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Clin Med V and VI > Nephrology > Flashcards

Nephrology Flashcards

1
Q

What types of drugs are available to treat BPH?

A
  • Alpha blockers

- 5-alpha-reductase inhibitors

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2
Q

How do 5-alpha-reductase inhibitors work?

A

Blocks the conversion of testosterone to dihydrotestosterone and shrinking the size of the prostate

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3
Q

MC benign tumor in men

A

BPH

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4
Q

How do alpha-blockers work in the treatment of BPH?

A

They relax the smooth muscle in the prostate and bladder neck

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5
Q

Does autosomal dominant or autosomal recessive polycystic kidney disease usually manifest earlier in life?

A

Autosomal recessive

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6
Q

Why might we see waxing and waning of hematuria in a patient with PKD?

A

Because sometimes the cysts bleed, and we only see hematuria when this happens

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7
Q

Preferred method of diagnosing PKD

A

Ultrasound

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8
Q

If a patient has cryptochordism, what can we do to determine if the testis is anywhere in the body, or if is congenitally absent?

A

hCG test - Give hCG for 3 days; will cause a significant increase in serum testosterone if testes are present

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9
Q

What lab must you draw before initiating hormone replacement therapy for hypogonadism?

A

PSA levels - giving HRT to a man with cancer is like putting gasoline on a fire

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10
Q

How does Sildenafil work?

A

-Helps sustain penile blood inflow by inhibiting PDE-5, which fosters penile detumescense

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11
Q

Do varicoceles more often occur in the left or right side?

A

Left side

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12
Q

Is extravaginal or intravaginal testicular torsion more common?

A

Extravaginal

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13
Q

Which type of testicular torsion is more common in neonates?

A

Extravaginal

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14
Q

Which type of testicular torsion is more common in males ages 8-18?

A

Inravaginal

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15
Q

MC type of incontinence

A

Urge incontinence

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16
Q

Mainstay of urge incontinence tx

A

Bladder training

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17
Q

Medications that can be used to treated urge incontinence

A

Tolterodine

Oxybutynin

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18
Q

MCC of stress incontinence

A

Hypermobility and significant displacement of the urethra during exertion

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19
Q

Mainstay of stress incontinence tx

A

Kegal exercises

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20
Q

Most effective tx option for obstructive incontinence

A

Surgical decompression

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21
Q

Sexually transmitted epididymitis is commonly associated with what pathogens?

A

Chlamydia and N. gonorrhoeae

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22
Q

Non-sexually transmitted epididymitis is often caused by what types of pathogens?

A

Gram (-) rods

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23
Q

In sexually transmitted epididymitis, which pathogens are visible as intracellular diplococci?

A

N. gonorrhoeae

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24
Q

How long do we treat sexually transmitted epididymitis?

A

10-21 days

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25
How long do we treat non-sexually transmitted epididymitis?
21-28 days
26
Part of a patient's presenting symptoms will help distinguish epididymitis from orchitis?
With orchitis, the urinary symptoms of epididymitis are absent
27
MC form of orchitis
Mumps orchitis
28
If a patient's history is unknown, what can we do to help distinguish whether a patient is presenting with orchitis or testicular torsion?
Testicular ultrasound w/Dopper blood flow measurements (less flow=torsion, more flow=orchitis)
29
Types of prostatitis
- Acute bacterial - Chronic bacterial - Nonbacterial - Prostatodynia
30
What types of organisms are usually responsible for acute bacterial prostatitis?
Gram (-) bacteria
31
Initial abx therapy for treatment of acute bacterial prostatitis should include what drug types?
Aminoglycosides and Ampicilin
32
How long do we treat patients with acute prostatitis with abx therapy?
4-6 weeks
33
Optimum duration of therapy for chronic bacterial prostatitis
6-12 weeks
34
MC "type" of prostatitis
Nonbacterial prostatitis
35
If we suspect prostatitis in an older man with irritative voiding symptoms, what must we rule out before giving the diagnosis of prostatitis?
Bladder cancer
36
ACE treatment for hyperkalemia
- Antagonize the arrhythmia with calcium - Cellular redistribution - give insulin and glucose - Excretion - give diuretics, Kayexalate, dialysis
37
What are red cell casts associated with?
Glomerular bleeding
38
What are leukocyte casts associated with?
- Common in pyelonephritis | - Can be in glomerulonephritis and interstitial nephritis
39
What are renal tubular epithelial cell casts associated with?
- Acute tubular necrosis - Glomerulonephritis - Tubulointerstial disease
40
What are granular waxy casts associated with?
Degenerative cellular elements
41
What are broad casts associated with?
Chronic renal failure
42
"Maltese cross"-appearing lipid bodies are associated with what syndrome?
Nephrotic syndrome
43
MC causes of urethritis
-N. gonorrhoeae and Chlamydia
44
Second most common urologic cancer
Bladder carcinoma
45
With what types of high-risk patients do you want to perform a periodic screening for bladder cancer?
- Tobacco users - Those with occupational exposures - Those with exposure to arsenic in their drinking water
46
MC site of prostate cancer metastasis
Axial skeleton
47
Standard method of diagnosing prostate cancer
Transrectal ultrasound-guided biopsy
48
In what part of the prostate gland do most cancers arise?
In the periphery of the gland
49
In what types of cells does renal cell carcinoma originate?
Proximal tubule cells
50
Would you see an increase or decrease in RBC production in a person with renal cell carcinoma?
Increased
51
Treatment of choice for localized renal cell carcinomas
Radial nephrectomy
52
Is better survival associated with seminomas or nonseminomas testicular cancer?
Seminomas
53
How do you confirm a diagnosis of testicular cancer?
With an inguinal orchiectomy
54
Increased or decreased DTRs with hypochloremia?
Increased
55
Chvostek's sign and Trousseau's sign are associated with what electrolyte imbalance?
Hypocalcemia
56
Why might a patient with hypercalcemia experience polyuria?
Because Ca++ can act as an osmotic agent
57
What should you look for if a thorough H/P don't shed light on the cause of hypercalcemia?
Malignancy
58
Increased or decreased DTRs with hypermagnesemia?
Decreased
59
Increased or decreased DTRs with hypomagnesemia?
Increased
60
What electrolyte antagonizes magnesium and can thus be given IV for hypermagnesemia?
Calcium
61
Increased or decreased HR with hypermagnesemia?
Decreased (bradycardia and decreased BP)
62
Electrolyte imbalance that can be responsible for cerebral edema, brain herniation, seizures, and coma
Hyponatremia
63
Hyper- or hyponatremia associated with SIADH?
Hyponatremia
64
Hyper- or hyponatremia associated with diabetes insipidus?
Hypernatremia
65
EKG changes associated with hypokalemia
- Prolonged PR interval - Peaked P wave - Blunted T wave - ST Depression - U wave
66
EKG changes associated with hyperkalemia
Bradycardia, VFib, other arrhythmias
67
Tx of RPGN
High-dose, pulse glucocorticoid therapy
68
MCC of acute renal injury
Prerenal failure
69
With what type of renal injury are muddy-brown casts associated?
Acute tubular necrosis
70
What type of renal injury would you suspect if you noticed concomitant rhabdomyolysis?
Pigment-induced injury
71
What type of injury would you suspect if you noticed that the patient had two black, necrotic toes?
Cholesterol embolization
72
What can we do to the urine while treating pigment-induced renal injury?
Make it more alkaline
73
What type of tx is to be avoided in a person with cholesterol embolization?
Anticoagulation
74
Least common cause of acute renal failure
Post-obstructive
75
Would you think prerenal, intrinsic, or post-obstructive acute renal failure if a patient complained of intense lower abdominal pain?
Post-obstructive
76
Does membranous nephropathy usually present with nephrotic or nephritic syndrome?
Nephrotic
77
How would you treat membranous nephropathy?
High-dose, alternate-day steroids for 6-12 months
78
What type of histologic change will you observe in a patient with membranous nephropathy?
Thick capillary walls
79
Tx of IgA nephropathy
- ACE-I/ARB to reduce proteinuria and to control HTN | - Steroids if 1-3g/day proteinuria
80
Most common cause of ESRD in the USA
Diabetes

Clin Med V and VI (5 decks)

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