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Fun Med Renal Urology > Nephrology Quiz 2 > Flashcards

Nephrology Quiz 2 Flashcards

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
Q

what do kidneys look like on CT/US in patient with juvenile nephronophthisis?

A

small, scarred

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26
Q

kidneys look small and scarred on imaging, but what is diagnostic for medullary cystic kidney disease?

A

open biopsy

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27
Q

____ are contractile cells that constitute the central stalk of the glomerulus

A

mesangial cells

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28
Q

what is the glomerular basement membrane made of?

A

Type 4 collagen fibers

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29
Q

pan relief for acute uncomplicated bacterial cystitis?

A

Phenazopyridine

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30
Q

Treatment for uncomplicated bacterial cystitis?

A

Nitrofuratnoin
-sulf/trim
fluoroquinolones

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31
Q

pyelonephritis is also known as

A

acute complicated bacterial cystitis - upper and lower tract

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32
Q

patient presents with an obstruction of urination, NO tenderness on prostate exam, chills/rigors. What do you suspect?

A

acute complicated bacterial cystitis

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33
Q

Diagnostic for acute complicated bacterial cystitis

A

UA + microscopy/culture

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34
Q

Treatment for outpatient acute COMPLICATED bacterial cystitis?

A

ceftriaxone + Bactrim/augmentin/fluoroquinolone (broad coverage until culture comes back)

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35
Q

interstitial cystitis/bladder pain syndrome (IC/BPS) requires what duration of bladder symptoms for diagnosis?

A

> 6 weeks

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36
Q

discomfort associated w/ bladder filling, relieved by emptying. Patient explains he prefers to maintain lower bladder bolumes.

A

Interstitial cystitis/bladder pain syndrome

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37
Q

Allodynia is when non-noxious stimuli is perceived as painful stimuli. It is a hallmark symptom in?

A

IC/BPS

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38
Q

what will you see on UA and prostate exams of possible IC/BPS patient?

A

unremarkable

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39
Q

most common pathogens for urethritis

A

gonorrhea & chlamydia

40
Q

patient presents with burning and mucopurulent discharge. you obtain UA and it reveals leukocyte esterases and WBC. Suspected diagnosis?

A

urethritis

41
Q

urethritis treatment of gonorrhea?

A

ceftriaxone + azithro

42
Q

urethritis treatment chlamydia

A

azithro or doxy

43
Q

higher risk of acute bacterial prostatitis with what ?

A

HIV

44
Q

what to be aware of if prostatitis is from s. aureus?

A

s. aureus infection elsewhere too

45
Q

results of acute bacterial prostatitis prostate exam

A

firm, edematous, exquisitely tender

46
Q

what other labs would you see in patient with acute bacterial prostatits

A

UA: bacteremia, pyuria, hematuria
elevated PSA
elevated ESR/CRP

47
Q

gram positive cocci in chains (bacterial prostatitis) indicates what type of infection?

A

enterococcal infection

amox and ampicillin treatment

48
Q

gram positive cocci in clusters indicates?

A

s. aureus

* treat with cephalosporin)

49
Q

ok to use nitrofurantoin in acute or chronic bacterial prostatitis?

A

NO - poor penetration

50
Q

staph aureus infections in patients with valvular disease are at high risk for what?

A

endocarditis

51
Q

in order to diagnose CHRONIC bacterial prostatitis, how long do they need to have symptoms?

A

> 3 months (OR recurrent urogenital symptoms)

AND bacteriuria is present

52
Q

treatment chronic bacterial prostatitis?

A

Fluoroquinolones - even if they previously had it

53
Q

risks of using fluoroquinolones?

A

c.diff, CNS toxicity, tendon rupture

54
Q

patient has chronic pelvic pain for 3 of past 6 months, and inflammatory cells post prostatic massage. NO bacteriuremia Thoughts?

A

chronic prostatitis

55
Q

pt presents with 4 month pelvic pain, ED, hx fibromyalgia. Prostate exam and UA unremarkable. differential?

A

chronic prostatitis

56
Q

what is the most common cause of scrotal pain?

A

epididymitis/orchitis

57
Q

commonest pathogen of epididymitis?

A

gonorrhea, chlamydia

58
Q

when would you perform the NAAT test?

A

with UA + culture for suspected epididymitis

59
Q

what other virus could cause epididymitis?

A

Mumps

60
Q

treatment of epididymitis?

A

Abx + NSAIDs+ local heat/ice

61
Q

how long should it take patient to improve with Abx therapy for epididymitis?

A

48-72 hours. If doesn’t improve, do scrotal US and refer

62
Q

are there serologic tests for IgA nephropathy?

A

no - do renal biopsy + immunofluorescence

63
Q

treatment IgA nephropathy

A

depends on risk for progression to renal failure. Low risk - monitor
high risk - ACE/ARB

64
Q

when would you see elevated antistreptolysin O titer?

A

post-streptococcal glomerulus

65
Q

where would you see anti GBM antibodies?

A

goodpastures/IgG

66
Q

what does immunofluorescence look like for goodpastures?

A

linear, smooth outline of capillaries.

67
Q

treatment of IgG

A

plasmapheresis + oral prednisone + cyclophosphamide

68
Q

will kidney transplant in a patient with IgG be successful?

A

ONLY if there are no more antibodies present, otherwise they will get it again

69
Q

what causes hyperlipidemia in patients with minimal change disease?

A

reduction in plasma oncotic pressure which directly stimulates hepatic APOPROTEIN B gene transcription, increasing levels of LDL

70
Q

treatment minimal change

A

prednisone HIGH DOSE

71
Q

immune complex deposition in SUBEPITHELIAL of glomerular capillary walls

A

membranous nephropathy

72
Q

IgG and C3 are found in which disorders?

A

IgG and membranous nephropathy

73
Q

in which glomerular disease is it especially important to monitor for thrombosis/DVT?

A

membranous nephropathy

74
Q

higher risk of hypercoagulable state in patients with membranous nephropathy where?

A

Renal vein thrombosis

75
Q

treatment of membranous nephropathy

A

antiprotein + ACE

-immunosuppressants for high risk patients with salvageable kidney function

76
Q

persistent albuminuria on 2 occasions 3-6 months apart

A

diabetic nephropathy

77
Q

what are kimmelstiel-wilson nodules and where would you see them?

A

large accumulations in glomerulus,forms thickened nodules

78
Q

what kind of finding might you see in the urine of someone with diabetic nephropathy?

A

foamy urine

79
Q

this disorder, most common in African americans, progresses to ESRD in 6-8 years

A

focal segmental

80
Q

treatment focal segmental glomerularsclerosis

A

diuretics + ACE+ statins

81
Q

2 most common glomerular diseases in kinds and young adults

A

IgA nephropathy

minimal change disease

82
Q

which hormones are involved in BPH?

A

testosterone, dihydrotestosterone, estrogen

83
Q

BPH occurs in the ______ zone of the urethra while prostate cancer occurs in the _____ zone

A

central/transitional zone; peripheral zone

84
Q

gold standard diagnostic for kidney stones?

A

noncontrast helical CT (US and XRAY can only identify small stones)

85
Q

what size kidney stone is usually passed on own?

A

<5 mm

>10 mm needs surgical intervention

86
Q

treatment calcium kidney stones <10 mm

A

hydration, pain manage (NSAID/opioids)
alpha blockers/CCBs to help it pass

strain the urine to collect!

87
Q

between lithotripsy and laparoscopic stone removal of stones, which is preferred?

A

laparoscopic - lithotripsy has lower success rates

88
Q

what is the correlation between parathyroid hormone (PTH) and stones?

A

elevated PTH puts patient at higher risk of making stones (related to calcium levels)

89
Q

childhood stones are likely what type

A

cysteine - will see cysteinuria and hexagon stones

90
Q

hexagonal stones?

A

cysteine

91
Q

which stone types do you treat with potassium citrate?

A

cysteine and uric acid stones

92
Q

uric acid stones are radiolucent, and correlate to a pH of less than what?

A

5.5

93
Q

these stones form in the presence of upper UTI, and look like a coffin lid

A

struvite

94
Q

treatment for struvite stones?

A

surgical removal - can’t pass

95
Q

this anatomical structure is an enlargement of the vas deferens and a reservoir for sperm

A

ampulla (of the vas)

96
Q

these cells exist outside of the testicular cell and produce testosterone

A

leydig cells

97
Q

what is a common autoimmune disease that affects sperm production/fertility?

A

cystic fibrosis

Fun Med Renal Urology (2 decks)

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