Nephrology/Urology Flashcards
Significance of creatine test
Creatinine is a waste produce from the muscles of the body and should be filtered out of the blood. Normal is 1.2 for women and 1.4 for men. anything above this indicates kidneys are not functioning properly
GFR
Measures how well the kidneys are with removing wastes and excess fluid from the blood. Normal is 90+, below 60 indicates a problem, below 15 is kidney failure.
Blood urea nitrogen level
Comes from the breakdown of protein that you ingest.
Normal between 7-20. As Kidney function decreases, BUN rises.
Pylonephritis
Etiology: E-Coli, pseudomonas aeruginosa, klebsiella, proteus, citrobacter, morganella species
S/sx: low grade fever, w/wo lower back pain. Severe case can cause high fever, rigors, N, V, flank pain, loin pain. S/S cystitis may or may not be present
Dx: CBC, Urinalysis, Urine Culture. In complicated cases renal US or Abd CT
Tx: Look up
Urethritis
Eti: Chlamydia is isolated in 50% of cases. Co-infection with gonococci common.
S/sx: Many asymptomatic. Some w/ discharge (can be mucopurulent), pruritus, hematuria, dyspareuni
Dx: Testing for cause- STI screening. Culture.
Tx: Treat cause (often will treat gonorrhea and chlamydia both -> ceftriaxone IM and azithromycin or doxy)
Interstitial Cystitis
Eti: Unknown. Associated illnesses are IBD, severe allergies, IBS
S/sx: Pain w/ bladder filling that is relieved with urination. May experience urgency, frequency, nocturia
Dx: Urinalysis, culture, urinary cytology, hydrodistension, Rule out genital herpes, vaginitis or urethral diverticulum
Tx: First Line-Amitriptyline, nifedipine
Acute Cystitis
Eti: E-Coli: 75-90% As well as S. Saprophyticus, klebsiella, proteus, enterococcus, citrobacter.
S/sx: dysuria, urinary frequency, urgency. Nocturne, hesitancy, suprapubic discomfort, and gross hematuria
Dx: Typically can be treated by history alone. urine dipstick, urinalysis, urine culture
Tx: Nitrofurantoin, bactrim
