Nephro

Question 1

meds that cause acute interstitial nephritis

Answer 1

ATBs (PCN, ceph, sulfa)

Question 2

target Hb for CKD patients

Answer 2

10-12

Question 3

supplement to decr ca oxalate stones

Answer 3

K citrate

Question 4

tx urge incontinence

Answer 4

anticholinergics

Question 5

best way to incr success of voiding trial

Answer 5

start alpha blocker (tamsulosin) at time of catheter insertion

Question 6

empiric tx of male w/ purulent discharge or leak set or at least 10 WBC

Answer 6

azith or doxy
and ceftriaxone or cefixime
if no improvement in 3 most, add metronidazole

Question 7

UTI and fever at least 4 days after ATBs

Answer 7

perinephric abscess

Question 8

imaging to dx renal colic

Answer 8

CT

Question 9

opioids you can use in pts with ESRD

Answer 9

fentanyl

methadone

Question 10

only pts that should be evaluated for asymptomatic bacteriuria

Answer 10

pregnant at 12-16 wks or 1st prenatal visit

Question 11

ways to decrease contrast induced nephropathy

Answer 11

hydration with NS or sodium bicarb
use low or iso-osmolar contrast
use as little contrast as possible

Question 12

tx of urge incontinence

Answer 12

behavioral modification

then anticholinergics

Question 13

outpatient tx for pyelonephritis

Answer 13

cipro

Question 14

outpatient tx for UTI

Answer 14

nitrofurantoin

Question 15

normal overnight protein excretion, but increased protein in daytime. dx?

Answer 15

orthostatic proteinuria

Question 16

PSA > 2. management

Answer 16

5 alpha reductase inhibitor

Question 17

imaging for hematuria

Answer 17

CT urography or IVP

Question 18

causes of neurogenic bladder (constant leakage)

Answer 18

DM
MS
SCI

Question 19

constant leakage of urine

Answer 19

neurogenic bladder

Question 20

tx of neurogenic bladder

Answer 20

timed voiding
bethanechol
self cath
resect internal sphincter of bladder neck

Question 21

start thiazide, become hypercalcemic, nausea/vomiting, NL PTH

Answer 21

hyperparathyroidism (incr Ca suppresses PTH, making it look normal)

Question 22

target Hb in person with CKD and on Epoeitin

Answer 22

10-12

Question 23

defn of microscopic hematuria

Answer 23

at least 3 RBCs/hpf

Question 24

management of microscopic hematuria

Answer 24

US kidneys
urine cytology
cystoscopy if age > 40 or have risk factors of bladder CA

Question 25

urinary retention, fecal impaction, next step

Answer 25

MRI lumbosacral spine

Question 26

what pt will have NL B12 levels even though is deficient (and will need MMA)

Answer 26

renal failure

Question 27

management of severe hyperkalemia (K>7)

Answer 27

calcium chloride or gluconate to stabilize cardiac myocytes
transfer K intracellularly:
- sodium bicarb
- glucose w/ insulin
- albuterol
total body K decr w/ sodium polystyrene sulfonate (but takes a long time)

Question 28

WBC casts

Answer 28

pyelonephritis

Question 29

RBC casts

Answer 29

glomerulonephritis

Question 30

urine eosinophils

Answer 30

drug induced tubulointerstitial nephritis

Question 31

which fluoroquinolone not indicated for UTIs

Answer 31

moxifloxacin

Question 32

imaging for suspected ureteral stone

Answer 32

helical CT scan of abd pelvis w/o contrast

Question 33

4 things to look for if suspect UTI

Answer 33

dysuria
back pain
frequency
hematuria

Question 34

dx of interstitial cystitis

Answer 34

cystoscopy

Question 35

differential for terminal hematuria

Answer 35

lesion of bladder neck or prostatic urethra

Question 36

differential for hematuria throughout micturition

Answer 36

lesions of bladder (not neck though) or kidneys

Question 37

management of hematuria

Answer 37

if 40, cystoscopy

Question 38

kegel exercises are best for what type of incontinence

Answer 38

stress incontinence (like pregnant women)

Question 39

tx urge incontinence

Answer 39

anticholinergics

• oxybutynin
• tolterodine

Question 40

tx stress incontinence

Answer 40

pseudoephedrine