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Fun Med Renal Urology > Nephrology Quiz 2 > Flashcards

Nephrology Quiz 2 Flashcards

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1
Q

regarding urinary casts, RED CELL CASTS are markers of what?

A

glomerular injury

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2
Q

IgA Nephropathy is also known as?

A

Berger Disease/IgA

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3
Q

on physical exam, combination HTN + abdominal mass is suggestive of which renal disease?

A

polycystic kidney disease

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4
Q

Which gene (on which chromosome) is responsible for slower progression of polycystic kidney disease?

A

ADPKD2 on chromosome 4

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5
Q

which diagnostic test is performed first when evaluating polycystic kidney disease

A

Ultrasound (if unclear, CT scan)

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6
Q

What is the criteria regarding number of cysts on each kidney, diagnosing polycystic kidney disease?

A

age < 60: 2+ cysts on each kidney

age > 60: 4+ cysts on each kidney

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7
Q

hematuria that is persistent and recurring in someone with polycystic kidney disease suggests what?

A

renal cell carcinoma

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8
Q

Patient with polycystic kidney disease endorses flank pain + fever + leukocytosis. What do you suspect?

A

renal infection

on CT, infected cysts have increased wall thickness

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9
Q

kidney stones in polycystic kidney disease are which type?

A

calcium oxalate

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10
Q

cerebral aneurysms are commonly located where in the brain?

A

Circle of Willis

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11
Q

This disease is benign at birth, and then diagnosed at age 40-50

A

Medullary Sponge Kidney

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12
Q

What area of the kidney is affected in medullary sponge kidney?

A

enlarged at interpapillary collecting ducts

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13
Q

you’ll see a “swiss cheese appearance” on imaging of this disorder

A

medullary sponge kidney

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14
Q

can you transplant a non-PKD kidney to a PKD patient with success?

A

YES - they will NOT develop PKD

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15
Q

what does gross hematuria in PKD patient typically represent?

A

rupture of a cyst into the renal pelvis (resolves within 7 days)

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16
Q

in a patient with suspected renal infection, you get a UA. It is normal, but you can’t rule out infection…why?

A

UA may be normal because cyst may not communicate with the urinary tract

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17
Q

True or false: 50% patients with PKD present with hypertension, but it will develop in most patients at some point in the course of the disease anyways.

A

TRUE

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18
Q

True or false: aggressive BP control seems to help slow the decline in GFR with a patient who has PKD

A

false - it does not stop the decline in GFR

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19
Q

this common, BENIGN disorder is present at birth and diagnosed at age 40-50

A

medullary sponge kidney

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20
Q

symptoms of medullary sponge kidney

A 
hematuria
recurrent UTI
nephrolithiasis
nephrocalcinosis
tubular acidosis
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21
Q

Diagnosing medullary sponge kidney? (what is seen on this imaging?)

A

CT - cystic dilation of distal collecting tubule, striated appearance, calcifications i collecting duct

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22
Q

medullary sponge treatment?

A

none - keep hydrated, add thiazide diuretics to decrease calcium excretion

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23
Q

common cause of ESRD in young individuals

A

juvenile nephronophthisis

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24
Q

patient aged 14 with ESRD, suspicious of what?

A

juvenile nephronophthisis

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25
what do kidneys look like on CT/US in patient with juvenile nephronophthisis?
small, scarred
26
kidneys look small and scarred on imaging, but what is diagnostic for medullary cystic kidney disease?
open biopsy
27
____ are contractile cells that constitute the central stalk of the glomerulus
mesangial cells
28
what is the glomerular basement membrane made of?
Type 4 collagen fibers
29
pan relief for acute uncomplicated bacterial cystitis?
Phenazopyridine
30
Treatment for uncomplicated bacterial cystitis?
Nitrofuratnoin -sulf/trim fluoroquinolones
31
pyelonephritis is also known as
acute complicated bacterial cystitis - upper and lower tract
32
patient presents with an obstruction of urination, NO tenderness on prostate exam, chills/rigors. What do you suspect?
acute complicated bacterial cystitis
33
Diagnostic for acute complicated bacterial cystitis
UA + microscopy/culture
34
Treatment for outpatient acute COMPLICATED bacterial cystitis?
ceftriaxone + Bactrim/augmentin/fluoroquinolone (broad coverage until culture comes back)
35
interstitial cystitis/bladder pain syndrome (IC/BPS) requires what duration of bladder symptoms for diagnosis?
> 6 weeks
36
discomfort associated w/ bladder filling, relieved by emptying. Patient explains he prefers to maintain lower bladder bolumes.
Interstitial cystitis/bladder pain syndrome
37
Allodynia is when non-noxious stimuli is perceived as painful stimuli. It is a hallmark symptom in?
IC/BPS
38
what will you see on UA and prostate exams of possible IC/BPS patient?
unremarkable
39
most common pathogens for urethritis
gonorrhea & chlamydia
40
patient presents with burning and mucopurulent discharge. you obtain UA and it reveals leukocyte esterases and WBC. Suspected diagnosis?
urethritis
41
urethritis treatment of gonorrhea?
ceftriaxone + azithro
42
urethritis treatment chlamydia
azithro or doxy
43
higher risk of acute bacterial prostatitis with what ?
HIV
44
what to be aware of if prostatitis is from s. aureus?
s. aureus infection elsewhere too
45
results of acute bacterial prostatitis prostate exam
firm, edematous, exquisitely tender
46
what other labs would you see in patient with acute bacterial prostatits
UA: bacteremia, pyuria, hematuria elevated PSA elevated ESR/CRP
47
gram positive cocci in chains (bacterial prostatitis) indicates what type of infection?
enterococcal infection | amox and ampicillin treatment
48
gram positive cocci in clusters indicates?
s. aureus | * treat with cephalosporin)
49
ok to use nitrofurantoin in acute or chronic bacterial prostatitis?
NO - poor penetration
50
staph aureus infections in patients with valvular disease are at high risk for what?
endocarditis
51
in order to diagnose CHRONIC bacterial prostatitis, how long do they need to have symptoms?
> 3 months (OR recurrent urogenital symptoms) AND bacteriuria is present
52
treatment chronic bacterial prostatitis?
Fluoroquinolones - even if they previously had it
53
risks of using fluoroquinolones?
c.diff, CNS toxicity, tendon rupture
54
patient has chronic pelvic pain for 3 of past 6 months, and inflammatory cells post prostatic massage. NO bacteriuremia Thoughts?
chronic prostatitis
55
pt presents with 4 month pelvic pain, ED, hx fibromyalgia. Prostate exam and UA unremarkable. differential?
chronic prostatitis
56
what is the most common cause of scrotal pain?
epididymitis/orchitis
57
commonest pathogen of epididymitis?
gonorrhea, chlamydia
58
when would you perform the NAAT test?
with UA + culture for suspected epididymitis
59
what other virus could cause epididymitis?
Mumps
60
treatment of epididymitis?
Abx + NSAIDs+ local heat/ice
61
how long should it take patient to improve with Abx therapy for epididymitis?
48-72 hours. If doesn't improve, do scrotal US and refer
62
are there serologic tests for IgA nephropathy?
no - do renal biopsy + immunofluorescence
63
treatment IgA nephropathy
depends on risk for progression to renal failure. Low risk - monitor high risk - ACE/ARB
64
when would you see elevated antistreptolysin O titer?
post-streptococcal glomerulus
65
where would you see anti GBM antibodies?
goodpastures/IgG
66
what does immunofluorescence look like for goodpastures?
linear, smooth outline of capillaries.
67
treatment of IgG
plasmapheresis + oral prednisone + cyclophosphamide
68
will kidney transplant in a patient with IgG be successful?
ONLY if there are no more antibodies present, otherwise they will get it again
69
what causes hyperlipidemia in patients with minimal change disease?
reduction in plasma oncotic pressure which directly stimulates hepatic APOPROTEIN B gene transcription, increasing levels of LDL
70
treatment minimal change
prednisone HIGH DOSE
71
immune complex deposition in SUBEPITHELIAL of glomerular capillary walls
membranous nephropathy
72
IgG and C3 are found in which disorders?
IgG and membranous nephropathy
73
in which glomerular disease is it especially important to monitor for thrombosis/DVT?
membranous nephropathy
74
higher risk of hypercoagulable state in patients with membranous nephropathy where?
Renal vein thrombosis
75
treatment of membranous nephropathy
antiprotein + ACE -immunosuppressants for high risk patients with salvageable kidney function
76
persistent albuminuria on 2 occasions 3-6 months apart
diabetic nephropathy
77
what are kimmelstiel-wilson nodules and where would you see them?
large accumulations in glomerulus,forms thickened nodules
78
what kind of finding might you see in the urine of someone with diabetic nephropathy?
foamy urine
79
this disorder, most common in African americans, progresses to ESRD in 6-8 years
focal segmental
80
treatment focal segmental glomerularsclerosis
diuretics + ACE+ statins
81
2 most common glomerular diseases in kinds and young adults
IgA nephropathy | minimal change disease
82
which hormones are involved in BPH?
testosterone, dihydrotestosterone, estrogen
83
BPH occurs in the ______ zone of the urethra while prostate cancer occurs in the _____ zone
central/transitional zone; peripheral zone
84
gold standard diagnostic for kidney stones?
noncontrast helical CT (US and XRAY can only identify small stones)
85
what size kidney stone is usually passed on own?
<5 mm | >10 mm needs surgical intervention
86
treatment calcium kidney stones <10 mm
hydration, pain manage (NSAID/opioids) alpha blockers/CCBs to help it pass strain the urine to collect!
87
between lithotripsy and laparoscopic stone removal of stones, which is preferred?
laparoscopic - lithotripsy has lower success rates
88
what is the correlation between parathyroid hormone (PTH) and stones?
elevated PTH puts patient at higher risk of making stones (related to calcium levels)
89
childhood stones are likely what type
cysteine - will see cysteinuria and hexagon stones
90
hexagonal stones?
cysteine
91
which stone types do you treat with potassium citrate?
cysteine and uric acid stones
92
uric acid stones are radiolucent, and correlate to a pH of less than what?
5.5
93
these stones form in the presence of upper UTI, and look like a coffin lid
struvite
94
treatment for struvite stones?
surgical removal - can't pass
95
this anatomical structure is an enlargement of the vas deferens and a reservoir for sperm
ampulla (of the vas)
96
these cells exist outside of the testicular cell and produce testosterone
leydig cells
97
what is a common autoimmune disease that affects sperm production/fertility?
cystic fibrosis

Fun Med Renal Urology (2 decks)

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