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Nephrology/Urology Flashcards

1
Q

Nephrotic syndrome includes what manifestations?

A
  • Proteinuria
  • Hypoalbunemia
  • Hyperlipidemia
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2
Q

Acute Glomerulonephritis (Nephritic Syndrome) includes what pt manifestations

A
  • Hematuria (RBC casts)
  • HTN
  • Edema /Azotemia (High nitrogen in blood)
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3
Q

Nephrotic syndrome includes what 3 etiologies?

A

Minimal Change
Focal Segmental Glomerulosclerosis
membranous nephropathy

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4
Q

MC Nephrotic syndrome etiology occurring in children: Effacement of podocytes: Tx is Prednisone

A

Minimal change Disease

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5
Q

Nephrotic syndrome etiology Involves AA, HTN and fibrosis of glomerulus: “Not Steroid responsive”

A

Focal Segmental Glomerulosclerosis

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6
Q

Nephrotic syndrome etiology Involves thickening of the glomerular basement membrane: 2T immune complex depositions

A

Membranous Nephropathy

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7
Q

Nephritic Syndrome (AGN) includes what etiologies?

A
  • IgA Nephropathy (Berger’s Disease)
  • Post infectious
  • Rapidly Progressive GN
  • Good Pasture’s
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8
Q

Nephritic Syndrome (AGN) MC after GABHS or Impetigo: Facial Edema: Post-Strep: coca cola urine

A

Post Infectious GN

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9
Q

Nephritic Syndrome (AGN): Linear IgG depositis, hemoptysis and kidney failure (Hematuria

A

Good Pasture’s

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10
Q

Nephritic Syndrome (AGN) progresses to ESRD in weeks due to fibrin and protein deposition:

Crescent formation biopsy Tx:

A

Rapid Progression GN

CS and Cyclophosphamide

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11
Q

MC Nephritic Syndrome (AGN) in adults WW: post URI or GI infection; IgA mesangial deposits: Tx: ACE/ CS

A

IgA Nephropathy (Berger’s Disease)

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12
Q

Acute Kidney Injury Types

A

Prerenal (MC). Intrinsic, and post renal.

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13
Q

MCC of prerenal AKI is _______: which leads to_______ if not corrected ? BUN:Cr is?

A

Hypovolemia (NSAID/IV contrast): Leads to ATN

B:Cr 20:1

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14
Q

Intrinsic types of AKI?

A

Acute Tubular necrosis (ATN MC type)

Acute tubulointerstitial nephritis (AIN)

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15
Q

Intrinsic AKI caused by hypo/ tension-volemia or aminoglycosides: UA= Muddy Brown casts/Epithelial cell

A

ATN

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16
Q

AIN is caused by a ________–> to ________ casts?

A

Hypersensitivity (PCN, NSAID Sulfa: WBC Casts

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17
Q

RBC casts are pathognomonic for ?

A

Acute Glomerulonephritis

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18
Q

FeNa >2 you think what AKI?

A

ATN

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19
Q

Low FeNa< 2 you think what type of AKI?

A

Prerenal

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20
Q

Autosomal Dominant D/O: Abdominal Flank pain /palpable mass, recurrent infections, Hematuria, HTN

Dx: Tx:

A

Adult Polycystic Kidney Disease

Dx: Renal US Tx: ACEi/ renal transplant

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21
Q

Adult Polycystic Kidney Disease is associated with what Extrarenal common abnormalities

A

Berry Aneurysms and MVP

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22
Q

MCC and 2nd MCC of ESRD

A

1st MCC DM-II

2nd MCC HTN

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23
Q

what is the single best predictor of Chronic Kidney Disease?

A

Proteinuria

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24
Q

Best Diagnostic tool for CKD?

A

Spot Albumin/U creatinine Ratio (ACR)
“preferred over 24 hour collection”

(ACR <2 Normal; 2-20 micro: >20 nephropathy)
(Albuminuria 24H <30mg=Normal: 30-300mg: >300 neph)

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25
Q

What are the GFR CKD stages?

A 
Stage 0= >90 
Stage 1= 60-90
Stage 2= 30-59
Stage 3= 15-30
Stage 4= <15
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26
Q

Non-physiologic excess of ADH from pituitary or ectopic
2T stroke, trauma CNS tumor, ecstasy:

Hyponatremia Na < 120: Isovolemic- no edema:
Dx: Tx:

A

Syndrome of Inappropriate ADH

Dx: Concentrated urine Tx: H2O restriction < 800ml/day
Hyponatremia - hypertonic saline/Lasix

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27
Q

ADH (vasopressin) deficiency or insensitivity: Large amounts of urine 20L /day: Hypernatremia: Polydipsia

Dx Tx:

A

Diabetes Insipidus

Dx: Fluid deprivation–> dilute urine
Desmopressin–> reduces urine (central)

Tx: Desmopressin or carbamazepine

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28
Q

Drugs that can cause Diabetes insipidus –> partial or complete insensitivity to ADH?

A

Lithium or Amphotericin B

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29
Q

Electrolyte imbalance that causes Increased DTRs and prolonged PR and QT interval–> _____?

A

hypomagnesemia : Torsades

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30
Q

Hypermagnesemia treatment

A

-Calcium Gluconate

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31
Q

Electrolyte imbalance that causes muscle weakness/ cramps, palpitations, T wave flattening or U waves ECG

A

Hypokalemia

32
Q

Hyperkalemia treatment (Wide QRS in ECG)

A
  1. Calcium Gluconate
  2. Insulin
  3. B2 Agonists
33
Q

MCC of epididymitis in <35 and >35?

A

< 35 Chlamydia or Gonorrhea
>35 E.coli or Klebsiella

Mumps

34
Q

Orchitis manifestations?

A

Scrotal- pain redness, swelling
UA- Pyuria/bacteruria
(+) Phrens
(+) Cremasteric reflex

35
Q

Orchitis Treatment?

A

<35 Doxy + Ceftriaxone (Chlamydia/Gono)

> 35 Levo or Ofloxacin (Cephalexin/amoxicillin children)

Chronic- 4-6 week trial

36
Q

Abrupt scrotal/inguinal pain: < 6 hours NV, 10-20 yo:
Negative phrens, negative cremasteric, Blue Dot Sign

Dx: Tx:

A

Testicular Torsion

Dx: Doppler US Tx: Orchiopexy w/I 6 hours

37
Q

Orchiopexy tx for Cryptorchidism is recommended as early as ______, until then observation can be done?

A

6 months (ideally prior to 1 year)

38
Q

Sx repair for hydrocele persistent or communicating can be done if not resolved by what age?

A

1 year of age or electively

39
Q

Cystic testicular mass worsened when patient is upright or Valsalva: MC sx correctable infertility cause

A

Varicocele

40
Q

Varicocele MC involves what vessels?

A

Pampiniform venou Plexus and internal spermatic vein

41
Q

Left sided varicocele in older man= ________

Right sided varicocele in < 10 yo= _________

A

Older man L side= Renal cell carcinoma

< 10 yo R side = Retroperitoneal malignancy

42
Q

Fever, tachycardia, back/flank pain CVA tenderness, NV UA= WBC?

A

Pyelonephritis

43
Q

suprapubic discomfort, hematuria, dysuria, in creased frequency and urgency?

A

Acute Cystitis

44
Q

Definitive Dx for acute cystitis/Pyelonephritis?

Tx: for pyelonephritis

A

Urine Cx= WBC >100,000

Fluoroquinolone or Aminoglycoside X 14 days

45
Q

Acute Cystitis complicated Tx?

A

Fluoroquinolone or Aminoglycoside IV 7-10 days

46
Q

Acute Cystitis uncomplicated?

A

Nitrofurantoin- 100 bid X 7days
Ciprofloxacin 250 mg BID X 3 days
TMP- DS BID X3 days

47
Q

Acute Cystitis pregnant Tx?

A

Amoxicillin (Augmentin) or cephalexin 7-14 days

Nitrofurantoin

48
Q

Foreskin becomes trapped behind corona of glans?

A

Paraphimosis (Phimosis retract over glans)

49
Q

fever/ chills, Increased frequency/urgency, dysuria, peri anal pain, LBP exquisitely tender, hot, boggy prostate

A

Acute prostatitis

50
Q

Recurrent UTIs, obstruction sx, LBP non-tender, boggy prostate

A

Chronic Prostatitis

51
Q

Prostatitis Tx?

A

> 35 Fluoroquinolone or TMP (E.coli)

<35 Doxycycline + Ceftriaxone (Chlamydia/Gonorrhea)

52
Q

Obstructive and irritative urinal symptoms: Uniformly enlarged, firm, “Rubbery prostate”:

A

Benign Prostatic Hyperplasia (BPH)

53
Q

Benign Prostatic Hyperplasia (BPH) Dx; Tx:

A

Dx: PSA < 4

Tx: 5-A reductase Inh. (Finasteride Dutasteride) “Androgen Inhibitors” (suppresses growth)

A-1 blockers Tamsulosin, Terazosin, -zosin (m. relaxation)
“Only relieves symptoms”

54
Q

MC cancer on prostate cancer ?

A

Adenocarcinoma

55
Q

Prostate cancer highlights?

A
  • Urethral obstruction
  • Back/bone pain
  • PSA> 4ng (>10 ng = METS)
56
Q

Painless gross or microscopic hematuria, irritative s/sx

A

Bladder cancer

57
Q

MC cancer in bladder cancer ?

A

Transitional Cell cancer

58
Q

Hematuria, flank/abdominal pain, palpable mass, malaise, weight loss, HTN, Hypercalcemia, L varicocele,

A

Renal Cell Carcinoma (95 originate in kidney)

59
Q

in 1st 5 yo life: Hematuria, HTN, painless palpable abdominal mass, anorexia, and anemia?

A

Wilms Tumor (Nephroblastoma)

60
Q

Sudden constant upper/lateral back pain radiating to groin/ anteriorly: NV, restless position, hematuria

A

Nephrolithiasis

61
Q

Urinary pH >7.2 stone formation is associated with what stone

A

Struvite Nephrolithiasis

62
Q

MC type of Nephrolithiasis ?

A

Calcium Oxalate

63
Q

Calculi formed 2T urea-splitting organism proteus or Klebsiella, pseudomonas?

A

Struvite Calculi (–> Staghorn)

64
Q

Narrowest point of urinary tract?

A

Ureterovesicular joint

65
Q

Tx of stone less than ______mm in diameter that have a 80% chance of spontaneous passage?

A

5mm

Tx: Iv fluids: Analgesic, antiemetic
Tamsulosin A-1 blocker

66
Q

Tx for large stones >8mm

A

Lithotripsy (Uretoscopy w stent)

67
Q

Erectile dysfunction treatment phosphodiesterase 5 Inh

that works 30 min.-4 hours before sexual activity

A

Sildenafil (Viagra)

68
Q

Erectile dysfunction treatment phosphodiesterase 5 Inh

that works within 30 min. with no regard of sex timing

A

Tadalafil (Cialis)

69
Q

Erectile dysfunction treatment phosphodiesterase 5 Inh

that works 60 minutes prior to sexual activity

A

Vardenafil (Levitra)

70
Q

Priapism management?

A 
Phenylephrine (intracavernous injection)
Terbutaline (Orally or sub Q)
Needle aspiration (Blood removal)
71
Q

Urethritis Dx: and Tx:

A

Dx: Nucleic acid amplification

Tx: Gono: Ceftriaxone (250mg) X1 or Azythromycin 2 G
Non-Gono: Azithromycin 1G or Doxy 100 BID X 10

72
Q

Atherosclerotic MC in elderly: HTN onset <20 or >50 or HTN resistant to 3 drugs: AKI post ACEi; Abd. Bruit

Tx:

A

Renovascular Hypertension (Renal Artery stenosis)

Tx: Stent definitive

73
Q

Enuresis Tx:

A

Desmopressin
Imipramine
(Alarm or behavioral)

74
Q

Incontinence marked by overactive bladder Detrusor muscle?

Tx:

A

Urge incontinence

Tx: Oxybutynin or Tolterodine (Anticholinergics)
TCA-Mirabregon

75
Q

Incontinence marked by increased abd. pressure, ;laxity of pelvic floor muscle: laughing, sneezing, coughing

Tx:

A

Stress Incontinence

Tx: Midodrine

76
Q

Incontinence marked by urinary retention (incomplete emptying). underactive detrusor muscle:

Dx:

A

Overflow Incontinence

Dx: Post void residual .200 ml Tx: Tamsulosin (A-1 b)

PANCE (13 decks)

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