Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Urology > Quiz 1 > Flashcards

Quiz 1 Flashcards

1
Q

Optimal daily urine volume should be?

A

~2500 ml

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

How much water intake is required to make the optimal amount of daily urine?

A

~250+ ml qh

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Burning pain with voiding felt in suprapubic area may be a sign of what?

A

Acute cystitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Painful suprapubic area may be a sign of what?

A

Acute urinary retention

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Is chronic retention painful in the bladder area (suprapubic)?

A

No - little or no pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Urethritis s/sxs (ddx common features of dysuria)

A

20-40 M or F
Pain throughout urination that is burning in quality
Freq, urethral d/c, inflamed urethra (m), local LA
UA: Pyuria, bacteriuria, hematuria
suprapubic palpation is painless
CVA tenderness (-)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Cystitis s/sxs (ddx common features of dysuria)

A

F: 15+ yrs, M: infant, elderly
Timing of pain is midstream/late that is burning in quality
No radiating pain, but chronic may cause dull abd or perineal pn
Freq, gross hematuria, fatigue
Mildly positive CVA tenderness
UA: Pyuria, bacteriuria, hematuria

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Pyelonephritis s/sxs (ddx common features of dysuria)

A

F: 15+ yrs, M: infant, elderly
Timing of pain is variable and may be burning
Pain referral: Flank, abdominal pain
Fever is usually present, may be high
Freq, myalgia, fatigue, weakness, N&V
suprapubic palpation is Painless unless concurrent cystitis
CVA tenderness is strongly positive
UA: Pyuria, bacteriuria, hematuria

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Chronic prostatitis s/sxs (ddx common features of dysuria)

A

M 30+ yrs
Timing of the pain is variable with the quality being pelvic dullness
Pain radiation: Testicular pain, general pelvic pain
Freq, altered libido, pn on ejaculation
suprapubic palpation is painless
CVA tenderness is mildly + or -
UA: pyuria, often negative

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Oliguria and anuria causes?

A

May be caused by acute renal failure (due to shock or dehydration), fluid-ion imbalance, OR bilateral ureteral obstruction. REFER for immediate tx!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Oliguria definition?

A

<500 ml urine output daily

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Anuria definition?

A

<100 ml urine output daily

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Does the degree of hematuria relate to the seriousness of the cause?

A

NO! The degree of hematuria does not relate the seriousness of cause; thus, the presence of any RBCs >1 occasion should be investigated to R/O serious condition
Gross hematuria in adults considered sign of cancer until ruled out!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Asymptomatic microscopic hematuria is commonly from what source?

A

Renal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Gross hematuria is commonly from what source?

A

Uroepithelial.

Gross, painless hematuria often the first manifestation of an urothelial tumor.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is the most common cause of hematuria in children without UTI or GN?

A

Hypercalciuria with microcalculi (metabolic cause of hematuria)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

If there is a history of hematuria and the first UA is clear, when do you do a repeat?

A

1 week

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

If there is a history of trauma or exercise induced hematuria, when do you do a repeat urine?

A

in 24- 48 hrs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Adult bladder capacity?

A

350 to 450 ml.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

A random S.G. of greater than _________ is a good indication that there is no intrinsic Ki dz?

A

1.020

Normal Specific Gravity - 1.003 - 1.030

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Dip-strips pick up what types of protein?

A

Albumin but not globulin, thus abN globulins such as Bence-Jones proteins are missed.

22
Q

What type of test picks up both albumin and globulin?

A

3% sulfosalycilic acid (SSA)

23
Q

If a Dip-strip = pos. & SSA = pos what does this mean?

A

Protein is albumin or globulin and further testing is

needed.

24
Q

If a Dip-strip = neg. & SSA = pos what does this mean?

A

Protein is globulin and a further workup is essential.

25
Q

If a Dip-strip = pos. & SSA =neg what does this mean?

A

False positive, probably due to high pH.

26
Q

What should be done if protein is >1+?

A

Do a 24 hour urine collection if protein is greater than 1+

150 mg/24 h

27
Q

What is the level of plasma glucose needed to see positive glucose in the urine?

A

Positive results seen when plasma glucose levels reach 170 mg/dl (nephron thresholds vary).

28
Q

What should you do if you find urine glucose?

A

Run a serum glucose– if normal consider renal tubular dz.

29
Q

When will urine nitrites be positive?

A

Picks up conversion of nitrate to nitrite by coagulase- splitting bacteria (E. coli, enterobacter, pseudomonas)
Seen with >100,000 organisms/mL.

30
Q

Why is urine nitrites such a useful test?

A

Useful to detect asymptomatic urinary tract infections - a positive test may be the only sign of PN in women (especially those pregnant), children & elderly.

31
Q

What test will often be the first indication of viral hepatitis?

A

Urine urobilinogen.

It elevates before the serum enzymes and urinary bilirubin.

32
Q

What type of cast is pathognomonic of acute GN or vasculitis?

A

RBC casts.

33
Q

What is endogenous creatinine clearance (24 hr urine and serum samples) used for?

A

Accurate and reliable measure of renal function without need for infusion.

34
Q

What is the gold standard for measuring GFR?

A

Inulin infusion.

35
Q

Nephritic syndrome definition?

A

Glomerular inflammatory process causing renal dysfunction.

36
Q

Nephritic syndrome s/sxs?

A

PHAROH: Proteinuria, Hematuria (cola colored urine), Azotemia, RBC casts, Oliguria, HTN

37
Q

MC cause of (post) infectious nephritic syndrome?

A

Most common: group A beta-hemolytic strep ⇒PSGN: “Nephrotoxic Strep”

38
Q

Glomerular bleeding characteristics?

A 
Dark red, brown, cola-colored urine
Proteinuria
Dysmorphic RBCs (acanthocytes)
HTN
Edema
Back/flank pain
Reduced renal function
(+) URI/fever/rash hx
39
Q

Urologic bleeding characteristics?

A 
Bright red urine
Clots may be present
RBC morphology: Isomorphic
Urinary voiding sxs
Back/flank pain
Normal renal function
(+) trauma hx
40
Q

What type of hypersensitivity is Post-infectious glomerulonephritis (eg. PSGN)?

A

Type III

41
Q

S/sxs of PSGN?

A

Prior group A beta-hemolytic strep (GAS) infx: strep pharyngitis or rash (impetigo). Latent period 1-3 weeks post pharyngitis 3-6 weeks after skin infx

Fever, confusion, HTN, periorbital edema, hematuria, HA, N&V, malaise.

42
Q

UA of PSGN?

A

Cola-colored urine, oliguria, RBCs, RBC casts (pathognomonic, but not always present), Proteinuria <3.5.

43
Q

What UA finding is pathognomonic for PSGN?

A

RBC casts

44
Q

What serology is used to dx PSGN?

A

Streptozyme test for 5 antibodies

45
Q

PSGN tx?

A

1) Treat infection if present (penicillin, erythromycin)
2) Treat any edema or HTN (conventional: loop diuretics)
3) Limit protein (about 1g/kg per day) and sodium
4) Bed rest
5) Botanicals: Curcuma, Echinacea
6) Quercitin, bromelain
7) Vit C to bowel tolerance Vit E 800 IU
8) Constitutional hydrotherapy, skin brushing

46
Q

What is a serious DDX variant of PSGN?

A

Same etiologies of acute GN can cause Rapidly Progressing Glomerulonephritis (RPGN). Drugs (penicillin, hydralazine, allopurinol and rifampaim), sometimes idiopathic. Can see anti-ANCA.
Can lead to acute renal failure.

47
Q

What are 3 categories of cause of nephritic syndrome?

A
  1. Post-infectious (PSGN mc)
  2. Autoimmune (Goodpasture, Wegeners, H-S purpura)
  3. Primary kidney dz: IgA nephropathy
48
Q

MC cause of primary nephritic syndrome?

What is the cause?

A

IgA nephropathy AKA Berger Dz.

Idiopathic.

49
Q

IgA nephropathy s/sxs?

A

Episodic gross hematuria <5 days after viral or bacterial URI (flu-like sx) or gastroenteritis; persistent microscopic hematuria, mild persistent proteinuria, HTN; rarely– acute or chronic renal failure.
Asymptomatic in 30-40%.

50
Q

General treatment approach to Nephritic syndromes:

A

1) Avoid sodium, avoid high-potassium foods, low protein diet, low antigen diet (gluten, meat, dairy)
2) Grifola, Withania, Tinospora
3) Diuretics (use with caution)
4) Fish oil (12 g/d)
5) Treat HTN: goal BP is <125/75 mmHg in presence of proteinuria >1g/d.
6) Remove other allergens (environmental, etc)
7) Conventional approach: corticosteroids, alkyating agents (cyclophosphamide), calcineurin inhibitors, rituximab and ocrelizumab

51
Q

Nephrotic syndrome definition?

A

The end result of a variety of diseases that damage (immunological or other assaults) the GBM ⇒ protein wasting (from alteration of the negative charge), and increased permeability of glomerular capillaries.

52
Q

Nephrotic syndrome s/sxs?

A

Massive prOteinuria, peripheral edema, hyperlipidemia, hypoalbuminemia, foamy urine, cough, exertional dyspnea

Urology (2 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions