Glom/Polycyst Kidneys

Question 1

Renal pain usually where?

Answer 1

ipsilat CVA

can radiate to testes/labium

Question 2

Ureteral pain usually from what?

Answer 2

result of obstruction

(U) acute

Question 3

Vesical (bladder) pain usually from/where?

Answer 3

acute urinary retention

suprapubic

Question 4

Prostatic pain usually from/where?

Answer 4

inflamm

perineum

Question 5

Penile pain (U) from?

Answer 5

inflamm from STD

Question 6

Testicular pain (U) from?

Answer 6

acute conditions (i.e. torsion)

Question 7

Hematuria in adults considered what?

Answer 7

malignancy until proven otherwise

Question 8

Initial Hematuria is?

(U) from?

Answer 8

blood at start of stream

(U) urethral

Question 9

Terminal Hematuria is?

(U) from?

Answer 9

blood at end of stream

(U) bladder neck, prostate

Question 10

GFR dependent on what? (2)

Answer 10

Permeability of capillary to water/solutes,

Surface area of capillary

Question 11

GFR drops how much every year > 40?

Answer 11

1%

Question 12

GFR rate?

Answer 12

Male: 125 ml/min
Female: 115 ml/min

Question 13

Creatine made where/from?

Answer 13

liver

arginine/glycine

Question 14

Creatine primarily stored where?

Answer 14

muscles (98%)

Question 15

Urea is?

Made where/from?

Answer 15

Nitrogen-containing metabolite

liver
degration of protein

Question 16

Urea prdxn depends on what? (3)

Answer 16

1) protein in diet
2) catabolic states
3) liver fxn

Question 17

[Urea] response to renal dz-caused decrease in GFR how?

Answer 17

↑

Question 18

What drugs may cause Hematuria?

Answer 18

Anticoag
Analgesic abuse (papillary necrosis)

Question 19

Volume overload categorized into what two things?

Answer 19

Obstructed venous return (venous stasis)

Systemic processes (CHF, cirrhosis, neph synd)

Question 20

If edema goes away in the a.m., what is the cause?

Answer 20

venous stasis

Question 21

Dehydration is?

Volume depletion is?

Answer 21

loss of pure H2O

loss of Na+ and H2O

Question 22

Differentiate b/w dehyd and volm dep how?

Answer 22

check urine sodium

Question 23

HypoNa+ is?

Answer 23

serum Na+ < 130

Most (C) electrolyte imbalance in hospitalized pts

Question 24

HypoNa+ clinical presentation?

Answer 24

↓ serum osmo w/ ↑ urine osmo
No cardiac/renal/liver dz
Normal thyroid/adrenal fxn

Question 25

Asympt HypoNa+ tx?

Answer 25

SLOWLY H2O restriction Normal saline w/ Lasix (loop)

Question 26

Hypertonic hypoNa+ U seen w/?

Answer 26

hyperglycemia

Question 27

HyperNa+ U prevented by what mechanism?

Answer 27

thirst

Question 28

HyperNa+ from dehydration presentation?

Answer 28

ortho hypoTN | oliguria

Question 29

DI present w/ urine osmo of what?

Answer 29

< 250 + hyperNa+

Question 30

HypoK+ presentation?

Answer 30

mm weakness, fatigue, cramps | Long T, U, depressed ST

Question 31

HypoK+ tx?

Answer 31

oral/IV K+ | check Mg if not improving

Question 32

HyperK+ presentation?

Answer 32

mm weakness, GI | Tall T, wide QRS

Question 33

HyperK+ tx, first step?

Answer 33

Rerun test | Stop any K+ sparing/containing meds

Question 34

HyperK+ tx, toxicity?

Answer 34

Insulin + D50W Abuterol Hemodialysis (if renal insuff)

Question 35

HypoCa2+ is most C cause of what?

Answer 35

renal failure

Question 36

HypoCa2+ presentation?

Answer 36

mm spasm Chovostek/Trousseau Wide QT

Question 37

HypoCa2+ tx?

Answer 37

Oral/IV Ca2+

Question 38

HyperCa2+ U caused by?

Answer 38

hyperPTH | *always check PTH levels!

Question 39

HyperCa2+ presentation?

Answer 39

constipation, polyuria | stupor, coma

Question 40

HyperCa2+ tx?

Answer 40

Saline + Lasix

Question 41

HyperCa2+ tx if caused by malignancy?

Answer 41

bisphosphates

Question 42

Glomerulonephritis classifications? (2)

Answer 42

1) Renal abnormalities only | 2) Caused by systemic dz (i.e. lupus, DM)

Question 43

Glomerulonephritis U caused by?

Answer 43

Immune complexes (IgA nephropathy AKA Berger's)

Question 44

Other causes of Glomerulonephritis?

Answer 44

Malig HTN | Hemolytic-Uremic synd

Question 45

Glomerulonephritis lab results?

Answer 45

RED CELL CASTS hematuria proteinuria (precedes appearance of blood)

Question 46

Berger's presents in adults? In children?

Answer 46

asympt microscopic (not visible) hematuria gross (visible) hematuria following URI

Question 47

Henoch-Schonlein Purpura is? Presents as?

Answer 47

most C systemic vasculitis in kids IgA neph skin, arthralgia, GI

Question 48

Glomerulonephritis caused by Group A beta-hemolytic Strep epidemiology? Lab results? Tx?

Answer 48

(U) kids, winter ASO titers supportive

Question 49

Wegener's granulomatosis is? Lab results? Other sxs?

Answer 49

systemic vasculitis + ANCA pulmonary hemorrhage

Question 50

Goodpasture's Synd is? Lab results? Other sxs?

Answer 50

systemic vasculitis Anti-glom basement memb antibody pulmonary hemoptysis

Question 51

Glomerulonephritis physical exam findings?

Answer 51

``` COLA-COLORED URINE Red cell casts HTN Periorbital/Sacral edema Oliguria ```

Question 52

Glomerulonephritis lab tests?

Answer 52

UA = red cell casts, (P) proteinuria Cr BUN Strep (ASO titer) Blood cx in febrile pts

Question 53

Glomerulonephritis tx?

Answer 53

No Na+, K+ Fluid restrict Loops Steroids

Question 54

Polycystic Kidney Disease epidemiology? Presentation?

Answer 54

20 - 40 yo 90% inherited Pain (most C complaint) Palpable flank mass HTN (reduced RAAS fxn) STONES

Question 55

Polycystic Kidney Disease labs?

Answer 55

Hgb/Hct (anemia from ↓ erythropoietin pdx or from chronic dz) Electrolytes BUN, Cr UA (protein/blood) Erythropoietin

Question 56

Polycystic Kidney Disease imaging?

Answer 56

Abd renal US

Question 57

Polycystic Kidney Disease tx?

Answer 57

Stones: litho, IV/PO fluids HTN: ACE Avoid contact sports: rupture kidney cysts