephritis
membranous proliferative glomerulonephritis
glomerulosclerose focale et segmentaire
92
cause of hypercoagulability in SN(5)
```
Loss of antithrombine 3
altered level of protein C et S
increased platelet aggregation
hyperfibrinogenemia
impaired fibrinolysis
```
93
why hyperfibrinogenemie
because of increase hepatic synthesis of fibrinogene
94
the most common manif of hypercoagulability in SN
renal vein thrombosis
95
why microcytic anemia in SN
because of loss of transferrin
96
complication of SN(5)
```
microcytic anemia
VIT D deficiency
low thyroxin level
infection
malnutrition
```
97
why low vit D in SN
because of increase excretion of cholecalciferol binding protein
98
why low thyroxin level in SN
loss of thyroxin binding protein
99
protein transporter of fer
transferrin
100
protein transporter of T3 T4
thyroxin binding globulin
101
protein tranporter of vit D
cholecalciferol binding protein
102
why acute renal failure in cocaine abuse
rhabdomyolisis
103
rhabdomyolisis in acute renal failure
myoglobin causes acute tubular necrosis
104
red flag for acute tubular necrosis in cocaine abuse
CPK >20000
105
differentiate drugs induced renal failure and drugs induced intersticial nephritis(2)
no wbc in the urinary sediment in drug u=induced renal failure
as the opposite of intersticial nephritis induced by drug
106
drugs causing renal failure
aminoglycoside
107
what to do during administration of aminoglycoside(2)
monitor renal fonction
| monitor drug level
108
patient with CRAB cause of that(2)
paraproteinemia=
| Bencejones
109
other name of Multiple myeloma
kahler disease
110
why renal inssuficiency in MM
obstruction of distal and collectig tubules by bence jones protein
111
simple renal cyst on ct (4)
black mass with no multilocular
no septae intra the mass
on thickened wall
ono enhancement on CT
112
management of simple renal cyst(2)
observation
| reassurance
113
most common cause of SN in hogkin lymphoma
minimal change disease
114
the best way to remove K+ in the body in case of Hyperkaliemia(3)
kayexalate
dyalisis
diuretics
115
what's kayexalate(2)
cation exchange resin
| Na+ entre K + sort
116
why amitryptiline can cause urinary retention(4)
anticholinergic effect
block detrusor contraction
prevent sphincter relaxation
no relaxation
117
why foley catheterization is important in urinary retention(2)
to provide symptomatic relief
| to document retention
118
quid of priapism
painful and persistent erection
119
Med causing priapism(2)
trazodone
| prazocin
120
disease causing priapism(2)
sickle cell disease
| leukemia
121
quid of trazodone
it's a anti depressant
122
diabetic patient with proteinuria possibilities(2)
infection
| glomerular basement changes
123
the 2 presentations of diabetic nephropathy
nodular glomerulosclerosis
| diffuse glomerulosclerosis
124
most common cause of nephropathy in diabetic
diffuse glomerulosclerosis
125
clue for UTI in urinalysis(2)
leucocyte esterase positive
| nitrites
126
quid of nitrites
presence of enterobacteriacea
127
quid of leucocyte esterase
pyuria
128
clue for chronic prostatitis(3)
voiding symptom
<10 WBC in prostatic secretion (N)
no bacteria found
129
why in SN you have accelarated atherosclerosis(3)
hyperlipidemia
High LDL
Low HDL
130
risk in aptient with SN
MI
| Stroke
131
prevention rx of hyperlipidemia in SN
statin
132
patient with HBP develops high creatine next step
abdominal US
133
what to do ig in HBP US shows hydronephrosis
foley is mandatory
134
how acyxclovir causes renal failure
renal tubular obstruction by crystalization of the drug in urine
135
what the main risk factor for acyclovir causing renal failure
inadequate hydration
136
specificity in urinalysis in colic nephretic(3)
wbc
rbc
no cast
137
indication of EPO(2)
anemia in renal failure
| less than 10 g HB
138
side effect of EPO(4)
worsening HTA
headaches
flulike syndrome
red cell aplasia
139
how to prevent HTA worsening in EPO administration
slow raising of HMt with a goal of 30-35%
140
urinary retention with anticholinergic(4)
diphendramine
doxepin
hydroxyzine
chlorpheniramine
141
the earliest abnormality seen in diabetics
glomerular hyperfiltration rate
142
the earliest abnormality that can be quantified in diabetics
thickening of the basement membrane
143
role of ACE inhibitor in the prevention of nephropathy in diabetics
decrease intra glomerular HTA
144
prevention of acyclovir induced nephropathy
agressive hydration
145
after coronary stenting patient develops blue toe and high creat cause?
cholesterol emboli by disruption of plaques
146
clue cholesterol emboli inducing renal circulation problem and pedal circulation
elevated eosinophiles
| low C3
147
patient taking NSAIDS develops high creat
analgesic nephropathy
148
physiopatho of analgesic nephropathy
papillary necrosis
| chronic tubulointersticial nephritis
149
danger of analgesic(3)
premature aging
UT cancer
atherosclerotic vascular disease
150
HTA puls right sided renal bruit
stenose de l'artere renale
151
rx of stenose of renal artery
percutaneous angioplasty with placement
152
first cause of renal artery stenosis
fibro muscular disease
153
HIV black with SN cause of that
focal segmental glomerulosclerosis
154
2 causes of glomerular hematuria(2)
IGA nephropathy
| GNA
155
clue for IGA nephropathy(3)
upper respiratory infection
later hematuria
complement is normal
156
painless hematuria in black
sickle cell trait
157
cause of hematuria in sickle cell disease
papillary necrosis
158
patient with HBP, gross and micro hematuria in smoker, next step
cystoscopy
159
why you should ask for cystoscopy even if you suspect HBP
any hematuria and risk factor of bladder cancer,cystoscopy is mandatory
160
what's the most important risk factor for bladder cancer
smoking
161
renal cause of hematuria(3)
CA
IGA nephropathy
GNA
162
ureteral cause of hematuria(2)
stones
| stricture
163
bladder cause of hematuria(2)
ca
| cystitis
164
prostate and uretral cause of hematuria(2)
ca prostate
| uretritis
165
rsk factors for bladder cancer(6)
```
cigarette
cyclosporine
painter
chronic cystitis
metal worker
pelvic radiation
```
166
the most common cause of death in patient on dyalisis
cardiovascular
167
most common cause of death in renal transplant
cardiovascular
168
patient with SN develops acute flanck pain in the right DX
renal vein thrombosis
169
what the most comon disease causing SN
membranous glomerulonephritis
170
most common cause of painless hematuria in adults
bladder cancer
171
SRAA axis in hypovolemia(3)
angiotensine constrict efferent arterioles
prostaglandin dolate afferent arteriole
but if hypovolemia worsens this mechanism will fail and you will have damage in kidney
172
why elderly in nursing room can easily develops prerenal azatemia(3)
because they are taking
Aspirin
Ace inhibitor
diuretics
173
cause of epididymitis in elderly
E coli
174
cause of epididymitis in sexually active individual(2)
chlamydia
| gonorrhea
175
symptom of epididimytis(2)
scrotal pain
| irradiation in flank
176
name two improtant caus of pulmonary renal syndrome(2)
wegener
| good pasture
177
rx in Wegener(2)
cycolphosphamide
| steroids
178
rx in goodpasture (2)
plasmapheresis
179
why plasmapheresis in goodpasture
because of the presence of anti membrane basal antibody
180
rx of uncomplicated cystitis(4)
nitrofurantoin
TMS
phosphomycin
fluoquinolones
181
duration of rx of uncomplicated cystitis using TMS
3 jours
182
indication ofquinolones in uncomplicated cystitis
if you cannot use the 3 first drug listed above
183
meaning of complicated cystitis(3)
diabetes
immunosuppression
kidney disease
184
RX of complicated cystitis
fluoquinolones
185
indication of urine culture in uncomplicated cystitis
if rx fails
186
patient renal failure taking metformin risk
lactic acidosis
187
risk for metformin to induce lactic acidosis(3)
renal fialure
hepatic failure
sepsis
188
clue for chlamydial uretritis(3)
mucopurulent discharge
no bacteria
sexual active individual
189
clue for gonococcal uretritis
purulent discharge
190
tetrad of amyloidosis(4)
hepatomegaly
renal problem
heart problem S4
maladie inflammatoire sous jascente
191
finding in renal biopsy in amyloidosis ordinary microscopy
apple green birefringence under polarised light
192
stain coloration for amyloidosis
congo red stain
193
finding in renal biopsy in amyloidosis electronical microscopy
extra cellular or amyloid fibrils
194
most common type of renal stones
oxalate calcium 75/90%
195
cause of fat malabsortion
surgical ileal resection
chronic diarrhea
small bowel disease
196
condition predisposing for renal calcium stones
fat malsorption
197
why fat malabsortion causes renal oxalate calcium stones
because in fat mlabsorption, fat chelates calcium making oxalate free to be absorb
198
stone in parathyroidism
calcium stone
199
stone in chemo
acid uric stone
200
cause of cysteine stone
inborn error of metabolism in children
201
cause of struvite stone
proteus infection
202
quid of hepato renal syndrome
renal failure in patient with cirrhosis
203
rx of hepato renal syndrome
liver transplant
204
cause of death in hepato renal syndrome(2)
hemmorrahe
| infection
205
most common cause of death in patient with hepatic failure
renal problem
206
patient with long term renal failure best long term measure in management
tranplantation renal from living related donor
207
what are the 2 options for end stage renal disease(2)
dyalisis
| renal transplantation
208
advantage of transplantation over dyalisis(4)
good quality of living and survival
anemia bone disease and HTA are well controlled
autonomic neuropathy is improved
better survival rate
209
is dyalisis improves autonomic neuropathy in diabetics
no
210
clue for alport syndrome(3)
high creat
deafness
hematuria
211
biopsy finding in alport
foam cells
212
electron microscopy in alport
alternating areas of thinned and tickened capillary loopswith splitting GBM
213
cause of infertility in athlete
steroid abuse
214
why steroid abuse causes of infertility in athlete(2)
blockage of GNRH release
| no LH and FSH
215
after renal transplantation patient develops oliguria
| high BUN/CREAT DX(5)
```
acute rejection
ureteral obstruction
cyclosporine toxicity
ATN
vascular obstruction
```
216
after renal transplantation patient develops oliguria
| high BUN/CREAT ,work up?(3)
US
biopsy
cyclosporine level
217
rx of acute rejection
steroids IV
218
biopsy in acute rejection
heavy lymphocyte infiltration and vascular involvementwith swelling of the intima
219
test to do after renalm transplantation(4)
radfio isotope scanning
MRI
US
Biopsie renale
220
prevention of contrast nephropathy(2)
hydration
or
acetylcysteine
221
action of aqcetyl cysteine in caseof contrast nephropathy rx
vasodilation
| antioxydant
222
cause of painless hematuria(3)
analgesic
SCD
CA
223
[hysiopatho of analgesic induced nephropathy
papillary necrosis
caused by vasoconstriction of medullary blood vessel
(vasa recta)
224
most specific test to DX renal carcinoma
ct of abdomen
225
work up for patient with HBP symptomatic first step(2)
creat
| urinalysis
226
work up for patient with HBP symptomatic creat and urinalysis anormal next step(2)
U/S
or
abdomen CT
227
clue to differentiate prostatis from cystitis(2)
systemic symptom
| boggy and tender prostate
228
after urinalysis what's the next step for prostatitis
midstream urine sample culture
229
clue to differentiate acute from chronic prostatis
no systemic sympton in chronic prostatitis
230
rx of acute prostatitis
TMS
231
rx of chronic prostatitis
fluoquinolones
232
rx of acute pericarditis in qacute renal failure
hemodyalisis
233
clasic EKG findings in acute pericarditis(2)
ST and PR elevation in AVR
| PR segment depression in other leads
234
the best test to DX renal calculi
ct of abdomen
235
xray of calcium stone
radioopaque
236
xray of acid uric stone
radioluscent
237
most beneficial next step in aptient with acid uric stone(2)
citrate de K+ to alkalinisation of the urine
or
bicarb K+
238
people at risk for acid uric stone
low pH urine
239
cause of low PH urine(2)
renal ammonia secretion deficit
| hyperuricosuria
240
patient with classic renal colic and negative xray
acid uric stone
calcium stone 1-3 mm
non stone cause
241
nonstone cause of renal colic(2)
caillot
| tumor
242
what's the target when alkalinisation of the urine
PH>6,5
243
terminal hematuria(2)
bladder disease
| prostate disease
244
initial hematuria
uretritis
245
total hematuria(2)
renal disease
| ureter
246
clue for renal hematuria
no clots
247
best test for bladder cancer
cystoscopy
248
clue for mixed essential cryoglobulinemia(3)
hematuria
proteinuria
palpable purpura
249
what infectious test should be done if you suspect cryoglonulinemia
HCV serology
250
why HCV serology in cryoglobulinemia
majority of patient have HCV infection
251
complement in cryo
low
252
most common cause of painlesss hematuria
bladder cancer
253
BPH treatment(3)
doxazocin or
tamsulosin Alpha 1 blockers plus
finasteride
254
quid of finasteride
5 alpha reductase inhibitor
255
zone of prostate touched by BPH
transitionnal zone
256
ALP in ca prostate
high
257
rapid rx in hyperkalemia even if renal failure
gluconate de calcium
258
next step after gluconate de calcium in hyperkalemia rx
remove calcium in the body
259
EKG in hyperkaliemia(4)
peaked T waves
wide RQS complex
bradycrdia
no P waves
260
cause of C3 levels(4)
immune complex reaction
GNA
cryoglobulinemia
membranous glomerulonephritis
261
Clue for GNA(3)
hta
skin infection
low c3
262
management of urolithiasis(3)
CT abdomen
analgesics
fluid > 2 l/jour
263
when to refer urolithiasis in urologic physician(3)
anuria
sepsis
acute ranl failure
264
grasseur of stone to be passed with hydration
less than 5 mm
265
clue for ATN(3)
BUN/CREAT2
| urine osmolarity 300-350(never < 300)
266
what can cause ATN
prolonged hypotension
267
hallmark of ATN
muddy brown cast
268
quid of brown cast
renal tubular epithelial cells
269
mechanism of cystitis
ascending infection
270
role of sexual intercourse in cystitis(3)
massage uretral during sexual intercourse
entry of germs dans la vessie
honeymoon cystitis
271
RBC cast
GNA
272
WBC cast(2)
intersticial nephritis
| pyelonephritis
273
fatty cast
SN
274
broad and waxy cast
chronic renal failure
275
patient at risk for contrast nephropathy(2)
diabetics
| Creat> 1,5
276
what should be done to prevent contrast nephropathy(4)
nonionic contrast agent
acetylcysteine
good hydration
277
SN with focal glomerulosclerosis(4)
african american
HIV
heroin use
obesity
278
SN in hogkin(2)
minimal change
or
focal glomerulosclerosis
279
pyelonephritis unresponsive to rx after 48 h
ask for CT or US
280
why imagery in pyelonephritis unresponsive to rx after 48 h
rule out obstruction
or
abcess
281
vascular changes in HTA(2)
atherosclerotic changes of afferent and efferent artery renal arterioles and glomerular capillar tufs
narrowing of renal arterioles with sclerosisand intimal tickening
282
vascular changes in diabetics(4)
increased extra cellular matrix
basement membrane tickening
mesangial expansion
fibrosis
283
clue for drugs induced intersticial nephritis(4)
eosiniphilia
hematuria
sterile pyuria
eosinophiluria
284
in renal failure with platelet dysfunction ,bilan de coagulation
Pt,PTT normal
| BT prolonged
285
action of desmopressin in renal failure with platelet dysfunction(2)
release of factor 8
| and v willebrand
286
why platelet transfusion is not good in renal failure with platelet dysfunction
because transfused platelet will be inactivated
287
important clue for renal carcinoma
unilateral varicocele that fails to empty when the patient is in recumbent position
288
in rhabdomyolysis clue for myoglobinuria
large amount of blood in urinalysis with relative absence of RBC in microscopy(0-1 rbc)
289
differentiate myoglubunuria from Hemoglobinuria
large amount of blood in urinalysis with relative absence of RBC in microscopy(0-1 rbc)=myoglobin
290
rx of renla stone with hypercalciuria(3)
high fluid intake
sodium restriction
thiazide diuretic
291
indication of amikacin in pyelonephritis
multi drug resistant pyelonephritis
292
kahler disease(2)
plasma cells myeloma
| Myelomatosis
293
clue for malignant cystic mass(2)
thick and irregular wall
multiple septae
presence of contrast enhancement
294
physical exam of urinary retention
tenderness and fulllness on palpation along the midline below the umbilicus
295
why patient with SN is at risk for MI and stroke(2)
hypercoagulable state
| accelerated etherosclerosis
296
hallmark of diabetic nephropathy
nodular glomerulosclerosis
297
diabetes with proteiunuria and UTI you treat the UTI proteinuria still persist
glomerular basement membrane damage
298
drugs causing crystal induced nephropathy(5)
```
acyclovir
sulfonamides
methotrexate
ethyleneglycol
protease inhibitor
```
299
anemia in renal insufficiency(2)
normochromic
| normocytic
300
cause of hematuria in AF
papillary necrosis
301
any hematuria with no glomerular involvement plus risk factor of bladdder cancer
cystoscopy
302
when to avoid nitrofurantoin in the rx of uncomplicated cystitis
clearance creat <60/ml/mn
303
contraindication of metformin(2)
sepsis
renal failure
hepatic failure
304
clue for chlamydial uretritis(3)
Multiple sexual partners
absent bacteriuria
mucopurulent discharge
305
finding in amyloidosis
renal amyloid deposit showing apple green birefringence under polarised light after congo red stain ing
306
clue for hepatorenal syndrome(2)
high creat in patient with cirrhosis
| no improvement of creat value after fluid resuscitation
307
indication of hemodyalisis(7)
```
refractory hyperkaliemia
volume overload or pulmonary edema unresponsive to diuretics
refractory metabolic acidosis
uremic pericarditis
uremic encephalopathy or neuropathy
caogulopathy due to renal failure
```
308
first in hyoerkaliemia(2)
gluconate de calcium
| later use insulin and/orsodium polystyrene sulfonate
309
first episode of renal stone management
hydration
| no further metabolic work up is required
310
mady having sex for the first time ,days later develops urinary symptom
honeymoon cystitis
311
cause of honey moon cystitis
sexual intercourse introduces bugs directly in bladder
312
size of kidney in HTA
small size
