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Rosh Review > Nephrology, Fluids, Electrolytes > Flashcards

Nephrology, Fluids, Electrolytes Flashcards

1
Q

Treatment for epididymitis without concern for STI

A
  • Levofloxacin/Ciprofloxacin or Bactrim
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2
Q

What is Prehn sign

A

Relief of pain with elevation of affected testicle (sensitivity of 90% for epididymitis)

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3
Q

Most common cause of nephrotic syndrome in children? Tx?

A

Minimal change nephrotic syndrome

  • can be preceded by URI
  • Tx = steroids
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4
Q

Lab work in nephrotic syndrome

A
  • Proteinuria > 3.5 g/24hr (3+ or 4+ on dipstick)
  • Hypoproteinemia
  • Hyperlipidemia
  • Hypercoagulability
  • Fatty casts
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5
Q

Management of peritonitis in PD patient

A

Outpatient with intraperitoneal abx for 10-14 days

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6
Q

Laboratory values in post-streptococcal glomerulonephritis

A
  • Elevated antistreptolysin O titers
  • Elevated anti-DNase B titers
  • Decreased C3 levels
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7
Q

What is the most common cause of death in patients with SLE?

A

Kidney disease, particularly diffuse proliferative glomerulonephritis

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8
Q

When is the cremasteric reflex absent?

A
  • Testicular torsion
  • Upper and lower motor neuron disorders
  • Spinal injury of L1-L2
  • Iatrogenic transection of ilioinguinal nerve during surgery for hernia repair
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9
Q

What is Prehn sign?

A

Relief of pain with elevation of a painful testicle -> epididymitis

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10
Q

AV Fistula Complications

A
  1. Dialysis-Associated Steal Syndrome
    - occurs secondary to retrograde flow from artery distal to AV anastomosis
    - most common when a large artery supplies blood through fistula into a large, low-pressure vein
  2. Hemorrhage
    - often due to platelet dysfunction, supratherapeutic anticoagulation, or fistula abnormalities
    - hemostasis via direct pressure, topical hemostatic agents, desmopressin, suture, tourniquet
  3. Stenosis
    - upper extremity and chest wall edema
    - outflow stenosis (bounding pulse, absent thrill)
    - inflow stenosis (weakened radial pulse and high pitched bruit)
    - vascular surgery consult
  4. Thrombosis
    - Most commonly due to venous outflow stenosis, venous stasis, or compression
    - Absence of bruit and thrills
    - Vascular surgery consult for thrombectomy or thrombolysis
  5. Aneurysm or pseudoaneurysm
    - aneurysms form 2/2 repetitive cannulation and weakening of vessel walls
    - pseudoaneurysms are rare
    - vascular surgery consult
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11
Q

Presentation of autosomal dominant polycystic kidney disease

A
  • HTN
  • Hematuria
  • Proteinuria
  • Impaired kidney function
  • Flank pain often due to renal hemorrhage, calculi, or UTI
  • Cerebral aneurysms
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12
Q

What is the most common cause of death in people with autosomal dominant polycystic kidney disease?

A

CAD

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13
Q

Features of nephrotic syndrome

A 
NAPHROTIC
N- Na decrease (hyponatremia)
A- Albumin decrease (hypoalbuminemia)
P- Proteinuria >3.5 g/day
H- Hyperlipidemia
R- Renal vein thrombosis
O- Orbital edema (and peripheral edema)
T- Thromboembolism
I- Infection (due to loss of immunoglobulins in urine)
C- Coagulability (due to loss of antithrombin III in urine) and Casts (fatty)
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14
Q

Pediatric definition of nephrotic syndrome

A
  • Proteinuria greater than 50 mg/kg/day
  • Urine protein/creatinine ratio more than 2.0 mg/mg
  • Hypoalbuminemia of less than 2.5 g/dL
  • Presence of edema and hyperlipidemia
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15
Q

Causes of nephrotic syndrome

A
  1. Minimal change disease: children, preceded by URI - rx: steroids
  2. Focal segmental glomerulosclerosis: African-Americans, HIV/IVDA
  3. Membranous nephropathy: Caucasians, HBV, HCV, SLE, gold, penicillamine, malignancy
  4. Membranoproliferative glomerulonephritis
  5. Diffuse mesangial proliferation
  6. Secondary associated with systemic disease or infection
  7. Congenital occurring within first 3 months of life
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16
Q

Most common cause of prostatitis

A

Most common: E. Coli
Others: proteus, other enterobacteriaceae, pseudomonas

Sexually active men, think of N. Gonorrhoeae, chlamydia

17
Q

Tx of acute prostatitis

A

> 35: Bactrim or fluoroquinolone (cipro) for 4 weeks

Sexually active men (<35): Ceftriaxone IM and doxycycline x14 days

18
Q

HUS triad and clinical presentation

A
  • Renal insufficiency
  • Thrombocytopenia
  • Microangiopathic hemolytic anemia (schistocytes)

Prodrome of abdominal pain, vomiting, bloody diarrhea to triad to seizures/lethargy

19
Q

Which carries a higher mortality, strep pneumo vs. E. Coli HUS?

A

Strep pneumo

20
Q

What is the recommended empiric antibiotic therapy for a patient with a renal abscess and a severe penicillin allergy?

A

Meropenem or imipenem

21
Q

Differentiating features of lymphogranuloma venereum

A
  • Unilateral inguinal lymphadenopathy (develops 1-3 weeks after appearance of initial lesion)
  • Chancre described to have purplish hue
  • Duration of lesion typically only up to 3 days
22
Q

Tx for lymphogranuloma venereum

A

Doxycycline (caused by chlamydia trachomatis)

23
Q

Ulcer appearance of granuloma inguinale

A

Beefy red ulcer - caused by klebsiella granulomatis

24
Q

At what ages are patients most likely to develop testicular torsion?

A

During puberty or the neonatal period

25
Q

Symptoms of BPH

A 
HI FUN
Hesitancy
Intermittence, incontinence
Frequency, fullness
Urgency
Nocturia
26
Q

What other lab findings aside from BUN:Cr ratio are consistent with prerenal AKI?

A

Urine Na <20 mEq/L and FENa <1%

27
Q

What labs could be elevated in testicular cancer

A
  • beta-hcg
  • alpha-fetoprotein (AFP)
  • LDH
28
Q

What lab study can be obtained to differentiate between ischemic and nonischemic priapism?

A

Cavernous blood gas analysis

29
Q

Tx of balanitis (inflammation of glans penis) or balanoposthitis (inflammation of distal foreskin)

A

Antifungal cream

Potentially abx

30
Q

Tx of phimosis

A

(Inability to retract the foreskin)

  • Topical steroid cream for 1-2 months (maybe, but not normally necessary only if chronic)
  • Periodic gentle retraction
  • Signs of ischemia->dorsal slit procedure
31
Q

What electrolyte abnormalities are associated with renal tubular acidosis?

A

Hyperchloremic metabolic acidosis with low bicarb and potassium

32
Q

What is the tx for epididymitis in patients >35 years old?

A

Bactrim or fluoroquinoline as gram-negative rods (E. Coli, Klebsiella, Enterobacter, and Citrobacter species) are more common

33
Q

What medication can induce epididymitis?

A

Amiodarone

Rosh Review (22 decks)

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