GU Flashcards
etiologies of primary nephrotic syndrome
Min change dz FSGS membranous
etiologies of secondary nephrotic syndrome
DM (mc overall cause in adults) SLE amyloidosis
PE sg/sx of nephrotic syndrome
Edema, worse in the morning. In children periorbital edema. Anemia DVT
dx of nephrotic syndrome
24hr uring protein of >3.5 is gold standard oval fat bodies, or maltese cross shaped on urinalysis renal bx differentates type
Define nephrotic syndrome
Proteinurina, hypoalbuminemia, hyperlipidemia, edema Glomerular damage cases large tubular protein loss into the urine
Maltese cross makes you think of
Nephrotic syndrome
Minimal change dz and FSGS tx
Steroids
AGN etiologies
IGA nephropathy (Berger dz) Postinfectious AGN Membrano proliveraitive GN
When does postinfectious AGN occur?
After GABHS
Classic sx of 2-14 yo boy w/ puffy eyelids and facial edema up to 3 weeks after strep with cola-colored urine
Post infectious GN
HTN hematuria , dependent edema and azotemia, oliguria are the hallmarks of which GU d/o
AGN
RBC casts make you think of?
AGN
Muddy brown or epithelial cell casts
ATN
White blood cell casts, pyuria
AIN or pyelo
Waxy casts
Chronic ATN or end stage renal dz
Fatty casts (maltese crosses/oval fat bodies)
Nephrotic syndrome
Hyaline casts
Nonsepc.
lab indications of AKI
Inc Serum creat >50%, OR BUN
What are the three types of AKI?
Pre-renal Post-renal Intrinsic
Prerenal AKI is the result of what?
Reduced renal perfusion
Post renal AKI is result of what?
Obstruction of urine (stone)
what is the most common type of kidney stone?
Calcium
What is the most specific imaging modality for kidney stones?
CT
A kidney stone of less than what size will likely pass on it’s own?
5mm
List 3 possible treatments for stress incontinence in women
Kegels estrogen tx surgical tx w/ ureteral sling
65 yo male presents with frequency. On DRE you feel an elastic moderately enlarged prostate. What is the most likely dx
BPH
PSA above what level is concerning
>4.0
2 major rf’s for ED
DM HTN
rf for bladder ca
Smoking
Paraphimosis
Foreskin is retracted and cannot be reduced
Which is an emergency phimosis or paraphimosis
Paraphimosis
What is the name of the condition that involves fibrous scar tissue in the penis causing curvature of the erect penis
Peyronie’s dz
Bot desticles should be descended by what age?
3mo
Bag of worms on exam
Varicocele
Fluid filled painless mass found in the scrotum which transilluminates should make you think of what?
hydrocele
Does spermatiacele transilluminate
yes
What is 1st line tx for varicocele
Watchful waiting unless there is a question of fertility
name the sign which is defined as dec pain w/ scrotal elevation
Prehn’s sign
Maltese cross in urine
Nephrotic syndrome
What is imaging study of choice if you suspect bladder ca
cystoscopy w/ bx
What is the most likely dx for a free floating painless, cystic mass found post and superior to testes?
spermatocele
Whta age ragne is assoc. with test torsion
10-20yo
Where is the epididymis found?
posterior upper pole
What is the best imaging to r/o test. torsion
Doppler US
What are 2 most common causes of epididymitis
N. Gonorrhea and Chlamydia
What meds are prescribed in order to help prevent chronic renal failure in diabetic pts
Acei or ARB
Whill epididymitis feel better w/ scrotal elevatio
yes
What is the normal level of sodium bicarb
24mEq/liter
What is the tx for epididymitis
Ceftriaxone and doxycycline
What is first line abx tx for cyctitis
Bactrim
What is most common organsim that causes a bladder infection
E. coli
Tenderness at the CVA shopuld make you think of what?
pyelonephritis
What is the condition where the urethral meatus is not at the tip of the penis
hypospadias or epispadias (hypo more common)
What is the most common org responsibble for prostatitis
E coli
What is the first line abx for prostatitis
Bactrim 4-6wks
RF for prostate ca
Age AA + fam hx High fat diet
DRE of pt w/ prostate ca
Enlarged prostate, nodules w/in prostate
Define priapism
painful persistent erection
Prostate bx consists of how many samples
6-12
Painless hematuria should make you think of what?
Bladder CA
What is the most common bladder ca?
transitional cell
define phimosis
foreskin can’t be retracted
How do you tx urethritis
ceftriaxone and doxy
3 year old boy presents w/ hematuria and painless palpable abd mass
wilms tumor
3 causes of prerenal renal failure
CHF Dehydration Hemorrhage
MC cause of postrenal failure
BPH (outflow obstruction
Muddy brown sediment in the urine should make you think of what?
ATN
Tea colored urine w/ red cell casts should make you think of what
Glomerulonephritis
What are the two most common predisposing fx in development of CRF
HTN and DM
Spongey prostate on DRE
Prostatits
Serum potassium would be elevated or dec in renal failure
elevated
Uprotein of >3.5g
Nephrotic syndrom
What hereditary pattern does polycistic kidney dz follow?
AD
ABG pH
7.35-7.45
What is the most accuarate way to dx urethritis
Urine PCR
What is considered normal PCO2
40mmHg
ABG shows a pH of 7.2 a bicarb of 25 and PCO2 of 50 is this respiratory or metabilic acidosis
Resp - CO2 is elevated
WBC casts should make you thnk of what dx
Pyelonephritis
PRiamry site for prostate ca
Peripheral zone
Tx for BPH
Alpha blockers 5 reductase inhibitors Surgery (TURP)
which BPH med provides sx relief but does not improve the clinical course
a1 blockers
Which BPH med provides improvement of the clinical course but no immediate sx improvement
5a reductase inhibitors
What medications should be avoided in pt’s with BPH
anticholinergics and antihistamines
chryptorchidism
undescended testicle
What are people with Cryptorchidism more at risk for?
testicular cancer
at what age is orhciopexy recommended for cryptorchidism?
6mos (and before 1 year)
Most cryptorchidisms resolve by what age?
3mos
What mechanism of action provides relief in pt’s with ED
PDe5 inhibitors inc NO levels and cGMP
Who should not use PDE5i?
pt’s who use nitrates or patients w/ cardiovascular dz