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Step Up to USMLE Step 2 > Genitourinary disorders > Flashcards

Genitourinary disorders Flashcards

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USMLE® Step 1 flashcards
1
Q

what is the only segment of the nephron loop that is permeable to water?

A

descending limb (medulla)

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2
Q

__________ cells drive sodium reabsorption and potassium secretion when stimulated by aldosterone

A

principal

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3
Q

__________ cells secrete protons and reabsorb potassium

A

intercalated

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4
Q

principal cells drive ________ reabsorption and __________ secretion when stimulated by aldosterone

A

sodium, potassium

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5
Q

intercalated cells secrete _________ and reabsorb ___________

A

potassium

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6
Q

which type of stones are radiolucent?

A

uric acid

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7
Q

how do you treat uric acid stones?

A

alkalinize urine

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8
Q

what is the pharm therapy for adult polycystic kidney disease?

A
  • vasopressin receptor antagonists
  • amiloride

prevent collection of fluid in cysts

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9
Q

subepithelial humps?

A

post strep glomerulonephritis

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10
Q

split basement membrane on EM?

A

alport syndrome

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11
Q

spike and dome basement membrane thickening?

A

membranous nephropathy

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12
Q

which type of nephrotic syndrome is associated with hep B and C?

A

membranous

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13
Q

treatment for membranoproliferative GN?

A

corticosteroids combined with either ASA or dipyridamole

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14
Q

treatment for amyloidosis GN?

A
  • melphalan
  • HSC transplant
  • renal transplant
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15
Q

prerenal azotemia FENa = ?

A

less than 1%

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16
Q

ATN FENa = ?

A

over 2%

17
Q

what is the equation for FENa?

A

[(urine Na / serum Na)] / [(urine Cr / serum Cr)]

18
Q

RTA leads to a(n) _______________ (anion / non-anion) gap metabolic acidosis

A

non-anion

19
Q

what is the defect in type 1 RTA?

A

impaired proton secretion leading to secondary hyperaldosteronism

20
Q

what differentiates type 1 RTA from the others?

A

urine pH OVER 5.3

21
Q

what is the treatment for type 1 RTA?

A
  • oral bicarb
  • potassium
  • thiazide diuretics
22
Q

what is the defect in type 2 RTA?

A

bicarb reabsorption defect

23
Q

what differentiates type 2 RTA from the others?

A

bone lesions on x-ray

24
Q

what is the treatment for type 2 RTA?

A
  • oral bicarb
  • potassium
  • thiazide or loop diuretic
25
Q

what is the defect in type 4 RTA?

A

primary or secondary hyperaldosteronism

26
Q

what differentiates type 4 RTA from the others?

A

HYPERKALEMIA (and high Cl)

27
Q

what is the treatment for type 4 RTA?

A
  • fludricortisone

- potassium RESTRICTION

28
Q

in a healthy person, serum pH is regulated by _____ reabsorption in the ___________ and blood _______

A
  • bicarb in the proximal tubule

- pCO2

29
Q

normal anion gap suggests a loss of ________

A

bicarb

30
Q

increased anion gap acidosis suggests _____ excess

A

proton

31
Q

how do you determine the approximate required correction of sodium in a patient with purely fluid losses as the cause of hypernatremia?

A

water deficit = total body water x ([Na]/140 - 1)

*total body water = 0.60 x mass in kg

**half is given in 24 hrs in addition to maintenance fluids, remainder is given over following 24-48 hrs

32
Q

how do glucocorticoids treat hypercalcemia (severe cases)?

A

decrease intestinal absorption

33
Q

lower limit of normal Ca2+ decreases _____ mg/dL for each 1g/dL albumin under 4

A
  1. 8

* ionized calcium will not be affected by albumin levels

34
Q

in men, purulent urethral discharge is seen with what organism?

A

n. gonorrhoeae

35
Q

what type of culture is used for n. gonorrhoeae?

A

thayer martin

36
Q

which type of testicular tumor requires radical orchiectomy with the possibility of retroperitoneal lymph node dissection?

A

nonseminomatous (early stage)

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