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Unit 3 Clin Med II > L16: Renal+Urology diagnostics > Flashcards

L16: Renal+Urology diagnostics Flashcards

1
Q

acute kidney injury staging is based on

A

GFR
Creatinine
Urine output

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2
Q

Normal serume creatinine

A

.5-1.2

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3
Q

Serum creatinine measures

A

Measures renal function

Know baseline, may be normal even with poor renal function

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4
Q

From catabolism in skeletal muscle and dietary meat intake→ released into circulation at constant rate→ stable plasma concentration→ freely filtered by glomerulus and excreted by the kidneys

A

serum creatinine

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5
Q

normal BUN

A

10-20

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6
Q

Product of protein catabolism excreted by kidneys

A

BUN

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7
Q

Increased BUN

A

dehydration, GI bleed, use of steroids or tetracyclines

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8
Q

marker for volume status

A

BUN/Creatinine ration

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9
Q

Normal GFR values

A

Males: 130 mL/min/1.73 m2
Females: 120 mL/min/1.73 m2

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10
Q

Stage 1 CKD

A

Kidney damage with normal or increased GFR>90

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11
Q

Stage 2 CKD

A

Kidney damage with normal or decreased GFR 60-89

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12
Q

Stage 3 CKD

A

Moderately decreased GFR 30-59

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13
Q

Stage 4 CKD

A

Severely decreased GFR 15-29

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14
Q

Stage 5 CKD

A

Kidney failure <15

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15
Q

Stage 5D CKD

A

Kidney failure with dialysis, no GFR

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16
Q

GFR is used to

A

Track disease progression/regression
Dosing of medications
Sex/race/body habitus dependent

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17
Q

improves estimates of GFR

A

Cystatin C

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18
Q

Sum of filtration rates of all functioning nephrons→ rough measure of number of functioning nephrons
Cannot be measured directly: Modification of Diet in Renal disease equation

A

GFR

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19
Q

One of the first signs of kidney disease and should not be ignored

A

protein on urinalysis

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20
Q

How to obtain Creatinine clearance

A

By 24-hour-urine collection, Cockcroft-Gault formula

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21
Q

Uses of Creatinine clearance

A

Approximates GFR: choosing/dosing medications

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22
Q

blood on urinalysis may indicate

A 
Calculi
glomerular damage
neoplasm
acute tubular necrosis
trauma
infection
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23
Q

Prostate Specific Antigen uses

A

Glycoprotein found in prostatic lumen

Not recommended in men >70

Screening for early detection of prostate cancer, monitor disease after treatment

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24
Q

Normal Prostate Specific Antigen antigen values

A

<4ng/mL

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25
increased Prostate Specific Antigen may indicate
prostate cancer BPH, prostatitis following prostate manipulation: ultrasound, biopsy
26
If you suspect | Systemic lupus erythematosus, order
ANA double stranded DNA antibody levels
27
If you suspect Granulomatosis with Polyangiitis, order
C-ANCA and P-ANCA
28
If you suspect Goodpasture syndrome, order
Anti-GBM antibodies
29
If you suspect Glomerulonephritis, order ______ to narrow down the cause
Hep B and C HIV Venereal disease research laboratory (VDRL) serology Serum complement
30
If you suspect Post-streptococcal glomerulonephritis, order
Antistreptolysin O
31
If you suspect Multiple myeloma, order
Serum and urine protein electrophoresis (SPEP, UPEP)
32
Possible causes of RBC casts
Glomerulonephritis | Vasculitis
33
Possible causes of WBC casts
Tubulointerstitial disease Acute pyelonephritis Glomerular disorders
34
Possible cause of epithelia cell casts
Acute tubular necrosis
35
uric acid crystals are
radiolucent on Xray, won't show up
36
struvite crystals are made of
magnesium ammonium phosphate
37
Hyaline casts indicate
dehydration
38
Better quantitative measurement for proteinuria or GFR determination
24 hour urine collection
39
To find bench jones proteins in multiple myeloma
Urine protein immunoelectrophoresis (UPEP)
40
Urine eosinophils are seen in
``` *Acute interstitial nephritis* Transplant rejection pyelonephritis prostatitis cystitis atheroembolic disease rapidly progressive glomerulonephritis ```
41
Microalbumin on urine study
The earliest clinically detectable sign of diabetic nephropathy or kidney damage
42
Xrays will miss
Smaller stones uric acid stones (radiolucent) stones overlying bony structure
43
How is a kidney, ureters, and bladder film (KUB) taken
supine and upright positions
44
Test of choice to exclude urinary tract obstruction
Renal ultrasonography
45
Stones that are visible on KUB film
Calcification in the urinary tract: | Calcium containing, struvite, cystine stones
46
staghorn means
nephrolithiasis involving renal pelvis and extending into >2 calyces
47
Other things that can be seen on KUB film
``` Prostatic calculi Bladder distention Pancreatic calculi Calcified arteries Calcification in biliary tract Bowel gas pattern Free air secondary to ruptured viscus Calcified prostate: the whole prostate is opaque ```
48
Renal ultrasonography vs CT
U/S is less sensitive that CT in initially detecting a renal mass, but doesn't use contrast
49
test to evaluate renal vascular flow
renal doppler ultrasonoography
50
May be seen on renal ultrasonography
Obstruction Nephrolithiasis: appear white Severity and length of ureteral strictures Renal cysts (appear black) and masses (grayish tissue color) Hydronephrosis Renal or perinephric abscess Atrophic kidneys Ureteral diverticuli Pyelonephritis: hypodense mass with internal echoes
51
can be seen on renal doppler ultrasonography
``` Renal vein thrombosis Renal infarction Renal artery stenosis Intrarenal vascular disease Arteriosclerosis ```
52
test of choice for nephrolithiasis
non-contrast CT | -can see stones not visible on KUB
53
On contrast CT, a stone looks like
stone in kidney prevents contrast from being normally excreted, dilated ureter
54
CT angiography can show
renal artery stenosis | renal vein thrombosis
55
Uses for CT
Distinguish benign vs malignant cysts Evaluate and stage renal cell carcinoma Bilateral pyelonephritis: triangular hypodense streaks spreading from pelvis to cortex: “stranding”
56
gold standard for Renal vein thrombosis
MRI
57
MRA can show
Renal artery stenosis
58
contraindications to MRI
Gadolinium in GFR<30 (chronic renal failure) or acute renal failure of any severity → nephrogenic systemic fibrosis
59
Shows size and shape of kidneys, ureters, bladder Contrast in injected, then x-rays taken Excretory function: time it takes for contrast to pass Not frequently used due to contrast dye
Intravenous pyelogram
60
Intravenous pyelogram can show
Stones: seen obstructing the flow of contrast in the lumen of the ureter Obstruction
61
Renal angiography uses
Pre-operative mapping of renal vasculature (main use) Stenosis→ angioplasty and stenting Fibromuscular dysplasia “sting of pearls”
62
Renal biopsy is used for diagnosis of
``` Unexplained acute renal failure Nephrotic syndrome Acute nephritis syndrome Renal mass Assessment for rejection following transplant ```
63
Bladder filled with contrast→ take x-rays Can be done while voiding Better for primary bladder conditions than intravenous pyelogram
Cystourethrogram
64
Cystourethrogram can show
Vesicoureteral reflux Distortion of the bladder Fistula Perforation
65
Thin fiber-optic tube (flexible vs. rigid) passed through a hollow sheath into the urethra and advanced into the bladder
cytoscopy
66
Cytoscopy complications
Post-procedure hematuria: expected, passes within 3 voids sepsis hemorrhage perforation of the bladder post-procedure dysuria
67
Urogynecologic malignancies that can be assessed with cytoscopy
``` Incontinence with irritative voiding symptoms Sterile hematuria/pyuria Recurrent infection Urethral diverticula Fistulas ```
68
Intrinsic bladder diseases that can be assesed with cytoscopy
Interstitial cystitis | Bladder tumors, stones, or scarring
69
Uses of testicular ultrasound
testicular/scrotal size, pain, masses Testicular torsion (Doppler) Location of undescended testes
70
How is a prostate ultrasound and biopsy performed, and on whom
transrectally | high PSA to detect prostate cancer

Unit 3 Clin Med II (8 decks)

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