Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

EOR - Internal Med > Internal Med - Uro/Renal > Flashcards

Internal Med - Uro/Renal Flashcards

1
Q

1 cause of renal vascular disease

A

1 → Diabetic kidney disease

Hypertension, smoking, renal artery stenosis, glomerular disease, renal cysts, genetics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Stage 1 - Stage 5 Kidney failure classification

A

Stage 1 - Normal GF >90

Stage 5 - Kidney Failure GFR <15 → Dialysis pts

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Acute kidney injury occurs when

A

Abrupt decline in renal fitration

Elevated Creatinine and decreased GFR; Azotemia → Rise in blood urea nitrogen (BUN) concentration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Causes of prerenal kidney injury

A

Kidney working fine, but perfusion issue → Volume loss, heart failure, loss of peripheral vascular resistance (Sepsis or anesthesia)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

MCC of prerenal kidney injury

A

Hypovolemia → MC

NSAIDs, IV contrast, ACE/ARBS (renal artery stenosis)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Tx of prerenal kidney injury

A

Fluids, cardiac support, tx shock

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Intrinsic kidney injury MCC

A

Direct damage to kidneys

MC → Nephrotoxic drugs (aminoglycosides like Gentamicin) or Cyclopsporine

Other causes → Tumor lysis syndrome, vasculitis, crystals from gout, myoglobin from rhabdo

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Celluar cast is the hallmark of which type of kidney dz (pre, intrinsic or postrenal)

A

Intrinsic renal disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Muddy casts signify

A

ATN

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Tx of intrinsic renal dz

A

IV fluids remove drugs + Lasix can help kidneys get moving

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Postrenal kidney injury causes

A

Some type of obstruction in the ureteres → Usually low or no urine output

BPH + Tumors → Common

Congenital or structual abnormalities

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Acute tubular necrosis causes

A

Damaged tubules → Cant concentrate urine = high FENa

UA → Muddy casts

MCC = Prerenal failure

Drugs (Amp B, aminoglycosides, NSAIDs, ACE)

Ischemic causes → Dehydration, shock, sepsis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Chronic kidney dz definition

A

Progression of ongoing loss of kidney function (GFR less than 60) or presence of kidney damage (proteinuria, glomerulonephritis or structual damage from polycystic kidney dz)

Lasting longer than 3 months

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

PE findings of CKD

A

Broad waxy casts; fatigue, pruritis, Kussmaul respirations, asterixis (flapping tremor), muscle wasting

Pruritis d/t immune system dysfunction and elevated proinflammatory cytokines involved

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Lab findings in a pt with CKD

A

Hypocalcemia (low Ca), hyperphosphotemia (high PO24), metabolic acidosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

5 Ps as the MCC of acute insterstitial nephritis

A

Pee- Diuretics, especially sulfa ones

Pain-free - NSAIDs

PCN and cephalosporins

Proton Pump Inhibitors

rifamPin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

UA of acute interstitial nephritis

A

WBC casts and eosinophils

Immune mediated response to things like drugs, infections like strep, SLE, Sjorgens, Sarcoid etc

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

BPH sx

A

Decreased force of urinary stream, hesitancy (stop/start), straining, postvoid dribbling, incomplete emptying, frequency, nocturia, urgency, recurrent UTis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Dx of BPH

A

DRE → Enlarged rubbery prostate

Labs → PSA often elevated >4

US → Evaluate bladder size, prostate size, degree of hydronephrosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Tx of BPH

A

alpha a1 receptor blockers - Zosins - Terazosin, tamsulosin

5-alpha reductase inhibitors → Finasteride

PDE-5 enzyme inhibitors → Tadalafil/Sidelenfil

*TURP = Surgery of prostate, resection; used if refractory to meds

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Painless gross hematuria in a pt with smoking hx

A

Bladder cancer; Transitional cell carcinoma = MC type

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Dx of bladder cancer

A

Cystoscopy with biopsy is gold standard

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Tx of bladder cancer

A

Surgery; biological therapy; chemotherapy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Epididymitits in men <35 MCC

A

Chlamydia and gonorrhea

In men >35 → E.Coli

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Sx of epididymitis

A

Dysuria, unilateral dull aching scrotal pain that can radiate to ipsilateral flank

Swollen epidymis; tender +/- fever/chills

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

+ phrens sign in epididymitis

A

Relief with elevation is classic sign

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Dx of epididymitis

A

UA → Pyuria and bacteruria

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Tx of epididymitis

A

Over 35 → Tx E.Coli - Levofloxacin 500mg x 10 days or Trimeth/Sulfa (Bactrim) BID x 10 days

Under 35→ Tx gonorrhea or chlamydia = Ceftriazone 500mg IM plus doxy 100mg BID x 10 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Glomerulonephritis, MC in kids, what is the MCC

A

Strep infection; Check antistrep O titer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Damage to renal glomeruli by deposition of inflammatory proteins in glomerular membranes as a result of immunologic response

A

Glomerulonephritis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Dx of glomerulonephritis

A

Hematurea; RBC casts, proteinuria, HTN, decreased GFR

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Tx of glomerulonephritis

A

Steroids + Immunesupressive drugs to control inflammatory response

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Fluid-filled sac around testicle often first noticed as swelling of scrotum

A

Hydrocele

34
Q

Hydrocele are MC in what populations

A

Newborns and usually dissapear w/o tx within first year; Older men can develop these d/t inflammation or injury

35
Q

Dx of hydrocele

A

Transillumination on PE; US may needed

36
Q

Tx of hydrocele

A

Watchful waiting; rare = surgery

37
Q

Hydronephrosis MCC

A

Blockage in ureter → Kidney stone, enlarged prostate, blood clot, tumor

38
Q

Sx of hydronephrosis

A

Difficulty urinating and pain in the side, abd or groin

39
Q

Tx of hydronephrosis

A

Abx if infection; In severe cases urine drained from bladder/kidney

40
Q

Difference between nephritic and nephrotic syndrome

A

Nephrotic → Loss of a lot of protein

Nephritic → Loss of a lot of blood

41
Q

Inflammation that damages glomerular basement membrane leading to hematuria and RBC casts in urine

A

Nephritic syndrome

42
Q

MCC of nephritic syndrome

A

Infections, immune system disorders, inflammation of blood vessels

43
Q

Dx of nephritic syndrome

A

High BUN and Cr and hematuria, proteinuria and RBC casts in urine

44
Q

Tx of nephritic syndrome

A

*Depends on cause

Steroids and immunosupressive drugs can be used to control inflammatory response

Dialysis if symptomaic azotemia

45
Q

Inflammation of kidneys that may involve glomeruli, tubules, or interstitial tissue surrounding glomeruli and tubules

A

Nephritis

46
Q

Types of nephritis

A

Glomerulonephritis → Inflammation of glomeruli

Interstitial nephritis → Inflammation of the spaces between renal tubules

47
Q

MCC of nephritis

A

Autoimmune dz that affect kidneys

Pyelonephritis from UTI

Lupus Nephritis → SLE

Athletic Nephritis → Strenous exercise

48
Q

tx of nephritis

A

Tx based on what provoked inflammation of kidneys

Lupus → Hydroxychlorquine can be used

49
Q

Autosomal kidney disease causing a mutation of PKD1/PKD2

A

Polycystic kidney disease → Growth of numerous cysts on kidneys can lead to → Kidney failure/ESD

50
Q

Sx of Polycystic kidney dz

A

Painful enlargements of the kidneys d/t cysts; Flank pain; Htn

MC in young patients >30yo

51
Q

Polycystic kidney dz cardiovascular abnormalities

A

Mitral valve prolapse, LVH

10% have brain aneurysms

52
Q

Dx of Polcystic kidney dz

A

US will show many fluid-filled cysts

CT shows large renal size and multiple thin walled cysts

53
Q

Tx of polycystic kidney disease

A

No cure; supportive, BP control

ACE/ARBs → Renoprotective

54
Q

Difficulty with urination or no symptoms at all, dx?

A

Prostate cancer

MC area → Peripheral zone

55
Q

MC area of prostate cancer to occur

A

Peripheralzone

56
Q

PE findings of prostate cancer

A

DRE → hard, irregular, nodular

57
Q

PSA for prostate cnacer

A

PSA >4 → BPH, prostate cancer, prostatitis

58
Q

When should prostate screenings occur

A

White male @ 50 yrs

Black male, positive family hx, or +BRCA gene @ 40yrs

59
Q

If PSA is 4.1 - 10 and DRE is negative

A

Biopsy is recommended

60
Q

If PSA is <4.0 and DRE is negative

A

Annual follow up recommended

61
Q

PSA >10

A

Transrectal US with biopsy is indicated; regardless of DRE findings

62
Q

If DRE is abnormal

A

Transrectal US with biopsy is indicated, regardless of PSA level

63
Q

Ascending infection of gram-negative rods into prostatic ducts

A

Prostatitis

64
Q

Sx of prostatitis

A

Acute → Sudden onset of fever, chills, low back pain combined with urinary frequency, urgency, and dysuria

Chronic → Variable- asymptomatic → Acute splenomegaly

*All forms present with irrative bladder symptoms (frequency, urgency, dysuria) and some obstruction

65
Q

PE findings in Prostatitis

A

Tender, enlarged prostate on DRE

66
Q

Dx of prostatits

A

UA → Pyuria and hematuria

Prostatic fluid → Leukocytosis, culture → E.coli positive ; Chronic will show enterococcus

*If prostatitis is suspected, DO NOT massage prostate, can lead to sepsis

67
Q

Tx of prostatitis

A

Men under 35 → Chlamydia,gonorrhea - Ceftriazxone and doxy

Over 35 → E. coli and pseudomonas - fluroquinolones or Bactrim 4-6 wks

Chronic prostatitis → Fluroquinolones or bactrim 6-12 weeks

NSAIDs - Analgesia

68
Q

Irrititative voiding, fever, flank pain, N/V, CVA tenderness

A

Pyelonephritis

69
Q

MC bug in pyelonephritis

A

E.coli

UA → Bacteria + WBC casts

70
Q

Tx of pyelonephritis

A

Outpatient → FQ like Cipro or Levaquin/Bactrim for 1-2 weeks

Inpatient → IV FQ, 3rd or 4th gen cephalosporins, PCN, Gentamicin

*Failure to respond to tx → US

71
Q

Flank pain radiating into scrotum, gross hematuria, right sided hydronephrosis and normal abd xray

A

Renal calculi

72
Q

Sx of renal calculi or renal stones

A

Colicky flank pain radiating to groin, hematuria, CVA tenderness, N/V

73
Q

Dx of renal calculi

A

CT Scan (Spiral CT) without contrast of abd and pelvis → Gold std

UA → Microscopic hematuria

BUN & Cr levels elevated

74
Q

MC type of renal calculi

A

Calcium oxalate → MC 80% ; Avoid grapefruit juice makes stones worse

Struvite → Associated with chronic UTI

Uric acid → Excess meat/alcohol; gout

Cystine → Rare, genetic, radiolucent

75
Q

Tx of renal calculi

A

Analgesia → IV morphine, NSAIDs

Hydration

Abx if UTI is present

Alpha blocker→ Flomax helps passage of stones

76
Q

What size renal calculi can be passed on their own?

A

<5mm will spontaneous pass

>5-10 may need lithotripsy

>10mm need stend or nephrostomy

77
Q

Triad → Hematuria, flank pain, abdominal mass

A

Renal cell carcinoma

78
Q

MC type of renal carcinoma

A

Renal clear cell; Second → Transitional Cell

***RF = SMOKING

79
Q

Dx and tx of renal carcinoma

A

Dx → US or CT then biopsy

Tx → Surgery radical nephrectomy = curative

80
Q

Nephritic vs Nephrotic which one affects protein?

A

Nephrotic -PRO→ Protein losing

Nephritic -Blood loss

81
Q

Disorders that can cause nephritic syndrome

A
  • Those caused by type III hypersensitivity
    • poststreptococcal glomerulonephritis
    • IgA nephropathy (Berger’s disease)
    • diffuse proliferative glomerulonephritis (often caused by SLE)
  • Those with multiple potential causes
    • membranoproliferative glomerulonephritis (MPGN)
    • rapidly progressive glomerulonephritis (RPGN)
  • Alport syndrome which affects collagen synthesis
82
Q

MC type of testicular cancer

A

Germ cell tumor; Nonseminomatous germ cell tumor

EOR - Internal Med (9 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions