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GU Flashcards

1
Q

EKG changes: Name the electrolyte disorder which causes prolonged PR interval widened QRS.

A

Hypermagnesemia

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2
Q

EKG changes: Name the electrolyte disorder which causes long QT.

A

Hypocalcemia

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3
Q

EKG changes: Name the electrolyte disorder which causes flattened T waves U waves.

A

Hypokalemia

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4
Q

EKG changes: Name the electrolyte disorder which causes short QT.

A

Hypercalcemia

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5
Q

EKG changes: Name the electrolyte disorder which causes tall T waves.

A

Hypomagnesemia

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6
Q

EKG changes: Name the electrolyte disorder which causes peaked T waves

A

Hyperkalemia

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7
Q

Which electrolyte abnormality do spironolactone and ACE inhibitors predispose a patient to?

A

Hyperkalemia

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8
Q

What does the “S” in MUDPILES (causes of metabolic acidosis) stand for?

A

S : salicylates

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9
Q

What does the “E” in MUDPILES (causes of metabolic acidosis) stand for?

A

E : ethylene glycol

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10
Q

What does the “L” in MUDPILES (causes of metabolic acidosis) stand for?

A

L: lactic acidosis

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11
Q

What does the “I” in MUDPILES (causes of metabolic acidosis) stand for?

A

I : idiopathic

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12
Q

What does the “P” in MUDPILES (causes of metabolic acidosis) stand for?

A

P : paraldehyde

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13
Q

What does the “D” in MUDPILES (causes of metabolic acidosis) stand for?

A

D : diabetes

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14
Q

What does the “U” in MUDPILES (causes of metabolic acidosis) stand for?

A

U : uremia

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15
Q

What does the “M” in MUDPILES (causes of metabolic acidosis) stand for?

A

M : methanol

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16
Q

MUDPILES is used to describe the causes of which acid base disorder?

A

Causes of metabolic acidosis

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17
Q

What electrolyte disorder may occur after a large blood transfusion?

A

Hypocalcemia

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18
Q

Osteitis fibrosa cystica or Brown tumors occur with which electrolyte disorder?

A

Hypercalcemia

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19
Q

How will high glucose levels change sodium levels on lab values?

A

Serum sodium is decreased with high serum glucose

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20
Q

Which disorder has oval fat bodies in the urine?

A

Nephrotic syndrome

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21
Q

Is the FENa (fractional excretion of sodium) low normal or high in acute tubular necrosis?

A

High

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22
Q

Is the FENa (fractional excretion of sodium) low normal or high in pre renal failure?

A

Normal

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23
Q

What are the CT findings expected with pyelonephritis?

A

Perinephric stranding

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24
Q

What procedures can assist in confirming the diagnosis of interstitial cystitis?

A

Urodynamics - Cystoscopy with hydrodistention of bladder

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25
Q

What is a blue dot sign associated with?

A

Torsion of the appendix testis (paratesticular nodule superior aspect of testicle)

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26
Q

How are pain and cremasteric reflex different in testicular torsion vs. torsion of the appendix testis?

A

Torsion has diffuse pain and absent cremasteric - Appendix testis has superior testicle pain and + cremasteric

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27
Q

When would you use an open book procedure?

A

Testicular torsion (Refers to manually turning and lowering the testicle to relieve the torsion)

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28
Q

What modality should be used to diagnose testicular torsion?

A

Ultrasound with Doppler

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29
Q

What is a + transillumination of the scrotum associated with?

A

Hydrocele

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30
Q

What disorder is likely with severe testicular pain and a negative Phren’s sign?

A

Testicular torsion (Elevation of the testicle does not change the pain)

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31
Q

Describe a positive Phren’s sign.

A

Elevation of the testicle relieves the pain

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32
Q

What disorder is Phren’s sign associated with?

A

Epididymitis

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33
Q

What GU disorder is LeRiche syndrome associated with?

A

Erectile dysfunction

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34
Q

What other electrolyte must be corrected in the treatment of hypokalemia?

A

Magnesium

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35
Q

What is the most common electrolyte abnormality with furosemide or bumetanide?

A

Hypokalemia

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36
Q

What electrolyte abnormality potentiates the cardiac toxicity of digoxin?

A

Hypokalemia

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37
Q

List dietary modifications for chronic kidney disease

A

Restrict protein sodium potassium and fluid intake

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38
Q

What urinalysis findings are consistent with acute tubular necrosis?

A

Muddy casts and renal tubular cells

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39
Q

What is the most likely cause of acute tubular necrosis in a patient who has recently used cocaine?

A

Rhabdomyolysis

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40
Q

Which type of acute renal injury is most likely following injection of radio contrast dye?

A

Acute Tubular Necrosis (ATN)

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41
Q

What is the most common cause of prerenal failure?

A

Dehydration

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42
Q

What is the most likely underlying disorder in a patient who develops acute renal failure after initiation of an ACE inhibitor?

A

Renal artery stenosis

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43
Q

What are the two most common long term complications of polycystic kidney disease?

A

Hypertension and renal failure

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44
Q

What renal disorder is linked to cerebral aneurysm?

A

Polycystic kidney disease

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45
Q

What type of tumor is the most common renal cancer found in children?

A

Wilms Tumor

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46
Q

What are flank pain hematuria and a palpable abdominal/renal mass hallmark signs of?

A

Renal cell carcinoma

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47
Q

What is the most common causative factor for bladder cancer?

A

Smoking

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48
Q

What non-infectious disorder causes cystitis in response to specific foods?

A

Interstitial cystitis

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49
Q

What is the most common type of incontinence?

A

Mixed (both stress and urge)

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50
Q

What type of incontinence results from an over active detrusor muscle?

A

Urge incontinence

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51
Q

What type of incontinence results from activity such as laughing or coughing?

A

Stress incontinence

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52
Q

Sudden onset of severe testicular pain which does not alleviate with elevation of the testicle?

A

Testicular torsion

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53
Q

Name two disorders which may cause orchitis in children?

A

Mumps and brucellosis infections

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54
Q

What hematological disorder may cause priapism?

A

Sickle cell crisis

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55
Q

What medication classes can not be taken with PDE5 inhibitors?

A

Nitrates or alpha blockers (May result in hypotension)

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56
Q

What are the most common causative agents for prostatitis in an 15-30 year old male?

A

Chlamydia and/or gonorrhea

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57
Q

What is the most common causative agent for prostatitis in an elderly male?

A

What is the most common causative agent for prostatitis in an elderly male?

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58
Q

What surgical procedure is most commonly used in patients with BPH who fail pharmacological treatment?

A

Transurethral Resection of the Prostate (TURP)

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59
Q

What counseling must be given to a patient who is started on doxazosin terazosin or prazosin?

A

Take while sitting on bed prior to sleep to avoid orthostatic hypotension

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60
Q

What is the most common type of renal calculus in children?

A

Cystine

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61
Q

Which type of renal calculus is highly associated with chronic infection?

A

Struvite

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62
Q

What are the 3 electrolyte abnormalities which occur with tumor lysis syndrome?q

A

Hyperkalemia -Hyperuricemia - Hyperphosphatemia

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63
Q

What nephropathy is associated with lupus?

A

Membranous nephropathy

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64
Q

Most common histology of bladder cancer?

A

Transitional cell carcinoma

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65
Q

What is the Dx? Hematuria flank pain and a palpable flank mass.

A

Renal cell carcinoma

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66
Q

What is the Dx? Eosinophils in the urine sediment.

A

Allergic interstitial nephritis

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67
Q

What are the 2 most common types of nephrotic syndrome?

A

Focal Segmental Glomerulosclerosis (FSGS) - Membranous glomerulonephritis

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68
Q

What is the most common type of nephrolithiasis?

A

Calcium oxalate

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69
Q

Ventricular septal defect -Atrial septal defect -Patent ductus arteriosus

A

Malignancy and hyperparathyroidism

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70
Q

What is the Dx? Hypernatremia and azotemia.

A

Most likely dehydration

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71
Q

“Doughy skin” with skin tenting may represent which electrolyte abnormality?

A

Hypernatremia

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72
Q

The recommended age to start annual prostate screening?

A

White male average risk: 50 years old - Black male, + FMHX or + BRCA mutations: 40 years old

73
Q

Inability to retract the foreskin from the penis?

A

Phimosis

74
Q

What is the Dx? Gram stain of penile discharge reveals gram-negative intracellular diplococci.

A

Gonorrhea

75
Q

Where is the most likely initial distant site for prostate cancer to metastasize?

A

Bone

76
Q

Inability to replace the foreskin back over the glans in an uncircumcised male?

A

Paraphimosis

77
Q

Describe a + Chvostek’s sign. What does it indicate?

A

The facial muscle contracts in response to tapping of the facial nerve. Sign of hypocalcemia

78
Q

What is the treatment for asymptomatic hyponatremia?

A

Fluid restriction

79
Q

Enlarged prostate with a firm nontender discrete mass?

A

Prostatic carcinoma

80
Q

What is the Dx? Nausea vomiting rash hematuria and eosinophilia in a patient taking allopurinol.

A

Acute interstitial nephritis

81
Q

Peaked T waves on EKG?

A

Hyperkalemia

82
Q

Bag of worms in scrotum?

A

Varicocele

83
Q

Most common presentation for bladder carcinoma?

A

Painless hematuria

84
Q

Most likely organisms causing acute epididymitis in young males?

A

Chlamydia and Neisseria gonorrhoeae

85
Q

Definitive treatment for a 3 year old with an undescended testicle?

A

Orchiopexy

86
Q

Most likely organisms causing epididymitis in an older male?

A

E. Coli - Klebsiella - Pseudomonas

87
Q

What is the Dx? Male patient presents with fever chills dysuria perineal pain and decreased stream.

A

Acute prostatitis (Do not massage the prostate = bacteremia)

88
Q

What factors are associated with increased risk of infertility in males?

A

Cryptorchidism - Hypogonadism - Orchitis Hx - Testicular torsion

89
Q

Most common cause of dysuria in an adult male?

A

Urethritis

90
Q

What is the Dx? UA shows pyuria white blood cell casts and hematuria.

A

Pyelonephritis

91
Q

What may correcting a patients hyponatremia too quickly cause?

A

Pontine crenation which may lead to central pontine myelinolysis

92
Q

Organism most likely to cause urethritis in males under 30?

A

Neisseria gonorrhoeae (Note: 30% have concurrent Chlamydia infection)

93
Q

Risk factors for stress incontinence?

A

Age - Obesity - Vaginal deliveries

94
Q

Drug of choice for treatment of BPH?

A

1st line: alpha-1-blockers - 2nd line: 5-alpha-reductase inhibitors

95
Q

What are the hallmark manifestations of acute hypernatremia?

A

Lethargy - Weakness - Muscle twitching

96
Q

What are the three hemodynamic factors that influence renal perfusion?

A

Cardiac output - Blood pressure - Systemic vascular resistance

97
Q

Hemolysis of red blood cells may cause increased serum levels of what electrolyte?

A

Potassium

98
Q

What drug may slow the progression of diabetic nephropathy?

A

ACE inhibitors and angiotension II receptor blockers (ARBs)

99
Q

What is the Dx? Proteinuria and fatty casts in urine.

A

Nephrotic syndrome

100
Q

What is the Dx? RBC casts in the urine.

A

Glomerulonephritis

101
Q

What is the most common form of nephrotic syndrome?

A

Membranous

102
Q

What is the serologic marker for Wegener’s granulomatosis?

A

Antineutrophilic cytoplasmic autoantibodies (ANCA)

103
Q

What are the hallmark signs of nephrotic syndrome?

A

Upper and lower extremity edema with normal jugular venous pressure

104
Q

What is the most common type of renal cell carcinoma?

A

Clear cell

105
Q

Acid-base disorder associated with renal failure?

A

Metabolic acidosis with increased anion gap

106
Q

Diagnostic tests for renal artery stenosis?

A

Initial: Renal artery Doppler US - CT or MRI angiography to confirm

107
Q

What is the Dx? Proteinuria hypoalbuminemia hyperlipidemia lipiduria and edema.

A

Nephrotic syndrome

108
Q

What is the Dx? Hematuria hypertension oliguria with worsening azotemia.

A

Nephritic syndrome

109
Q

Most common cause of acute renal failure?

A

Prerenal

110
Q

What two diagnoses should be considered with hematuria and red blood cell casts after URI?

A

IgA nephropathy (<5 days) - Post-streptococcal glomerulonephritis (10-21 days)

111
Q

What is the Dx? Paresthesia muscle cramping and agitation in a patient who has received multiple transfusions.

A

Hypocalcemia (Citrate in the transfused blood chelates calcium)

112
Q

What must be ruled out in a patient with polycystic kidney disease and the worst headache of their life?

A

Cerebral aneurysm rupture

113
Q

Common extrarenal manifestation of polycystic Kidney disease?

A

Cerebral aneurysm - Hepatic and pancreatic cysts

114
Q

List the symptoms of interstitial nephritis.

A

Arthralgias - Rash - Renal failure - Fever - Eosinophilia - Eosinophiluria

115
Q

Hyperkalemia in a patient receiving chemotherapy is indicative of what syndrome?

A

Tumor lysis syndrome

116
Q

What type of nephropathy is associated with Hodgkins lymphoma?

A

Minimal change nephropathy

117
Q

What type of nephropathy is associated with carcinomas?

A

Membranous nephropathy

118
Q

Most common type of kidney damage associated with HIV?

A

Focal Segmental Glomerulosclerosis (FSGS) presenting as nephrotic syndrome

119
Q

What is the treatment for acute, symptomatic hyperphosphatemia?

A

Phosphate binders - Acetazolamide - Dialysis

120
Q

What is treatment for hypophosphatemia?

A

Oral phosphate replacement

121
Q

Bones, stones, groans and psychiatric overtones is the mnemonic for what electrolyte disorder?

A

Hypercalcemia

122
Q

Trousseau and Chvostek sign are associated with what abnormality?

A

Hypocalcemia

123
Q

A patient with preeclampsia is given magnesium IV. She develops hypotension, bradycardia. What is the recommended treatment?

A

She is hypermagnesemic, treatments are: Calcium gluconate - Insulin& glucose - Furosemide - Dialysis if these are unsuccessful

124
Q

What electrolyte will not correct with supplementation until hypomagnesemia is corrected?

A

Hypokalemia

125
Q

Digoxin and what potassium abnormality leads to increased digoxin toxicity and ventricular arrhythmia?

A

Hypokalemia

126
Q

What is the endocrine disease that leads to hypernatremia?

A

Diabetes insipidus

127
Q

Correction of hyponatremia too quickly with 3% saline IV fluid will lead to what brain abnormality?

A

Pontine crenation

128
Q

Nephrotic syndrome is associated with protein loss in excess of how many grams per day?

A

3.5 g of protein or more

129
Q

A fraction of excreted sodium that is greater than 2% is associated with what renal condition?

A

Acute tubular necrosis

130
Q

Red blood cell casts on urinalysis are associated with what kidney condition?

A

Nephritic

131
Q

What is the treatment for anemia due to chronic renal failure?

A

Erythropoietin analogs (epoetin alfa, darbepoetin alfa)

132
Q

What is the most common cause of nephrotic syndrome in non-diabetic adults?

A

Membranous

133
Q

A 18 year old male presents with hematuria, hypertension and pedal edema after a recent viral infection. What antibody will be noted on lab work?

A

IgA (IgA nephropathy)

134
Q

What are the four main causes of acute tubular necrosis?

A

Prerenal (#1 cause) - Contrast dye - Drugs - Rhabdomyolysis

135
Q

What are the three components of prerenal failure?

A

Volume loss: bleed, dehydration - Weak cardiac pump: heart attack, CHF - Loss of SVR: sepsis, neuro injury, anaphylaxis

136
Q

A 65 year old male presents with suprapubic pain, anuria and a palpable bladder. What is the first step in the evaluation?

A

Foley catheterization

137
Q

A 65 year old female presents with painless hematuria. She has a 50 year smoking history. What underlying condition do you suspect?

A

Bladder cancer

138
Q

What is the treatment of choice for renal cell carcinoma without metastasis?

A

Radical nephrectomy

139
Q

A patient with polycystic kidney disease suddenly develops the worst headache of his life. What do you suspect?

A

Subarachnoid hemorrhage due to a ruptured cerebral aneurysm

140
Q

What is the gold standard for evaluating a patient with renal artery stenosis?

A

Angiography of the renal arteries

141
Q

A 30 year old female presents with persistant hypertension. She has an abdominal bruit on exam. What do you suspect is the underlying cause of her hypertension?

A

Renal artery stenosis

142
Q

A 17 year old male presents with hypertension and azotemia. What is his most likely diagnosis?

A

Polycystic kidney disease

143
Q

What is the most common renal cancer in children, presenting with a unilateral abdominal mass?

A

Wilms tumor

144
Q

Flank pain hematuria and palpable right abdominal renal mass is associated with what condition?

A

Advanced renal cell cancer

145
Q

What is the most common type of bladder cancer?

A

Transitional cell

146
Q

An untreated urinary tract infection leads to a high fever, chills, flank pain, nausea and vomiting. What condition do you suspect?

A

Pyelonephritis

147
Q

What class of medication can often help patients with interstitial nephritis?

A

Tricyclics such as amitriptyline

148
Q

What is the most common cause of urinary tract infection?

A

E. Coli

149
Q

Bilateral hydronephrosis leads to what type of renal failure?

A

Post renal failure due to obstruction

150
Q

Untreated pyelonephritis can lead to what kidney condition?

A

Hydronephrosis

151
Q

White blood cell casts on urinalysis are associated with what condition?

A

Pyelonephritis

152
Q

ear old male has recurrent dysuria and urinary frequency which has not improved with antibiotics. What underlying condition do you suspect?

A

Interstitial cystitis

153
Q

Urinary incontinence associated with activity is called what type of incontinence?`

A

Stress

154
Q

What antibiotics are indicated for the treatment of chlamydia and gonorrhea?

A

Ceftriaxone and doxycycline or ceftriaxone and azithromycin

155
Q

Elevation of the testicles will not relieve the pain in which condition?

A

Testicular torsion

156
Q

By what age should a males testicles be descended into the scrotum?

A

Six months (If they have not descended by six months surgery is indicated)

157
Q

A 20 year old male presents with an enlarged, firm, non-tender testicular mass. What underlying condition do you suspect?

A

Testicular cancer

158
Q

What reflex is absent in a patient with testicular torsion?

A

Cremasteric reflex

159
Q

A 24 year old male on examination of the testicles is found to have a “bag of worms” on the right side. What is the underlying condition?

A

Varicocele

160
Q

A painless unilateral swelling of the testicle that transilluminates is what disease condition?

A

Hydrocele

161
Q

What viral condition can cause orchitis in a young male child?

A

Mumps

162
Q

What is the suspected etiology of a tender, swollen, warm mass located above the testicle in a 24 year old male?

A

Chlamydia and-or gonorrhea

163
Q

What class of medication treats the prostate by shrinking it?

A

Five alpha reductase inhibitors (finasteride and dutasteride)

164
Q

What is the initial screening for a patient with BPH?

A

Digital rectal exam and PSA test

165
Q

A 55 year old male is found to have prostate cancer with metastasis. In addition to radical prostatectomy, what other treatment will he require?

A

Surgical castration or androgen deprivation medications such as leuprolide

166
Q

At what time should you instruct your patients with BPH to take their alpha blocker medications?

A

At bedtime to prevent postural hypotension

167
Q

What condition needs to be ruled out first in erectile dysfunction?

A

“Psychogenic conditions like performance anxiety

168
Q

Prostatitis in a 24 year old male is most commonly caused by what organism?

A

Chlamydia or gonorrhea

169
Q

Prostatitis in a 55 year old male is most commonly caused by what organism?

A

E. Coli

170
Q

What condition is defined as the inability to return retracted foreskin to its normal position?

A

Paraphimosis

171
Q

What condition is defined as the inability to retract the foreskin in an uncircumcised male?

A

Phimosis

172
Q

What type of kidney stones is a patient with a diet high in purines most likely to suffer from?

A

Uric acid stones

173
Q

What medications are used to treat patients with calcium oxalate stones but makes patients with uric acid stones worse?

A

Chlorthalidone and hydrochlorothiazide

174
Q

Which type of kidney stone requires chronic antibiotics?

A

Struvite stones

175
Q

What type of kidney stone does a female with a chronic urinary tract infection most likely have?

A

Struvite

176
Q

What type of kidney stone is most commonly seen in a young boy?

A

Cystine stone

177
Q

Before sending a patient home with kidney stones, in addition to pain medications, what should you give the patient?

A

A strainer so they can catch the stone and bring it in for analysis

178
Q

What test is the gold standard for diagnosing kidney stones?

A

CT scan

PANCE (9 decks)

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