GI/GU

Question 1

The causes of acute kidney injury (aki) can be divided into 3 categories. what are they?

Answer 1

pre renal
renal
post renal

Question 2

explain the difference between pre renal, renal and post renal causes

Answer 2

pre renal: caused my decreased renal perfusion; often because of volume depletion
renal: caused my process within the kidney
post renal: caused my inadequate drainage if urine distal to the kidneys

Question 3

examples of conditions that cause pre renal aki:

Answer 3

dehydration
heart failure
liver failure

Question 4

examples of conditions that cause intrinsic renal aki:

Answer 4

glomerular nephritis
acute tubular necrosis (caused by rhabdo, sepsis, prolonged pre renal aki)
hypertensive emergency

Question 5

examples of conditions that cause post renal aki:

Answer 5

ureteral obstruction ( requies bilateral obstruction)
UTI
neurogenic bladder
benign prostatic hypertrophy

Question 6

Causes of peritonitis

Answer 6

-infection of abdominal cavity usually caused my cirrhosis or ascites
-organ perforation in abdomen
- obstruction or hole in intestines

Question 7

What is appendicitis?

Answer 7

acute inflammation of the appendix, resulting in abdo pain, anorexia. treatment is removal of appendix

Question 8

what is acute pyelonephritis?

Answer 8

kidney infection - bacteria causes kidney inflammation
- one of most common kidney diseases
-generally occurs as complications of ascending UTI

Question 9

what is acute pyelonephritis?

Answer 9

kidney infection - bacteria causes kidney inflammation
- one of most common kidney diseases
-generally occurs as complications of ascending UTI

Question 10

Acute pyelonephritis will commonly present as what triad of symptoms?

Answer 10

-fever
- flank pain
- nausea and vomiting

Question 11

most common bacteria in acute pyelonephritis?

Answer 11

e.coli

Question 12

true or false :

in acute pyelonephritis, rebound, guarding and rigidity are typically absent

Answer 12

True

Question 13

What is one main difference in asessment/presentation between acute renal colic and acute abdomen?

Answer 13

acute renal colic patients will be in extreme pain, and won’t be able to find comfortable spot, whereas
acute abdomen, patients will want to lay completely still

Question 14

How do NSAIDS work for renal colic? (2 ways)

Answer 14

• decrease production of aracadonic acid which mediate pain receptors which alleviates pain caused by distention of renal capsule
  -block prostaglandins which decreases pain receptor activity and reduces ureteral contractions. they also contraxt the efferent arterioles of glomerulus causing reduction in GFR

Question 15

define DKA

Answer 15

potentially life threatening complications of diabetes mellitus resulting from insulin deficiency

Question 16

diagnostics for dka

Answer 16

pH <7.3
ketosis (ketonemia or ketonuria)
HC03 <15mmol/L due to high anion gap metabolic acidosis
hyperglycemia (may be mild/euglycemic dka)

Question 17

What is pancreatitis

Answer 17

Inflammation of the pancreas. can be acute or chronic

Question 18

2 common causes of pancreatitis

Answer 18

-etoh abuse
- gall stones

Question 19

what is Kehr’s sign, and what does it typically indicate ?

Answer 19

referred pain to the left shoulder on palpation of abdomen. typically indicates splenic rupture

Question 20

What is grey turner sign, and what does it normally indicate?

Answer 20

eccymosis or discoloration at the flank. typically indicates severe necrotizing pancreatitis

Question 21

what is Cullen sign, and what does it normally indicate ?

Answer 21

eccymosis in the perumbilical region. typically indicates hemorrhagic pancreatitis