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SmartyPance:GU & Renal > GU Renal Comp > Flashcards

GU Renal Comp 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

Which disorder has oval fat bodies in the urine?

A

Nephrotic syndrome

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14
Q

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

A

High

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15
Q

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

A

Normal

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16
Q

What are the CT findings expected with pyelonephritis?

A

Perinephric stranding

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17
Q

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

A

Urodynamics - Cystoscopy with hydrodistention of bladder

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18
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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19
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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20
Q

What modality should be used to diagnose testicular torsion?

A

Ultrasound with Doppler

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21
Q

What is a + transillumination of the scrotum associated with?

A

Hydrocele

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22
Q

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

A

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

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23
Q

Describe a positive Prehn’s sign.

A

Elevation of the testicle relieves the pain

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24
Q

What disorder is Prehn’s sign associated with?

A

Epididymitis

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25
Q

What GU disorder is LeRiche syndrome associated with?

A

Erectile dysfunction

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26
Q

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

A

Urodynamics - Cystoscopy with hydrodistention of bladder

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27
Q

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

A

Magnesium

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28
Q

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

A

Hypokalemia

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29
Q

What electrolyte abnormality potentiates the cardiac toxicity of digoxin?

A

Hypokalemia

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30
Q

List dietary modifications for chronic kidney disease.

A

Restrict protein sodium potassium and fluid intake

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31
Q

What urinalysis findings are consistent with acute tubular necrosis?

A

Muddy casts and renal tubular cells

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32
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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33
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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34
Q

What is the most common cause of prerenal failure?

A

Dehydration

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35
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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36
Q

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

A

Hypertension and renal failure

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37
Q

What renal disorder is linked to cerebral aneurysm?

A

Polycystic kidney disease

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38
Q

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

A

Wilms Tumor

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39
Q

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

A

Renal cell carcinoma

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40
Q

What is the most common causative factor for bladder cancer?

A

Smoking

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41
Q

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

A

Interstitial cystitis

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42
Q

What is the most common type of incontinence?

A

Mixed (both stress and urge)

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43
Q

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

A

Urge incontinence

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44
Q

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

A

Stress incontinence

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45
Q

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

A

Testicular torsion

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46
Q

Name two disorders which may cause orchitis in children?

A

Mumps and brucellosis infections

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47
Q

What hematological disorder may cause priapism?

A

Sickle cell crisis

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48
Q

What medication classes can not be taken with PDE5 inhibitors?

A

Nitrates or alpha blockers (May result in hypotension)

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49
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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50
Q

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

A

E. Coli

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51
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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52
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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53
Q

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

A

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

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54
Q

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

A

Struvite

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55
Q

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

A

Hyperkalemia -Hyperuricemia - Hyperphosphatemia

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56
Q

What nephropathy is associated with lupus?

A

Membranous nephropathy

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57
Q

Most common histology of bladder cancer?

A

Transitional cell carcinoma

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58
Q

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

A

Renal cell carcinoma

59
Q

What is the Dx? Eosinophils in the urine sediment.

A

Allergic interstitial nephritis

60
Q

What are the 2 most common types of nephrotic syndrome?

A

Focal Segmental Glomerulosclerosis (FSGS) - Membranous glomerulonephritis

61
Q

What is the most common type of nephrolithiasis?

A

Calcium oxalate

62
Q

Most common causes of hypercalcemia?

A

Malignancy and hyperparathyroidism

63
Q

What is the Dx? Hypernatremia and azotemia.

A

Most likely dehydration

64
Q

Doughy skin with skin tenting may represent which electrolyte abnormality?

A

Hypernatremia

65
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

66
Q

Inability to retract the foreskin from the penis?

A

Phimosis

67
Q

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

A

Gonorrhea

68
Q

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

A

Bone

69
Q

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

A

Paraphimosis

70
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

71
Q

What is the treatment for asymptomatic hyponatremia?

A

Fluid restriction

72
Q

Enlarged prostate with a firm nontender discrete mass?

A

Prostatic carcinoma

73
Q

Peaked T waves on EKG?

A

Hyperkalemia

74
Q

Bag of worms in scrotum?

A

Varicocele

75
Q

Most common presentation for bladder carcinoma?

A

Painless hematuria

76
Q

Most likely organisms causing acute epididymitis in young males?

A

Chlamydia and Neisseria gonorrhoeae

77
Q

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

A

Orchiopexy

78
Q

Most likely organisms causing epididymitis in an older male?

A

E. Coli - Klebsiella - Pseudomonas

79
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)

80
Q

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

A

Cryptorchidism - Hypogonadism - Orchitis Hx - Testicular torsion

81
Q

Most common cause of dysuria in an adult male?

A

Urethritis

82
Q

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

A

Pyelonephritis

83
Q

What may correcting a patients hyponatremia too quickly cause?

A

Pontine crenation which may lead to central pontine myelinolysis

84
Q

Organism most likely to cause urethritis in males under 30?

A

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

85
Q

Risk factors for stress incontinence?

A

Age - Obesity - Vaginal deliveries

86
Q

Drug of choice for treatment of BPH?

A

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

87
Q

What are the hallmark manifestations of acute hypernatremia?

A

Lethargy - Weakness - Muscle twitching

88
Q

What are the three hemodynamic factors that influence renal perfusion?

A

Cardiac output - Blood pressure - Systemic vascular resistance

89
Q

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

A

Potassium

90
Q

What drug may slow the progression of diabetic nephropathy?

A

ACE inhibitors and angiotension II receptor blockers (ARBs)

91
Q

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

A

Nephrotic syndrome

92
Q

What is the Dx? RBC casts in the urine.

A

Glomerulonephritis

93
Q

What is the most common form of nephrotic syndrome?

A

Membranous glomerulonephritis

94
Q

What is the serologic marker for Wegener’s granulomatosis?

A

Anti Neutrophilic cytoplasmic autoantibodies (ANCA)

95
Q

What are the hallmark signs of nephrotic syndrome?

A

Upper and lower extremity edema with normal jugular venous pressure

96
Q

What is the most common type of renal cell carcinoma?

A

Clear cell

97
Q

Acid-base disorder associated with renal failure?

A

Metabolic acidosis with increased anion gap

98
Q

Diagnostic tests for renal artery stenosis?

A

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

99
Q

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

A

Nephrotic syndrome

100
Q

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

A

Nephritic syndrome

101
Q

Most common cause of acute renal failure?

A

Prerenal

102
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)

103
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)

104
Q

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

A

Cerebral aneurysm rupture

105
Q

Common extrarenal manifestation of polycystic Kidney disease?

A

Cerebral aneurysm - Hepatic and pancreatic cysts

106
Q

List the symptoms of interstitial nephritis.

A

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

107
Q

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

A

Tumor lysis syndrome

108
Q

What type of nephropathy is associated with Hodgkin’s lymphoma?

A

Minimal change nephropathy

109
Q

What type of nephropathy is associated with carcinomas?

A

Membranous nephropathy

110
Q

Most common type of kidney damage associated with HIV?

A

Focal Segmental Glomerulosclerosis (FSGS) presenting as nephrotic syndrome

111
Q

What is the treatment for acute, symptomatic hyperphosphatemia?

A

Phosphate binders - Acetazolamide - Dialysis

112
Q

What is treatment for hypophosphatemia?

A

Oral phosphate replacement

113
Q

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

A

Hypercalcemia

114
Q

Trousseau and Chvostek sign are associated with what abnormality?

A

Hypocalcemia

115
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

116
Q

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

A

Hypokalemia

117
Q

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

A

Hypokalemia

118
Q

What is the endocrine disease that leads to hypernatremia?

A

Diabetes insipidus

119
Q

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

A

Pontine crenation

120
Q

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

A

3.5 g of protein or more

121
Q

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

A

Acute tubular necrosis

122
Q

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

A

Nephritic

123
Q

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

A

Erythropoietin analogs (epoetin alfa, darbepoetin alfa)

124
Q

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

A

Membranous

125
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)

126
Q

What are the four main causes of acute tubular necrosis?

A

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

127
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

128
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

129
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

130
Q

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

A

Radical nephrectomy

131
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

132
Q

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

A

Angiography of the renal arteries

133
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

134
Q

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

A

Polycystic kidney disease

135
Q

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

A

Wilms tumor

136
Q

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

A

Advanced renal cell cancer

137
Q

What is the most common type of bladder cancer?

A

Transitional cell

138
Q

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

A

Pyelonephritis

139
Q

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

A

Tricyclics such as amitriptyline

140
Q

What is the most common cause of urinary tract infection?

A

E. Coli

141
Q

Bilateral hydronephrosis leads to what type of renal failure?

A

Post renal failure due to obstruction

142
Q

Untreated pyelonephritis can lead to what kidney condition?

A

Hydronephrosis

143
Q

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

A

Pyelonephritis

SmartyPance:GU & Renal (4 decks)

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