GU 2 (Step up son) Flashcards

1
Q

A patient comes in with symptoms of acidosis. She has had multiple kidney stones and is found to have a urine pH >5.3 (nml 4.5-8). What is the likely problem? What is seen on labs? What can be done?

A

Distal (type 1) renal tubular acidosis…impaired H+ secretion

Low K+
Variable bicarb

Oral bicarb, K+, thiazide

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2
Q

A patient comes in with symptoms of acidosis and bone pain. She is found to have bone lesions. UA shows a urine pH less than 5.3. What could be going on? What would be seen on labs? What can be done? What other syndromes/diseases could this person have?

A

Proximal (type 2) renal tubular acidosis…impaired bicarb reabsorption

Low K+
Low bicarb

Oral bicarb, K+, thiazide or loop

Multiple myeloma, Fanconi syndrome, Wilson disease, amyloidosis, Vitamin D deficiency, autoimmune diseases

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3
Q

A diabetic patient comes in with symptoms of acidosis and is found to have a urine pH less than 5.3 and a high K+ and Cl-. What could be the cause? What should the treatment be?

A

Low Renin/Aldosterone (type 4) renal tubular acidosis…primary or secondary hypoaldosteronism

Treat with fludrocortisone
K+ restriction

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4
Q

The ol’ delta-delta is used to determine if there is only an anion gap acidosis or if there are multiple things going on. How is the delta-delta determined? What are the indications?

A

Corrected HCO3 = measured gap - normal gap…12 + measured HCO3

if the corrected HCO3 is:
Within normal range –> only an anion gap acidosis
Above normal range –> mixed w/ metabolic alkalosis
Below normal range –> mixed w/ non-gap acidosis

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5
Q

There can be mixed metabolic/respiratory conditions. How can an additional respiratory condition be determined with a metabolic acidosis?

A

Expected pCO2 = 1.5(HCO3) + 8 +/-2
Actual less than expected –> additional resp alk
Actual greater than expected –> additional resp acid

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6
Q

There can be mixed metabolic/respiratory conditions. How can an additional respiratory condition be determined with a metabolic alkalosis?

A

pCO2 greater than 50 –> additional resp acid

pCO2 less than 40 –> additional resp alk

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7
Q

What are the common causes of a UTI?

A
E. coli
Staph sapro
Proteus
Klebsiella
Enterobacter
Pseudomonas
Enterococcus
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8
Q

How is a UTI treated?

A

Amox, bactrim, or a fluoro for 3 days…14 days if relapse

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9
Q

How is urge incontinence treated?

A

Bladder training

Antimuscarinics (oxybutynin, tolterodine, solifenacin)

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10
Q

How is stress incontinence treated?

A

Therapy…weight loss, Kegel exercises

Midurethral sling

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11
Q

Who gets overflow obstruction?

A

Often men…BPH, urethral strictures

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12
Q

Patient comes in with hematuria. Has a hx of treated bladder cancer. What is an option?

A

Recurrence of bladder cancer…happens frequently

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13
Q

Growth on Thayer-Martin culture indicates what?

A

N. gonorrhea

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14
Q

Which STD can be confirmed with nucleic acid amplification?

A

Chlamydia

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15
Q

How is GC treated?

A

Single dose ceftriaxone with doxy or azithromycin

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16
Q

What is the most common cause of prostatitis? How is it treated?

A

Nonbacterial is more common

Still treat with bactrim for 4-6 weeks…also treat for STD if sexually active

17
Q

What is the most common non-derm cancer in men? Which cancer causes the most deaths?

A

Prostate cancer is more common than lung

Lung kills more than prostate…but prostate is second

18
Q

How can epididymitis be differentiated from testicular torsion?

A

Support the sack…pain goes away = epididymitis

19
Q

How is epididymitis treated?

A

Ceftriaxone and doxy or fluoroquinolone

NAIDs and sack support if non-infectious cause

20
Q

Where does a Wilms tumor originate? Who gets a Wilms tumor? What is often seen with a Wilms tumor?

A

Renal origin

Children less than 4yo

WAGR
     W- Wilms tumor
     A- Aniridia
     G- GU abnormalities
     R- Retardation
21
Q

Boy is born with hypospadias. Should the urethra be corrected before or after circumcision?

A

Before

22
Q

What is enuresis?

A

Nocturnal bed wetting…usually resolves by 4yo