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Nephrology/GU Flashcards

1
Q

What is hematuria?

A

5+ RBC in urine

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2
Q

What dz can cause hematuria?

A 
BAPI HUH
Benign familial
Alport
Post strep glemerulonephritis
IgA - Berger
Hemolytic uremic
UTI
Hypercalcuria
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3
Q

What is benign familial hematuria?

A

RBC in urine

d/t family gene - autosomal dominant

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4
Q

Benign familial hematuria - sx?

A

normal:

  • exam
  • renal fxn
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5
Q

Adult smokes + painless hematuria = ?

what can this lead to?

A

transitional cell carcinoma

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6
Q

Benign familiar hematuria - PE?

A

prerenal: dark
renal: casts
post renal: bright red

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7
Q

What is Alport sx?

A

can lead to ESRD

autosomal recessive

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8
Q

What are the genetic caused hematuria dz?

A

benign familial hematuria

Alport sx

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9
Q

Hematuria + hearing loss + vision loss = ?

A

Alport sx

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10
Q

Alport sx - dx?

A

renal bx

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11
Q

What is post strep glomerulonephritis?

A

d/t a strep infxn: throat or skin

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12
Q

When does post strep glomerulonephritis occur?

A

1-2 days after strep infxn

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13
Q

Which hematuria dz can cause HTN?

A

post strep glomerulonephritis
IgA
HUS

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14
Q

How to differentiate between post strep glomerulonephritis and IgA?

A

get ASO titers to r/o post strep glomerulonephritis

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15
Q

Post strep glomerulonephritis - tx?

A

control HTN
supportive
fluid balance

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16
Q

Baby had URI 1-2 days ago + hematuria + RBC casts = ?

A

IgA nephropathy

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17
Q

Post strep glomerulonephritis - labs?

A

increased BUN/Cr

UA: hematuria + RBC casts

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18
Q

IgA nephropathy - tx?

A

prednisone

ACE inhibitors

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19
Q

Athletic child w/ fever comes in with brown urine?

A

myoglobinuria/rhabdomyloysis

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20
Q

Myoglobinuria/rhabdomylosis - UA?

A

NO RBC

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21
Q

Myoglobinuria/rhabdomylosis - tx?

A

mannitol to flush it all out

rehydrate

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22
Q

HUS - sx?

A

rash
dark urine
HTN
bloody diarrhea

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23
Q

HUS - labs?

A

high PTT
high BUN/Cr
RBC + casts

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24
Q

What dz have RBC + casts?

A

HUS
post strep glomerulonephritis
IgA

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25
Q

HUS - dx?

A

stool: EHEC

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26
Q

HUS - what to be careful of?

A

abx

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27
Q

HUS - tx?

A

supportive

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28
Q

Henoch schonlein purpura?

A

IgA mediated
rash waist down
arthritis
abdominal pain

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29
Q

Baby has abdominal pain + arthritis + rash waist down =?

A

henoch schonlein purpura

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30
Q

Henoch schonelin purpura - labs?

A

CBC - check for non thrombocytopenia

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31
Q

What is proteinuria?

A

child: >30-40mg/kg/day
adult: >3-3.5g
protein: Cr > 0.2

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32
Q

What is the gold standard to check for protein?

A

24 hr urine

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33
Q

Orthostatic proteinuria?

A

protein in urine when sitting/standing

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34
Q

Orthostatic proteinuria - dx?

A

morning first void > 24 hr urine

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35
Q

Orthostatic proteinuria - tx?

A

benign

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36
Q

Minimal change dz?

A

COMMON CX OF PROTEINURIA IN KIDS

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37
Q

Minimal change dz - prognosis?

A

does NOT lead to ESRD

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38
Q

Baby comes in with sudden onset of edema?

A

minimal change dz

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39
Q

What kidney dz can be treated w/ ACE?

A

IgA

minimal change dz

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40
Q

Minimal change dz - dx?

A

renal bx

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41
Q

Bug for UTI?

A

e coli

adenovirus

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42
Q

female comes in w/ fever but NO URI?

A

UTI

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43
Q

RF for UTI?

A

female
male not circumcised
constipation

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44
Q

UTI can lead to ESRD if?

A

recurrent 3x

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45
Q

UTI sx?

A 
vomit
diarrhea
abdominal pain 
strong smelling urine
NO CVA tenderness in kids 
suprapubic pain
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46
Q

What to look out for in babies w/ systemic sx?

A

pyleo

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47
Q

Baby <12 mo has fever w/ no source?

A

UA

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48
Q

Gold standard for clean catch in babies?

A

catheter b/c bag is not clean catch

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49
Q

Dx for UTI in babies?

A

clean catch UA C&S

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50
Q

If urine culture comes back with flora?

A

prob not UTI

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51
Q

UTI - tx?

A

cover for e coli

7-14days

52
Q

UTI - admit if?

A

suspicious for sepsis, stones
unable to stay hydrated
<3 mo w/ fever

53
Q

When to US for UTI?

A

<2 yo
boy w/UTI
recurrent UTI (3x)
GU anamolies

54
Q

When to VCUG for UTI?

A

fails to respond in 2days
<2yo with 2nd UTI
recurrent UTI

55
Q

How to dx reflux neuropathy?

56
Q

How many grades are there for reflux neuropathy and when do you do surgery?

A

Grade I - V

Grade V - surgery

57
Q

What is enuresis?

A

wetting the bed at night

58
Q

What is concerning enuresis?

A

able to potty but now wetting the bed - secondary enuresis

59
Q

What are the categories of enuresis?

A

nocturnal
diurnal
primary enuresis
secondary enuresis

60
Q

What is dirunal?

A

peeing during the day and night

61
Q

What is primary enuresis?

A

NEVER been potty trained

62
Q

What is secondary enuresis?

A

potty trained for >6mo but starting to wet the bed

63
Q

Cx of enuresis?

A

UTI
anatomical prob
social probs at home

64
Q

Enuresis - PE check for?

A

spinal bifida

65
Q

Enuresis - tx?

A

1) bed wetting alarms

2) drugs (antidiuretic)

66
Q

What is polycystic kidney dz?

A

polyps on the kidney

67
Q

What are the types of polycystic kidney dz?

A

autosomal dominant

autosomal recessive

68
Q

Why is autosomal recessive not that important?

A

does not live very long

69
Q

Autosomal dominant polycystic kidney - PE?

A

flank pank

recurrent UTI

70
Q

Autosomal dominant polycystic kidney - dx?

A

2 cysts in 1 kidney
1 cyst in EACH kidney
FMAILY hx

71
Q

Autosomal dominant polycysit kidney - tx?

A

manage HTN

transplant

72
Q

What is CAH 21 Hydroxylase deficiency?

A

salt wasting sydndrome d/t too much androgen and coritosl

73
Q

CAH 21 hydroxylase deficiency - labs?

A 
hyponatremia
hyperkalemia
hypoglycemia
metabolic acidosis
hypovolemia
74
Q

What happens when you are hypovolemic?

A

too much renin produced –> dehydration, vomit, shock

75
Q

Hydroxylase deficiency - females?

A

amiguous genitalia and virilization

76
Q

Hydroxylase deficiency - males?

A

bilateral cryptorchidism (absence of a testes)

77
Q

What is phimosis?

A

inability to pull back prepuce (foreskin) over the glans

78
Q

What is phimosis at risk for?

A 
UTI
urinary retension
urinary reflux
STI
penile cancer
79
Q

Phismosis - timeline?

A

3yo: normal retraction of foreskin
3yo+: gentle retraction + topical hydrocortisone
DO NOT forcefully retract foreskin

80
Q

What is paraphismosis?

A

phimotic foreskin is retracted past the cornoal suclus and becomes trapped –> tight ring that impairs blood flow
MEDICAL EMERGENCY

81
Q

Parphismosis- PE?

82
Q

Paraphismosis -cx?

A

forceful retraction

83
Q

Parphismosis - tx?

84
Q

Balanoposthitis?

A

inflammation of glans
penile edema
phismosis

85
Q

Posthitis?

A

inflammation of prepuce and penile skin

86
Q

Balanoposthitis - bugs?

A

candida

strep

87
Q

Balanoposthitis - tx?

A

antifungal cream

+/-abx

88
Q

What is buried penis?

A

small penis but normal structures

89
Q

Buried penis - population?

90
Q

Buried penis - complication?

A

skin irritation d/t pee pooling

91
Q

Bured penis - tx?

92
Q

Microphallus?

A

penile length is below average/mean

93
Q

Microphallus can cause?

A

hypogonadotropic hypogonadism

primary testicular failure

94
Q

Undescended testes types?

A

retractile testes

cryptorchidism

95
Q

When does testes drop?

A

by the end of 6mo

96
Q

What is retractile testes?

A

testicles pull down into inguinal canal when exposed but settles down in warm bath
most descend by 2yo

97
Q

What is cryptorchidism?

A

true undescended testes

98
Q

Cryptorchidism - risk?

A

infertility

germ cell tumor

99
Q

Cryptorchidism - tx?

A

orchidopexy 6-12mo

100
Q

How to palpate for testes?

A

begin high in inguinal canal –> nothing? US

found? –> monitor

101
Q

What is varicocele?

A

enlargement of the veins in the scrotum

“boggy enlargement”

102
Q

Varicocele - PE?

A

left side
full testes
“bag of worms”
increase in size when standing

103
Q

Varicocele - cx?

A

obstruction of increase pressure of abdomen

104
Q

Varicocele-complication?

A

infertility

105
Q

Hydrocele?

A

non painful swelling of scrotum d/t fluid buildup

106
Q

Hydrocele - tx?

A

resolves in 6mo (common in newborns)
too big - surgery
does NOT affect infertility

107
Q

What is testical torsion?

A

twisting of the spermatic cord

108
Q

Testical torsion - PE?

A

painful and acute abdominal pain radiating to groin
N&V
swollen testes
NO relief when testes are elevated - negative Prehn sign
Negative cremasteric reflex

109
Q

Testicular torsion - dx?

A

scrotal doppler w/ flow doppler

110
Q

Epididymitits?

A

inflammation of epididymitis

111
Q

Epidimyitis - bugs?

A

bacterial: chlaymdia

112
Q

Epididymitis - PE?

A

painful and swollen testes
NO N&V
RELIEF when testes are elevated - positive Prehn sign
positive cremasteric reflex (drawing of the scrotum)

113
Q

Torsion of appendix testes-PE?

A 
acute pain of upper pole testes
small swelling of testes
NO FEVER
NO N&V
"blue dot"
114
Q

Torsion of appendix testes-labs?

A

testicular doppler: normal or decreased blood flow

115
Q

Torsion of appendix tests- tx?

A

pain control

self resolves

116
Q

Orchitis?

A

mumps

rare

117
Q

Orchitis - PE?

A

fever
HA
unilateral parotid gland swelling
bilateral testes pain

118
Q

Orchitis - timeline?

A

4-6days after parotiditis

119
Q

Orchitis - complication?

A

infertility

aseptic meningitis

120
Q

What is inguinal hernia?

A

protrusion of abdominal contents through inguinal canal

121
Q

Inguinal hernia -gender?

A

boys>girls

122
Q

Inguinal hernia - PE?

A

R>L

increase in size w/ valsalva

123
Q

Inguinal hernia - unincarcerated vs incarcerated?

A

un: not painful
in: painful –> ER

124
Q

What scrotal swelling is painful?

A 
epididymitis
orchitis
testicular torsion
torsion of appendix testes
incarcerated inguinal hernia
125
Q

What scrotal swelling is NOT painful?

A 
hydrocele
varicocele
inguinal hernia
nephrotic syndrome
testiuclar tumors
macro-orchidism
micro-orchidism

Pediatrics (12 decks)

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