Neph / Urology Flashcards
Which renal function is most sensitive to dehydration?
BUN
How will the urine appear with intrinsic renal disease?
Casts (WBC, RBC, granular, epithelial) and protein
What is a new bio-marker for detecting acute kidney injury?
Cystatin-C
What ultrasound finding indicates a chronic renal problem?
Small kidney (less than 10cm)
What are indications for dialysis?
Acidosis
Electrolyte disorder
fluid overload
Uremic complications
Most common causes of chronic kidney disease?
DM
HTN
Glomerulonephritis
Polycystic Kidney Disease
Three abnormal symptoms of renal failure?
Metallic taste
Hiccups
Pruritus
What is the gold standard for identifying renal disease?
GFR
What is the marker for kidney disease?
Proteinuria
What test looks for recent strep infection and can be helpful in evaluating post-streptococcal glomerulonephritis?
ASO titer
How do we define nephrotic syndrome?
Excretion of > 3.5 g of protein (per 1.73 sq meters of body surface area)
What are the manifestation of nephrotic syndrome?
Hypoalbuminemia
Lipiduria
Hypercholesterolemia
Edema
What is a key urine finding in nephrotic syndrome?
Oval fat body in urine
What is the diagnostic method of choice for polycystic kidney disease?
ultrasound
What are 80% of kidney stones made of?
Calcium
What stones are produced by infections?
Struvite stones
What is the modality of choice in identifying kidney stones?
Abd / Pelvic CT without contrast
What are 5 causes of Diabetes Insipidus?
Inherited Lithium Hypokalemia Hypercalcemia Renal Disease
What urine osmolality points to DI?
<250 mOsm / kg
How is DI treated?
intranasal desmopressin
What medication should be administered to patients with hyperkalemia and EKG changes?
Calcium Gluconate
What are EKG changes of Hyperkalemia?
Peaked T waves
wide QRS
flat P waves
What treatment is used to remove potassium from the body?
Kayexalate (sodium polystyrene sulfonate)
Classic sign of hypocalcemia - tapping on the cheek?
Chvostek sign (facial spasms)
Classic sign of hypocalcemia - inflating BP cuff on arm?
Trousseau sign (wrist / hand spasm)
What is suggested treatment for cystitis?
Fluoroquinolone or nitrofurantoin, 3-5 days
What meds will change your urine red / orange?
Phenazopyridine and Rifampin
Most common bug to cause pyelonephritis?
E Coli
Recommended treatment for prostatitis?
Cipro 500mg bid x 2-6wks OR
Levaquin 500mg qd x 2-6wks OR
TMP-SMX bid x 6wks
What is the bug in epididymitis for males <35 yrs old?
GC / Chlamydia
What is the bug in epididymitis for males >35 yrs old?
E Coli
Classic (though unreliable) sign of epididymitis?
Prehn’s sign (lifting of testicle relieves pain = epididymitis, does not relieve pain = torsion)
What medication class is effective in treating urge incontinence?
anticholingergic
What is most common kind of prostate cancer?
adenocarcinoma
Most common renal cancer?
adenocarcinoma
Classic triad for renal cancer?
Hematuria
Flank pain
Palpable mass
What is the most common solid renal tumor in children?
Wilms tumor (nephroblastoma)
What is the initial imaging to evaluate abdominal masses?
ultrasound
Most common cancer in young men?
Testicular
What are the risk factors for testicular cancer?
Cryptoorchidism or past testicular cancer
What diagnostic markers for non-seminomatous germ cell testicular cancer?
AFP (alpha-fetoprotein)
beta-HCG
What is it called when foreskin cannot be retracted over glans of penis?
Phimosis
What leads to paraphimosis?
frequent cauterizations without reducing the foreskin
What is a fibrous plaque causing penile curvature?
Peyronie’s disease
What class of meds are used for erectile dysfunction?
PDE (phosphodiesterase) 5 inhibitor
Which two scrotal masses trans-illuminate?
Hydrocele
Spermatocele
Which scrotal mass has a “bag of worms” presentation?
Varicocele
How can the presentation of varicocele be more pronounced?
Valsalva
