Nephrology/ GU

Question 1

What lab findings are expected in

pre-renal AKI?

1. Bun:Cr
2. FeNa
3. Urine Sodium Concentration
4. Urine Osm

Answer 1

Prerenal AKI

1. BUN: Cr >20
2. FeNa: <1%
3. Urine Sodium concentration: <20
4. Urine Osm: >500

Question 2

What lab findings are expected with:

intra-renal AKI?

1. BUN: Cr
2. Urine Osm:
3. Urine Sodium
4. FeNa

Answer 2

intrarenal AKI:

1. BUN:Cr <15
2. Urine Osm: <350
3. Urine Sodium: >40
4. FeNa: >2%

Question 3

What lab findings are expected in

post renal AKI?

1. Urine Osm:
2. Urine Na:
3. FeNa:
4. BUN:Cr

Answer 3

Post Renal AKI:

1. Urine Osm: <350
2. Urine Na: >40
3. FeNa: mixed
4. BUN:Cr >15

Question 4

What does it mean if the urine turns blue with a cyanide-nitroprusside test?

Answer 4

That there is cistine in the urine indicating a defective renal amino acid transporter

*A patient with a build up of amino acids in the urine will be at an increased risk for bilateral kidney stones.

Question 5

What is Bartter Syndrome?

Answer 5

Bartter Syndrome is an AR disorder that causes defective chloride reabsorption leading to decreased Na absorption in the loop of henle.

Decreased Na absorption leads to Hypovolemia, activation of RAAS, severely decreased potassium.

Look for polyhydraminos, hypokalemia, hypochloremia, metabolic acidosis, and hypovolemia

Question 6

What is Liddle Syndrome?

Answer 6

Liddle Syndrome is the dysregulation of the ENaC channels in the proximal tubule leading to increased absorption of Na.

The increased absorption of Na leads to hypertension, along with hypokalemia. You’ll also see decreased levels of aldosterone and renin in these patients

Question 7

What is the first line treatment for priapism that is <3 hours in duration?

Answer 7

for priapism that is <3 hours duration the first line treatment is

intracavernosal injection of phenylepinephrine

if this isn’t effective, intracavernosal needle aspiration is an option after 4 hours

Question 8

urethral opening on the ventral side of the penis

Answer 8

hypospadias

*hypospadias are associated with an abnormal curvature of the penis known as a chordee.

It can also be associated with inguinal hernias and cryptorchidism, although this is not as common

Question 9

What conditions predispose someone to the formation of uric acid stones?

Answer 9

Uric acid stones are formed in the setting of acidic urine and an increase in uric acid.

*look for a history of gout, tumor lysis syndrome, conditions with rapid cell turnover- leukemia, or metabolic acidosis (copious, frequent diarrhea)

diuretics like thiazides and loops can also precipitate uric acid stones

Question 10

how do you treat and prevent uric acid stones?

Answer 10

Hydration is the number 1 way to prevent the formation of stones, but you can also decrease the acidity of the urine with potassium citrate

allopurinol can also be used

Question 11

Patients with nephrotic syndrome are more susceptible to what type of infections?

Answer 11

patients with nephrotic syndrome are more susceptible to infections by encapsulated bacteria including strep pneumo.

make sure they get their vaccine.

Question 12

Which class of diuretics can cause gout?

Answer 12

Thiazide diuretics can cause gout.

indapamide

chlorthaladone

hydrochlorothiazide

Question 13

what is the first line treatment for HTN in a patient with proteinuria or evidence of CKD?

Answer 13

regardless of ethnicity, first line treatment of HTN in a patient with kidney issues are

ACEi/ARB

Question 14

What are the signs of epididymitis?

Answer 14

Epididymitis

(+) Phren’s sign

normal lie

localized tenderness at the posterior of testicle

present cremasteric reflex

if pt is <35: Chlamydia

if >35: E. coli