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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
Q

How long do we treat non-sexually transmitted epididymitis?

A

21-28 days

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26
Q

Part of a patient’s presenting symptoms will help distinguish epididymitis from orchitis?

A

With orchitis, the urinary symptoms of epididymitis are absent

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27
Q

MC form of orchitis

A

Mumps orchitis

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28
Q

If a patient’s history is unknown, what can we do to help distinguish whether a patient is presenting with orchitis or testicular torsion?

A

Testicular ultrasound w/Dopper blood flow measurements (less flow=torsion, more flow=orchitis)

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29
Q

Types of prostatitis

A
  • Acute bacterial
  • Chronic bacterial
  • Nonbacterial
  • Prostatodynia
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30
Q

What types of organisms are usually responsible for acute bacterial prostatitis?

A

Gram (-) bacteria

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31
Q

Initial abx therapy for treatment of acute bacterial prostatitis should include what drug types?

A

Aminoglycosides and Ampicilin

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32
Q

How long do we treat patients with acute prostatitis with abx therapy?

A

4-6 weeks

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33
Q

Optimum duration of therapy for chronic bacterial prostatitis

A

6-12 weeks

34
Q

MC “type” of prostatitis

A

Nonbacterial prostatitis

35
Q

If we suspect prostatitis in an older man with irritative voiding symptoms, what must we rule out before giving the diagnosis of prostatitis?

A

Bladder cancer

36
Q

ACE treatment for hyperkalemia

A
  • Antagonize the arrhythmia with calcium
  • Cellular redistribution - give insulin and glucose
  • Excretion - give diuretics, Kayexalate, dialysis
37
Q

What are red cell casts associated with?

A

Glomerular bleeding

38
Q

What are leukocyte casts associated with?

A
  • Common in pyelonephritis

- Can be in glomerulonephritis and interstitial nephritis

39
Q

What are renal tubular epithelial cell casts associated with?

A
  • Acute tubular necrosis
  • Glomerulonephritis
  • Tubulointerstial disease
40
Q

What are granular waxy casts associated with?

A

Degenerative cellular elements

41
Q

What are broad casts associated with?

A

Chronic renal failure

42
Q

“Maltese cross”-appearing lipid bodies are associated with what syndrome?

A

Nephrotic syndrome

43
Q

MC causes of urethritis

A

-N. gonorrhoeae and Chlamydia

44
Q

Second most common urologic cancer

A

Bladder carcinoma

45
Q

With what types of high-risk patients do you want to perform a periodic screening for bladder cancer?

A
  • Tobacco users
  • Those with occupational exposures
  • Those with exposure to arsenic in their drinking water
46
Q

MC site of prostate cancer metastasis

A

Axial skeleton

47
Q

Standard method of diagnosing prostate cancer

A

Transrectal ultrasound-guided biopsy

48
Q

In what part of the prostate gland do most cancers arise?

A

In the periphery of the gland

49
Q

In what types of cells does renal cell carcinoma originate?

A

Proximal tubule cells

50
Q

Would you see an increase or decrease in RBC production in a person with renal cell carcinoma?

A

Increased

51
Q

Treatment of choice for localized renal cell carcinomas

A

Radial nephrectomy

52
Q

Is better survival associated with seminomas or nonseminomas testicular cancer?

A

Seminomas

53
Q

How do you confirm a diagnosis of testicular cancer?

A

With an inguinal orchiectomy

54
Q

Increased or decreased DTRs with hypochloremia?

A

Increased

55
Q

Chvostek’s sign and Trousseau’s sign are associated with what electrolyte imbalance?

A

Hypocalcemia

56
Q

Why might a patient with hypercalcemia experience polyuria?

A

Because Ca++ can act as an osmotic agent

57
Q

What should you look for if a thorough H/P don’t shed light on the cause of hypercalcemia?

A

Malignancy

58
Q

Increased or decreased DTRs with hypermagnesemia?

A

Decreased

59
Q

Increased or decreased DTRs with hypomagnesemia?

A

Increased

60
Q

What electrolyte antagonizes magnesium and can thus be given IV for hypermagnesemia?

A

Calcium

61
Q

Increased or decreased HR with hypermagnesemia?

A

Decreased (bradycardia and decreased BP)

62
Q

Electrolyte imbalance that can be responsible for cerebral edema, brain herniation, seizures, and coma

A

Hyponatremia

63
Q

Hyper- or hyponatremia associated with SIADH?

A

Hyponatremia

64
Q

Hyper- or hyponatremia associated with diabetes insipidus?

A

Hypernatremia

65
Q

EKG changes associated with hypokalemia

A
  • Prolonged PR interval
  • Peaked P wave
  • Blunted T wave
  • ST Depression
  • U wave
66
Q

EKG changes associated with hyperkalemia

A

Bradycardia, VFib, other arrhythmias

67
Q

Tx of RPGN

A

High-dose, pulse glucocorticoid therapy

68
Q

MCC of acute renal injury

A

Prerenal failure

69
Q

With what type of renal injury are muddy-brown casts associated?

A

Acute tubular necrosis

70
Q

What type of renal injury would you suspect if you noticed concomitant rhabdomyolysis?

A

Pigment-induced injury

71
Q

What type of injury would you suspect if you noticed that the patient had two black, necrotic toes?

A

Cholesterol embolization

72
Q

What can we do to the urine while treating pigment-induced renal injury?

A

Make it more alkaline

73
Q

What type of tx is to be avoided in a person with cholesterol embolization?

A

Anticoagulation

74
Q

Least common cause of acute renal failure

A

Post-obstructive

75
Q

Would you think prerenal, intrinsic, or post-obstructive acute renal failure if a patient complained of intense lower abdominal pain?

A

Post-obstructive

76
Q

Does membranous nephropathy usually present with nephrotic or nephritic syndrome?

A

Nephrotic

77
Q

How would you treat membranous nephropathy?

A

High-dose, alternate-day steroids for 6-12 months

78
Q

What type of histologic change will you observe in a patient with membranous nephropathy?

A

Thick capillary walls

79
Q

Tx of IgA nephropathy

A
  • ACE-I/ARB to reduce proteinuria and to control HTN

- Steroids if 1-3g/day proteinuria

80
Q

Most common cause of ESRD in the USA

A

Diabetes

Clin Med V and VI (5 decks)

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