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► Med - Step 2 > Genitourinary > Flashcards

Genitourinary Flashcards

1
Q

finding in renal biopsy in MPGN

A

dense deposit in glomerular basement membrane

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2
Q

quid of dense deposit

A

C3

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3
Q

Physiopatho in MPGN

A

persistent activation of alternative pathway of complement

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4
Q

quid of nephritic factor

A

IGG against c3 convertase

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5
Q

clue for MPGN

A

Hematuria and SN

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6
Q

action of cyclosporin

A

inhibits interleukin 2 transcription

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7
Q

what s the most common side effect of cyclo

A

nephrotoxicity

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8
Q

how nephrotoxicity induced by cyclo manifest

A

hyperkalimia

Hus sometimes

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9
Q

side effect of cyclo to remember(5)

A 
nephrototoxycity
tremor
hta
gum hypertrophy
hyperkaliemia
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10
Q

Mycophenolate side effect

A

marrow suppression

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11
Q

azathioprine side effect(3)

A

diarhee
leukopenia
hepatotoxicity

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12
Q

patient with autosomal dominant polykystic renal disease with intracerebral hemorrrage,why

A

rupture of berry aneurism

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13
Q

most common extra renal manif of ADPKD

A

Hepatic cyst

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14
Q

other extra renal manif of ADPKD(3)

A

Mitral valve prolapse/aortic regurgitation
colonic diverticula
abdominal wall hernia or inguinal hernia

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15
Q

urinalysis sign of nephritis

A

WBC cast

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16
Q

patient on cephalexin develops dark urine

A

drug induced intersticial nephritis

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17
Q

hallmark of drugs induced intersticial nephritis(2)

A

eosiniphiluria

hypereosniphilie

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18
Q

treatment of drug induced intersticial nephritis

A

stop the offending agent

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19
Q

the first phenomenon occuring in diabetic

A

glomerular hyperfiltration

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20
Q

why GFR increases in diabetics patient

A

because of glomerular hypertrophy

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21
Q

perio to have high GFR in diabetic patient

A

0-5 ans

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22
Q

laps of time to have microalbuminuria

A

5-10 years

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23
Q

why you will have microalbuminuria

A

mesangial expansion

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24
Q

quid of arterial hyalinosis

A

thickening of the basement membrane=mesangial expansion

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25
Q

what will happen after ten years in diabetics patient(2)

A

mesangial nodule
(kimmelstiel nodules disease)
tubulointersticial fibrosis
nephrotic syndrome avec low GFR

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26
Q

what can you have during mesangial expansion

A

HTA

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27
Q

quid of glomerulosclerosis

A

tubulointersticial fibrosis

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28
Q

hallmark of renal problem in diabetics patient

A

microangiopathy

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29
Q

risks factor for diabetics nephropathy

A 
bad glycemia control
HTA
smoking
age 
ethnicity
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30
Q

what nationality is a risk fector for diabetic nephropathy

A

mexican

african american

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31
Q

first cause of renal failure in north america

A

diabetes

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32
Q

management of uncomplicated pyelonephritis

A

blood culture

followed by empiric antibiotics

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33
Q

indication of MRI or US in pyelonephritis(2)

A

persistent fever

rulet out abcess or obstruction

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34
Q

persistent fever in pyelonephritis(2)

A

abcess

obstruction

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35
Q

indication of iv pyelogram in pyelonephritis

A

chronic pyelonephritis

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36
Q

complication of acute pyelonephritis(3)

A

abcess
papillary necrosis
emphysematous pyelonephritis

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37
Q

cause of bleeding in renal failure

A

platelet dysfunction

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38
Q

rx of bleeeding in renal failure

A

desmopressin(DDAVP)

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39
Q

what cause platelet dysfunction in renal failure

A

accumulation of guanidino succinic acid

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40
Q

red urine in patient taking anti tb

A

drug reaction(rifampicin)

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41
Q

clue for renal cell carcinoma(2)

A

blood in urine

left sided varicoceles

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42
Q

work up of renal cell carcinoma

A

abdominal CT

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43
Q

clue for varicocele

A

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

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44
Q

why erythrocytosis in renal cell carcinoma

A

high production of erythropoietine by the tumor

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45
Q

paraneoplastic syndrome in RCC(5)

A 
anemia or erythrocytosis
hypercalcemia
thrombocytosis
cachexia
fever
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46
Q

patient whith tonic clonic seizure develops renal failure and high K+ why

A

rhabdomyolysis

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47
Q

why renal failure in rhabdomyolysis

A

tubular injury by myoglobin

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48
Q

cause of high K+

A 
rein prroblem
medication
Metaboloic acidosis
hyperglycemia
tissue or cell destruction
pseudo hyperkaliemia
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49
Q

medication induced high K+(7)

A 
amyloride
ACE inhibitor
ARBS
NSAIDS
K+sparing diuretics
non selectived B blocker
digoxin
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50
Q

secret to hyperkaliemie

A

all the time you block the SRAA —>high K+

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51
Q

quid of pseudo hyperkaliemia

A

hemolysed blood sample

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52
Q

why hyperglycemia causes high K+

A

K+ Movement out of the cells

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53
Q

why ACE inhibitor and ARB’s causes high K+

A

block SRAA axis

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54
Q

why k+ sparing diuretics causes high K+

A

block receptor aldosterone

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55
Q

why NSAIDS causes high K+

A

because prostanglandin plays a key role in the activation of SRAA axis

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56
Q

why digoxin causes high K+

A

by blocking K+NA+ ATPASE PUMP

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57
Q

why B Blocker causes high K+

A

block uptake of K+ by cells

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58
Q

EKG finding of hyperkaliemia

A

peaked T waves

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59
Q

Patient with disk herniation develops retention of urine

A

2 possibilities
-severe pain plus HBP
cauda equina syndrome

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60
Q

Patient with disk herniation develops retention of urine sever pain and HBP

A

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

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61
Q

clue of cauda equina syndrome

A

anal sphincter tone will decrease because of nerve root injury

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62
Q

cause of neurologic deficit in herniated disk

A

spinal nerve inpingement

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63
Q

why elderly is prone to dehydration(3)

A

decrease thirst response to dehydration
impaired renal Na+ conservation
impaired renal ability concentration

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64
Q

rx of dehydration

A

crystalloid

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65
Q

why you should rehydrate elderly with caution

A

because sodium loading can unmask subclinical heart failure in elderly

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66
Q

4 types of renal stones(4)

A

calcium oxalate/phosphate
acid uric
struvite or triple phosphate
cysteine

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67
Q

most common type of stone

A

calcium stone

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68
Q

most common cause of calcium stones(7)

A 
idiopathic hypercalciuria
hyperuricosuria
hyperoxaluria
decrease urinary citrate
renal tubular acidosis
chronic decrease of urine output
hypercalciuria secondary to systemic disorder
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69
Q

quid idiopathic hypercalciuria(2)

A

hypercalciuria

normal calcemia

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70
Q

whaT’s the most common cause of hypercalciuria

A

idiopathic hypercalciuria

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71
Q

systemic disorder causing hypercalciuria(2)

A

primary hyperparathyroidism

sarcoidosis

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72
Q

causes of hyperoxaluria(4)

A

high vit C intake
high green leafy vegetables intake
IBD
short bowel syndrome

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73
Q

finding in renal tubular acidosis

A

nephrocalcinosis

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74
Q

hypercalciuria in Men

A

> 300 mg /24 H

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75
Q

hypercalciuria in women

A

> 250 mg/24 h

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76
Q

rx of stones induced by idiopathic hypercalciuria(3)

A

fluid intake
dietary Na+ restriction
thiazide or amiloride

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77
Q

action of thiazide(2)

A

decrease urinary calcium excretion

precent precipitation of calcium in urine

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78
Q

rx of stones induced by hyperuricosuria(2)

A

purine restricted diet

allopurinol

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79
Q

recommandation for rx of calcium stone what to restrict

A

Na+
oxalate
proteins

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80
Q

restriction of na+ in calcium stones

A
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81
Q

source of oxalate (3)

A

dark roughage
chocolate
vit C

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82
Q

protein source to avoid in calcium stone(4)

A

beef
poultry
eggs
fish

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83
Q

what to increase in rx of calcium stone

A

fluid

normal or high calcium intake

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84
Q

fluid to take during rx of calcium stone

A

> 3 l day

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85
Q

intake of calcium in rx of calcium stone

A

1000 mg daily

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86
Q

why furosemide is contraindicated in calcium stone

A

it increase excretion of calcium

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87
Q

first thing in acute non complicated calcium stone(3)

A

fluid
observation
analgesique

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88
Q

nephrotic syndrome tetrad

A

proteinuria > 3-3.5 g par 24 h
hypoalbuminemia
edema
hyperlipidemia and lipiduria

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89
Q

the most common manif of SN

A

proteinuria

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90
Q

basic pathology of SN

A

altered permeability of basement glomerular membrane

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91
Q

disease causing SN(5)

A

Minimal change
Membranous glomerulopathy
mesangial proliferative glomerulonephritis
membranous proliferative glomerulonephritis
glomerulosclerose focale et segmentaire

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92
Q

cause of hypercoagulability in SN(5)

A 
Loss of antithrombine 3
altered level of protein C et S
increased platelet aggregation
hyperfibrinogenemia
impaired fibrinolysis
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93
Q

why hyperfibrinogenemie

A

because of increase hepatic synthesis of fibrinogene

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94
Q

the most common manif of hypercoagulability in SN

A

renal vein thrombosis

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95
Q

why microcytic anemia in SN

A

because of loss of transferrin

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96
Q

complication of SN(5)

A 
microcytic anemia
VIT D deficiency
low thyroxin level
infection
malnutrition
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97
Q

why low vit D in SN

A

because of increase excretion of cholecalciferol binding protein

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98
Q

why low thyroxin level in SN

A

loss of thyroxin binding protein

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99
Q

protein transporter of fer

A

transferrin

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100
Q

protein transporter of T3 T4

A

thyroxin binding globulin

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101
Q

protein tranporter of vit D

A

cholecalciferol binding protein

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102
Q

why acute renal failure in cocaine abuse

A

rhabdomyolisis

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103
Q

rhabdomyolisis in acute renal failure

A

myoglobin causes acute tubular necrosis

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104
Q

red flag for acute tubular necrosis in cocaine abuse

A

CPK >20000

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105
Q

differentiate drugs induced renal failure and drugs induced intersticial nephritis(2)

A

no wbc in the urinary sediment in drug u=induced renal failure
as the opposite of intersticial nephritis induced by drug

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106
Q

drugs causing renal failure

A

aminoglycoside

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107
Q

what to do during administration of aminoglycoside(2)

A

monitor renal fonction

monitor drug level

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108
Q

patient with CRAB cause of that(2)

A

paraproteinemia=

Bencejones

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109
Q

other name of Multiple myeloma

A

kahler disease

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110
Q

why renal inssuficiency in MM

A

obstruction of distal and collectig tubules by bence jones protein

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111
Q

simple renal cyst on ct (4)

A

black mass with no multilocular
no septae intra the mass
on thickened wall
ono enhancement on CT

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112
Q

management of simple renal cyst(2)

A

observation

reassurance

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113
Q

most common cause of SN in hogkin lymphoma

A

minimal change disease

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114
Q

the best way to remove K+ in the body in case of Hyperkaliemia(3)

A

kayexalate
dyalisis
diuretics

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115
Q

what’s kayexalate(2)

A

cation exchange resin

Na+ entre K + sort

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116
Q

why amitryptiline can cause urinary retention(4)

A

anticholinergic effect
block detrusor contraction
prevent sphincter relaxation
no relaxation

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117
Q

why foley catheterization is important in urinary retention(2)

A

to provide symptomatic relief

to document retention

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118
Q

quid of priapism

A

painful and persistent erection

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119
Q

Med causing priapism(2)

A

trazodone

prazocin

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120
Q

disease causing priapism(2)

A

sickle cell disease

leukemia

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121
Q

quid of trazodone

A

it’s a anti depressant

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122
Q

diabetic patient with proteinuria possibilities(2)

A

infection

glomerular basement changes

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123
Q

the 2 presentations of diabetic nephropathy

A

nodular glomerulosclerosis

diffuse glomerulosclerosis

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124
Q

most common cause of nephropathy in diabetic

A

diffuse glomerulosclerosis

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125
Q

clue for UTI in urinalysis(2)

A

leucocyte esterase positive

nitrites

126
Q

quid of nitrites

A

presence of enterobacteriacea

127
Q

quid of leucocyte esterase

A

pyuria

128
Q

clue for chronic prostatitis(3)

A

voiding symptom

129
Q

why in SN you have accelarated atherosclerosis(3)

A

hyperlipidemia
High LDL
Low HDL

130
Q

risk in aptient with SN

A

MI

Stroke

131
Q

prevention rx of hyperlipidemia in SN

A

statin

132
Q

patient with HBP develops high creatine next step

A

abdominal US

133
Q

what to do ig in HBP US shows hydronephrosis

A

foley is mandatory

134
Q

how acyxclovir causes renal failure

A

renal tubular obstruction by crystalization of the drug in urine

135
Q

what the main risk factor for acyclovir causing renal failure

A

inadequate hydration

136
Q

specificity in urinalysis in colic nephretic(3)

A

wbc
rbc
no cast

137
Q

indication of EPO(2)

A

anemia in renal failure

less than 10 g HB

138
Q

side effect of EPO(4)

A

worsening HTA
headaches
flulike syndrome
red cell aplasia

139
Q

how to prevent HTA worsening in EPO administration

A

slow raising of HMt with a goal of 30-35%

140
Q

urinary retention with anticholinergic(4)

A

diphendramine
doxepin
hydroxyzine
chlorpheniramine

141
Q

the earliest abnormality seen in diabetics

A

glomerular hyperfiltration rate

142
Q

the earliest abnormality that can be quantified in diabetics

A

thickening of the basement membrane

143
Q

role of ACE inhibitor in the prevention of nephropathy in diabetics

A

decrease intra glomerular HTA

144
Q

prevention of acyclovir induced nephropathy

A

agressive hydration

145
Q

after coronary stenting patient develops blue toe and high creat cause?

A

cholesterol emboli by disruption of plaques

146
Q

clue cholesterol emboli inducing renal circulation problem and pedal circulation

A

elevated eosinophiles

low C3

147
Q

patient taking NSAIDS develops high creat

A

analgesic nephropathy

148
Q

physiopatho of analgesic nephropathy

A

papillary necrosis

chronic tubulointersticial nephritis

149
Q

danger of analgesic(3)

A

premature aging
UT cancer
atherosclerotic vascular disease

150
Q

HTA puls right sided renal bruit

A

stenose de l’artere renale

151
Q

rx of stenose of renal artery

A

percutaneous angioplasty with placement

152
Q

first cause of renal artery stenosis

A

fibro muscular disease

153
Q

HIV black with SN cause of that

A

focal segmental glomerulosclerosis

154
Q

2 causes of glomerular hematuria(2)

A

IGA nephropathy

GNA

155
Q

clue for IGA nephropathy(3)

A

upper respiratory infection
later hematuria
complement is normal

156
Q

painless hematuria in black

A

sickle cell trait

157
Q

cause of hematuria in sickle cell disease

A

papillary necrosis

158
Q

patient with HBP, gross and micro hematuria in smoker, next step

A

cystoscopy

159
Q

why you should ask for cystoscopy even if you suspect HBP

A

any hematuria and risk factor of bladder cancer,cystoscopy is mandatory

160
Q

what’s the most important risk factor for bladder cancer

A

smoking

161
Q

renal cause of hematuria(3)

A

CA
IGA nephropathy
GNA

162
Q

ureteral cause of hematuria(2)

A

stones

stricture

163
Q

bladder cause of hematuria(2)

A

ca

cystitis

164
Q

prostate and uretral cause of hematuria(2)

A

ca prostate

uretritis

165
Q

rsk factors for bladder cancer(6)

A 
cigarette
cyclosporine
painter
chronic cystitis
metal worker 
pelvic radiation
166
Q

the most common cause of death in patient on dyalisis

A

cardiovascular

167
Q

most common cause of death in renal transplant

A

cardiovascular

168
Q

patient with SN develops acute flanck pain in the right DX

A

renal vein thrombosis

169
Q

what the most comon disease causing SN

A

membranous glomerulonephritis

170
Q

most common cause of painless hematuria in adults

A

bladder cancer

171
Q

SRAA axis in hypovolemia(3)

A

angiotensine constrict efferent arterioles
prostaglandin dolate afferent arteriole
but if hypovolemia worsens this mechanism will fail and you will have damage in kidney

172
Q

why elderly in nursing room can easily develops prerenal azatemia(3)

A

because they are taking
Aspirin
Ace inhibitor
diuretics

173
Q

cause of epididymitis in elderly

A

E coli

174
Q

cause of epididymitis in sexually active individual(2)

A

chlamydia

gonorrhea

175
Q

symptom of epididimytis(2)

A

scrotal pain

irradiation in flank

176
Q

name two improtant caus of pulmonary renal syndrome(2)

A

wegener

good pasture

177
Q

rx in Wegener(2)

A

cycolphosphamide

steroids

178
Q

rx in goodpasture (2)

A

plasmapheresis

179
Q

why plasmapheresis in goodpasture

A

because of the presence of anti membrane basal antibody

180
Q

rx of uncomplicated cystitis(4)

A

nitrofurantoin
TMS
phosphomycin
fluoquinolones

181
Q

duration of rx of uncomplicated cystitis using TMS

A

3 jours

182
Q

indication ofquinolones in uncomplicated cystitis

A

if you cannot use the 3 first drug listed above

183
Q

meaning of complicated cystitis(3)

A

diabetes
immunosuppression
kidney disease

184
Q

RX of complicated cystitis

A

fluoquinolones

185
Q

indication of urine culture in uncomplicated cystitis

A

if rx fails

186
Q

patient renal failure taking metformin risk

A

lactic acidosis

187
Q

risk for metformin to induce lactic acidosis(3)

A

renal fialure
hepatic failure
sepsis

188
Q

clue for chlamydial uretritis(3)

A

mucopurulent discharge
no bacteria
sexual active individual

189
Q

clue for gonococcal uretritis

A

purulent discharge

190
Q

tetrad of amyloidosis(4)

A

hepatomegaly
renal problem
heart problem S4
maladie inflammatoire sous jascente

191
Q

finding in renal biopsy in amyloidosis ordinary microscopy

A

apple green birefringence under polarised light

192
Q

stain coloration for amyloidosis

A

congo red stain

193
Q

finding in renal biopsy in amyloidosis electronical microscopy

A

extra cellular or amyloid fibrils

194
Q

most common type of renal stones

A

oxalate calcium 75/90%

195
Q

cause of fat malabsortion

A

surgical ileal resection
chronic diarrhea
small bowel disease

196
Q

condition predisposing for renal calcium stones

A

fat malsorption

197
Q

why fat malabsortion causes renal oxalate calcium stones

A

because in fat mlabsorption, fat chelates calcium making oxalate free to be absorb

198
Q

stone in parathyroidism

A

calcium stone

199
Q

stone in chemo

A

acid uric stone

200
Q

cause of cysteine stone

A

inborn error of metabolism in children

201
Q

cause of struvite stone

A

proteus infection

202
Q

quid of hepato renal syndrome

A

renal failure in patient with cirrhosis

203
Q

rx of hepato renal syndrome

A

liver transplant

204
Q

cause of death in hepato renal syndrome(2)

A

hemmorrahe

infection

205
Q

most common cause of death in patient with hepatic failure

A

renal problem

206
Q

patient with long term renal failure best long term measure in management

A

tranplantation renal from living related donor

207
Q

what are the 2 options for end stage renal disease(2)

A

dyalisis

renal transplantation

208
Q

advantage of transplantation over dyalisis(4)

A

good quality of living and survival
anemia bone disease and HTA are well controlled
autonomic neuropathy is improved
better survival rate

209
Q

is dyalisis improves autonomic neuropathy in diabetics

A

no

210
Q

clue for alport syndrome(3)

A

high creat
deafness
hematuria

211
Q

biopsy finding in alport

A

foam cells

212
Q

electron microscopy in alport

A

alternating areas of thinned and tickened capillary loopswith splitting GBM

213
Q

cause of infertility in athlete

A

steroid abuse

214
Q

why steroid abuse causes of infertility in athlete(2)

A

blockage of GNRH release

no LH and FSH

215
Q

after renal transplantation patient develops oliguria

high BUN/CREAT DX(5)

A 
acute rejection
ureteral obstruction
cyclosporine toxicity
ATN
vascular obstruction
216
Q

after renal transplantation patient develops oliguria

high BUN/CREAT ,work up?(3)

A

US
biopsy
cyclosporine level

217
Q

rx of acute rejection

A

steroids IV

218
Q

biopsy in acute rejection

A

heavy lymphocyte infiltration and vascular involvementwith swelling of the intima

219
Q

test to do after renalm transplantation(4)

A

radfio isotope scanning
MRI
US
Biopsie renale

220
Q

prevention of contrast nephropathy(2)

A

hydration
or
acetylcysteine

221
Q

action of aqcetyl cysteine in caseof contrast nephropathy rx

A

vasodilation

antioxydant

222
Q

cause of painless hematuria(3)

A

analgesic
SCD
CA

223
Q

[hysiopatho of analgesic induced nephropathy

A

papillary necrosis
caused by vasoconstriction of medullary blood vessel
(vasa recta)

224
Q

most specific test to DX renal carcinoma

A

ct of abdomen

225
Q

work up for patient with HBP symptomatic first step(2)

A

creat

urinalysis

226
Q

work up for patient with HBP symptomatic creat and urinalysis anormal next step(2)

A

U/S
or
abdomen CT

227
Q

clue to differentiate prostatis from cystitis(2)

A

systemic symptom

boggy and tender prostate

228
Q

after urinalysis what’s the next step for prostatitis

A

midstream urine sample culture

229
Q

clue to differentiate acute from chronic prostatis

A

no systemic sympton in chronic prostatitis

230
Q

rx of acute prostatitis

A

TMS

231
Q

rx of chronic prostatitis

A

fluoquinolones

232
Q

rx of acute pericarditis in qacute renal failure

A

hemodyalisis

233
Q

clasic EKG findings in acute pericarditis(2)

A

ST and PR elevation in AVR

PR segment depression in other leads

234
Q

the best test to DX renal calculi

A

ct of abdomen

235
Q

xray of calcium stone

A

radioopaque

236
Q

xray of acid uric stone

A

radioluscent

237
Q

most beneficial next step in aptient with acid uric stone(2)

A

citrate de K+ to alkalinisation of the urine
or
bicarb K+

238
Q

people at risk for acid uric stone

A

low pH urine

239
Q

cause of low PH urine(2)

A

renal ammonia secretion deficit

hyperuricosuria

240
Q

patient with classic renal colic and negative xray

A

acid uric stone
calcium stone 1-3 mm
non stone cause

241
Q

nonstone cause of renal colic(2)

A

caillot

tumor

242
Q

what’s the target when alkalinisation of the urine

A

PH>6,5

243
Q

terminal hematuria(2)

A

bladder disease

prostate disease

244
Q

initial hematuria

A

uretritis

245
Q

total hematuria(2)

A

renal disease

ureter

246
Q

clue for renal hematuria

A

no clots

247
Q

best test for bladder cancer

A

cystoscopy

248
Q

clue for mixed essential cryoglobulinemia(3)

A

hematuria
proteinuria
palpable purpura

249
Q

what infectious test should be done if you suspect cryoglonulinemia

A

HCV serology

250
Q

why HCV serology in cryoglobulinemia

A

majority of patient have HCV infection

251
Q

complement in cryo

A

low

252
Q

most common cause of painlesss hematuria

A

bladder cancer

253
Q

BPH treatment(3)

A

doxazocin or
tamsulosin Alpha 1 blockers plus
finasteride

254
Q

quid of finasteride

A

5 alpha reductase inhibitor

255
Q

zone of prostate touched by BPH

A

transitionnal zone

256
Q

ALP in ca prostate

A

high

257
Q

rapid rx in hyperkalemia even if renal failure

A

gluconate de calcium

258
Q

next step after gluconate de calcium in hyperkalemia rx

A

remove calcium in the body

259
Q

EKG in hyperkaliemia(4)

A

peaked T waves
wide RQS complex
bradycrdia
no P waves

260
Q

cause of C3 levels(4)

A

immune complex reaction
GNA
cryoglobulinemia
membranous glomerulonephritis

261
Q

Clue for GNA(3)

A

hta
skin infection
low c3

262
Q

management of urolithiasis(3)

A

CT abdomen
analgesics
fluid > 2 l/jour

263
Q

when to refer urolithiasis in urologic physician(3)

A

anuria
sepsis
acute ranl failure

264
Q

grasseur of stone to be passed with hydration

A

less than 5 mm

265
Q

clue for ATN(3)

A

BUN/CREAT2

urine osmolarity 300-350(never

266
Q

what can cause ATN

A

prolonged hypotension

267
Q

hallmark of ATN

A

muddy brown cast

268
Q

quid of brown cast

A

renal tubular epithelial cells

269
Q

mechanism of cystitis

A

ascending infection

270
Q

role of sexual intercourse in cystitis(3)

A

massage uretral during sexual intercourse
entry of germs dans la vessie
honeymoon cystitis

271
Q

RBC cast

A

GNA

272
Q

WBC cast(2)

A

intersticial nephritis

pyelonephritis

273
Q

fatty cast

A

SN

274
Q

broad and waxy cast

A

chronic renal failure

275
Q

patient at risk for contrast nephropathy(2)

A

diabetics

Creat> 1,5

276
Q

what should be done to prevent contrast nephropathy(4)

A

nonionic contrast agent
acetylcysteine
good hydration

277
Q

SN with focal glomerulosclerosis(4)

A

african american
HIV
heroin use
obesity

278
Q

SN in hogkin(2)

A

minimal change
or
focal glomerulosclerosis

279
Q

pyelonephritis unresponsive to rx after 48 h

A

ask for CT or US

280
Q

why imagery in pyelonephritis unresponsive to rx after 48 h

A

rule out obstruction
or
abcess

281
Q

vascular changes in HTA(2)

A

atherosclerotic changes of afferent and efferent artery renal arterioles and glomerular capillar tufs
narrowing of renal arterioles with sclerosisand intimal tickening

282
Q

vascular changes in diabetics(4)

A

increased extra cellular matrix
basement membrane tickening
mesangial expansion
fibrosis

283
Q

clue for drugs induced intersticial nephritis(4)

A

eosiniphilia
hematuria
sterile pyuria
eosinophiluria

284
Q

in renal failure with platelet dysfunction ,bilan de coagulation

A

Pt,PTT normal

BT prolonged

285
Q

action of desmopressin in renal failure with platelet dysfunction(2)

A

release of factor 8

and v willebrand

286
Q

why platelet transfusion is not good in renal failure with platelet dysfunction

A

because transfused platelet will be inactivated

287
Q

important clue for renal carcinoma

A

unilateral varicocele that fails to empty when the patient is in recumbent position

288
Q

in rhabdomyolysis clue for myoglobinuria

A

large amount of blood in urinalysis with relative absence of RBC in microscopy(0-1 rbc)

289
Q

differentiate myoglubunuria from Hemoglobinuria

A

large amount of blood in urinalysis with relative absence of RBC in microscopy(0-1 rbc)=myoglobin

290
Q

rx of renla stone with hypercalciuria(3)

A

high fluid intake
sodium restriction
thiazide diuretic

291
Q

indication of amikacin in pyelonephritis

A

multi drug resistant pyelonephritis

292
Q

kahler disease(2)

A

plasma cells myeloma

Myelomatosis

293
Q

clue for malignant cystic mass(2)

A

thick and irregular wall
multiple septae
presence of contrast enhancement

294
Q

physical exam of urinary retention

A

tenderness and fulllness on palpation along the midline below the umbilicus

295
Q

why patient with SN is at risk for MI and stroke(2)

A

hypercoagulable state

accelerated etherosclerosis

296
Q

hallmark of diabetic nephropathy

A

nodular glomerulosclerosis

297
Q

diabetes with proteiunuria and UTI you treat the UTI proteinuria still persist

A

glomerular basement membrane damage

298
Q

drugs causing crystal induced nephropathy(5)

A 
acyclovir
sulfonamides
methotrexate
ethyleneglycol
protease inhibitor
299
Q

anemia in renal insufficiency(2)

A

normochromic

normocytic

300
Q

cause of hematuria in AF

A

papillary necrosis

301
Q

any hematuria with no glomerular involvement plus risk factor of bladdder cancer

A

cystoscopy

302
Q

when to avoid nitrofurantoin in the rx of uncomplicated cystitis

A

clearance creat

303
Q

contraindication of metformin(2)

A

sepsis
renal failure
hepatic failure

304
Q

clue for chlamydial uretritis(3)

A

Multiple sexual partners
absent bacteriuria
mucopurulent discharge

305
Q

finding in amyloidosis

A

renal amyloid deposit showing apple green birefringence under polarised light after congo red stain ing

306
Q

clue for hepatorenal syndrome(2)

A

high creat in patient with cirrhosis

no improvement of creat value after fluid resuscitation

307
Q

indication of hemodyalisis(7)

A 
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
Q

first in hyoerkaliemia(2)

A

gluconate de calcium

later use insulin and/orsodium polystyrene sulfonate

309
Q

first episode of renal stone management

A

hydration

no further metabolic work up is required

310
Q

mady having sex for the first time ,days later develops urinary symptom

A

honeymoon cystitis

311
Q

cause of honey moon cystitis

A

sexual intercourse introduces bugs directly in bladder

312
Q

size of kidney in HTA

A

small size

► Med - Step 2 (20 decks)

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