Nephrology and Urology Flashcards
What is the most likely diagnosis of pt presenting with dehydration, pallor, hemolytic anemia (helmet shaped schistocytes and burr cells on smear), thrombocytopenia, and elevated creatinine after GI illness?
Hemolytic uremic syndrome (HUS)
due to E.Coli O157:H7
When should surgical repair of a varicocele (collection of dilated and tortuous veins that surrounds the spermatic cord, feels like bag of worms) occur?
when there is evidence of atrophy or growth retardation of the affected testicle
What is the possible complication associated with undescended testicles?
increased risk of cancer (seminoma)
What is the silk glovesign and what does it indicate?
thickened processus vaginalis; inguinal hernia
What is the most likely diagnosis for pt with hearing loss, hematuria, extrusion of central portion of lens into anterior chamber, macular flecks, corneal erosions and family history of kidney failure?
Alport syndrome
abnormal basement membrane
What is the most likely diagnosis for pt presenting with absent/ hypoplastic/ dystrophic nails, proteinuria and orthopedic anomalies (hypoplastic patella)?
Nail-patella syndrome
15% can result in end stage renal disease
What is the most likely diagnosis for pt presenting with testicular pain, horizontal lying testes that is high riding, absence of cremasteric reflex, pain continues with elevation of testis, and nausea/ vomting?
Testicular torsion
dx: ultrasound
(tx: surgery)
What are 3 causes of pseudohyperkalemia (spurious hyperkalemia)?
- hemolyzed specimen
- thrombocytosis
- Leukocytosis
What are the 2 lab findings diagnostic of post-streptococcal glomerulonephritis?
- Antistreptolysin O (after strep pharyngitis)
2. DNase B antibody (after cutaneous strep)
What is the treatment used for microalbuminuria in diabetics and what is the possible side effects?
ACE inhibitors (lisinopril); chronic cough and angioedema
What is the most likely diagnosis for pt presenting with dark urine, hypertension, red blood cell casts in urine, and erythematous weeping lesions associated with yellowish crusting under/ around the nose?
Post-streptococcal Glomerulonephritis
can also occur after strep throat
What is the next best step in management for pt presenting with hydrocele after 1 year old?
surgical referral
possible inguinal hernia
What is the most likely diagnosis for pt with proteinuria in the evening but not in the morning without other symptoms?
Orthostatic proteinuria
dx: urine protein to creatinine ratio on 1st morning void followed by an upright specimen
What is the most likely diagnosis for pt presenting with recurrent painless hematuria after URIs with IgA within mesangial deposits of the glomerulus and normal C3 complement?
Berger disease (IgA nephropathy)
What is the difference between diabetes insipidus and pschogenic polydipsia?
DI: low urine osm, high serum osm
PP: low urine osm, low serum osm
What is the most likely diagnosis for a pt presenting with asymptomatic microscopic hematuria with a calcium to creatinine ratio less than 0.2?
Familial hematuria
check parents urine
What is the electrolyte derangement associated with ethylene glycol intoxication?
high anion gap metabolic acidosis with acute renal failure
high Na, high K, low Cl, low bicarb, high creatinine, high osm, low pH
…is when a tight prepuce is retracted over the glans of the level of the distal corona and can lead to ischemia of the distal shaft and glans of the penis
Paraphimosis
What is the most likely diagnosis of pt presenting with lower extremity and generalized edema, normal blood pressure, diffuse abdominal pain, elevated Tg/ cholesterol, proteinuria, hypoalbuminemia, but normal creatinine?
Idiopathic nephrotic syndrome
what is the most likely diagnosis for newborn presenting with deficient abdominal musculature, cryptorchidism, urinary tract anomalies (hydronephrosis, VUR), pulmonary hypoplasia (respiratory distress) and prenatal oligohydramnios?
Prune belly syndrome
Eagle- Barrett syndrome
What is the most likely diagnosis for pt presenting with painless fluid filled cyst liek nodule above the upper pole of the testicle?
Spermatocele
filled with nonviable sperm
What is the most likely diagnosis for pt presenting with scrotal pain localized to palpable mass at superior pole with bluish discoloration and positive cremasteric reflex?
Torsion of the testicular appendix
tx: supportive
What are the major reasons for delay in renal transplantation?
- active or recurrent UTIs
- uncontrolled malignancy
- ABO incompatibility
What is the most likely diagnosis for pt presenting with shortened QT interval, nausea, confusion, constipation, anorexia in the setting of prolonged immobilization or sarcoidosis?
Hypercalcemia
What renal disorder is fanconi syndrome associated with?
Type 2 renal tubular acidosis
fanconi syndrome: bicarb, phos, glu, and amino acid loss
What is the most likely diagnosis for pt presenting with dysuria, urinary frequency, difficulty voiding and friable, erythematou, edematous, fleshy donut shaped mass extruding from near the vaginal introitus?
Urethral prolapse
tx: topical estrogen cream BID for 2 weeks
What is the most likely diagnosis for pt presenting with cough, recurrent sinusitis, mucosal ulceration, hemoptysis, exercise intolerance, conjunctival injection, glomerulonephritis, and saddle nose deformity?
Granulomatosis with polyangitis
(aka Wegener granulomatosis)
(due to ANCA)
What GI manifestation is assocaited with autosomal recessive polycystic kidney disease?
congenital hepatic fibrosis
What is the change of body distribution of water from infancy to 10 years old?
total body weight decreases
extracellular water decreases
intracellular water increases
What dietary change can result in decreased renal stones?
decreased vitamin C intake
What disorder is most often associated with idiopathic nephrotic syndrome?
renal vein thrombosis
What is the most likely diagnosis for pt presenting with hypertension, headaches, bruit heard lateral to umbilicus?
renal artery stenosis (due to fibromuscular dysplasia)
What is the recommendations for urine microalbumin screening for type 1 versus type 2 diabetics?
Type 1: start 5 years after diagnosis
Type 2: start at diagnosis
what is the best long-term treatment for nocturnal enuresis?
enuresis alarms (older than 7 year old)
What is the most likely diagnosis for pt presenting with gross/ microscopic hematuria, pain with urination, normal blood pressure, no proteinuria, normal C3/C4/C50?
Idiopathic hypercalciuria
dx: 24hr urine for total calcium excretion or spot urine calcium to creatinine ratio
What is the next best step in management for patient with coma/ seizure due to hyponatremia?
immediately raise Na level by 2-3 meq using 3% NS
then raise by 0.5 meq/hr to normal using NS
