MSK 2 / Renal Flashcards
Ankylosing spondylitis:
presentation?
dx?
complications?
bilateral sacroiliitis + gradual- onset upward fusion of spine + enthesitis (pain at tendon attachment sites)
XR (bamboo spine)
restrictive lung dz, cauda equina syndrome, spine fx w/ spinal cord damage, osteoporosis, spondylodiscitis
Reiter syndrome (reactive arthritis):
presentation?
a/w…
dx?
triad of anterior uveitis, urethritis, arthritis
bacterial GI infx (Salmonella, Shigella, Campy, Chlamydia, Yersinia)
Psoriatic arthritis:
dx?
complications?
X-ray (pencil-in-cup deformity)
dactylitis (sausage fingers)
joint aspiration (r/o infx arthritis)
Takayasu arteritis:
presentation?
dx?
tx?
young Asian woman w/ absent pulses and asymmetrical BP
arteriogram
steroids, angioplasty for stenosed veins
Polyarteritis nodosa: pathophys/presentation? a/w... dx? tx?
vasculitis of renal and visceral vx → abd pain (bowel angina), fatigue, joint pain, renal failure
associated w/ HBV infx
Dx tissue bx, ↑P-ANCA
Tx steroids
Behçet syndrome:
presentation?
dx?
tx?
recurrent oral and genital ulcers, arthritis, uveitis, CNS sx
Dx tissue bx
Tx steroids
Churg-Strauss syndrome:
presentation?
dx?
tx?
triad of asthma + eosinophilia + granulomatous vasculitis
Dx tissue bx, ↑P-ANCA
Tx steroids
Wegener granulomatosis:
presentation?
dx?
tx?
triad of necrotizing: - vasculitis - granulomas in lungs and upper resp tract - glomerulonephritis → hematuria + hemoptysis
Dx tissue bx (necrotizing granulomas), ↑C-ANCA
Tx cyclophosphamide
Medullary sponge kidney:
presentation?
dx?
tx?
cystic dilation of collecting ducts → hematuria, recurrent UTIs, kidney stones
dx IV pyelo (sponge-like calyx)
no tx
RA stenosis:
dx?
tx?
etiology?
Dx renal arteriogram (if pt is in renal failure, use MRA instead since dye is nephrotoxic)
Tx angioplasty
Etiology: fibromuscular dysplasia (young women), atherosclerosis (old men)
RV thrombosis:
presentation?
dx?
tx?
intrinsic clot or extrinsic compression causes ↓renal blood outflow → flank pain, HTN, hematuria, proteinuria
Dx renal venography
Tx underlying cause
Hypertensive nephrosclerosis:
benign vs malignant?
Benign nephrosclerosis: hyaline arteriolosclerosis in chronic HTN
Malignant nephrosclerosis: hyperplastic (“onion skin”) arteriolosclerosis in rapidly progressive HTN
Sickle cell nephropathy:
presentation?
eventually results in…
tx?
recurrent sickling → papillary infarction
eventual papillary necrosis, renal failure, UTIs
ACE inhibitors (w/ hydroxyurea for SCD)
Kidney stone diet:
high fluids (#1), low sodium, low protein, high calcium (counterintuitive), low oxalate
Radiolucent KS?
Uric acid stones
KS 2/2 gout or tumor lysis syndrome?
Uric acid stones
KS 2/2 hypercalciuria or hyperoxaluria?
Ca stones
Prostate cancer:
dx?
tx?
Dx screen w/ PSA (≥10) or DRE (firm nodule); confirm w/ U/S-guided needle bx
Tx radical prostatectomy (local), radiation + flutamide + leuprolide (invasive)
Renal cell carcinoma (RCC): presentation? dx? tx? risk factors? if bil?
abdominal mass, flank pain, hematuria, and paraneoplastic syndromes (PAPER – PTH-rP, ACTH, prolactin, EPO, renin)
CT
radical nephrectomy
smoking (#1), obesity
von Hippel-Lindau
Bladder cancer: presentation? dx? tx? risk factors?
painless hematuria
Dx IV pyelo + cystoscopy w/ bx
Tx resection + close f/u for high recurrence
“Pee SAC” – pain killer abuse, smoking (#1), aniline dyes, cyclophosphamide
Testicular cancer: presentation? dx? tx? f/u labs?
firm, painless testicular mass
Dx transillumination (doesn’t light up), testicular U/S (solid mass)
- radical orchiectomy
- CT chest/A/P for staging
- radiation (if seminoma) vs retroperitoneal LN-ectomy (if nonseminoma)
f/u αFP + βHCG levels
Penile cancer:
etiology?
HPV-16/18 infx
Presentation of testicular torsion vs epididymitis?
torsion = pain + high riding testicle w/ horizontal lie
epididymitis = torsion + F/pyuria + cord tenderness
Organism a/w bladder SCC?
Schistosoma haematobium
