Quiz 5 - Urogenital Flashcards by Piper Dobner

which enzyme is responsible for regulating blood pressure in the kidney?

renin

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which kidney is lower?

right

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which PMHx are common in the renal patient?

lupus
DM
hypertension

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what are associated ROS for renal dz?

general: fever, wt loss, fatigue
CV - dypnes, chest pain, edema
GI - anorexia, NV cramps
GU - polyuria, dysuria, hematuria
Skin - rash, puritis

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what does deep breathing suggest

metabolic acidosis

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what are red flag symptoms of urinary frequency

fever
back pain
lower extremity weakness

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what are red flag symptoms of dysuria?

fever
flank pain
recent instrumentation
immunocompromised
recurrence

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what is involuntary bed wetting after age 5

nocturnal enuresis

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what are the three types of urinary incontinence

inability to hold urine due to:

overflow
stress
urge

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what are the red flags of polyuria?

abrupt onset
night sweats
cough
weight loss
psychiatric disorder

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what is oliguria?

decreased urine output

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anuria is?

urine output

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microscopic hematuria should be investigated when

then presence of any RBCs >1

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when painless urination is seen - what should be considered?

tumors of bladder, kidney, prostate - until proven otherwise

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what are red flags in regards to hematuria?

gross hematuria
persistant microscopic in elderly
hypertension
edema

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what is the most common cause of renal colic and what are red flag symptoms?

most often caused by passage of renal calculi

red flags:
fever
oliguria
anuria

what is commonly used for STI testing

NAAT PCR

which bacterial UTI is common in kiddos?

kelbsiella enterobacter

what host defenses reside in the uroepithelium and renal tubules?

tamm-horsfall glycoproteins

IgA local antibodies also exist in the uroepithelium

in regards to urethritis, which organisms are responsible?

Gonococcal urethritis - 50% cases, yellow green d/c

NGU - non gonococcal urethritis - most are Chlamydia, whitish-mucoid d/c

urgency, frequency, tingling with urination

what is a good ddx for recurrent UTI

bladder cancer
DM
prostate obstruction

what is unique to cystitis?

NO FEVER

usually asx in kiddos and elderly
run a UA

patient ptc with history of LUT infection, quickly have acquired chills, fever and tachycardia.. what condition is this and what is expected on lab work?

Acute Pyelonephritis

CBC - elevated WBC w left shift

UA - WBCs, pos LE, nitrites

** if protein is present on UA sign of nephron destruction

what are glitter cells and what do they represent?

PMNs with cytoplasmic granules in state of Brownian motion

seen in acute pyelonephritis

what is a common complication of acute pyelonephritis

renal abscess

what is key in regards to chronic pyelonephritis

can take over 20 years to develop usually asymptomatic Decreased SG is seen sometimes on UA Image with KUB (kidney ureter bladder X-ray)

how is a definitive dx for glomerular disorder discovered?

renal biopsy

what is the classic presentation of nephritic syndromes?

``` PHAROH proteinuria hematuria azotemia RBC casts oliguria HTN ```

what is the most common cause of post-infectious glomerulonephritis?

group A beta hemolytic strep - coca cola colored urine. if untreated could lead to nephrotic syndrome, acute kidney injury, htn encephalopathy

what are the 3 rapidly progressive glomerulonephritis conditions and what concomitant symptoms distinguish them?

goodpasture's syndrome - pulmonary hemorrhage henoch-schonlein purpura - skin lesions wegener's granulomatosis (ANCA -assocaited)

what is the most common cause of glomerulonephritis worldwide?

BERGER'S DZ | - IgA nephropathy,

nephrotic syndromes present with?

severe proteinuria - foamy urine DDX with other illnesses that present with edema CHF, liver failure, PN, malignant HTN

what is the most common cause of nephrotic syndrome and ESRD (end stage renal disease) in the US? what is commonly seen on lab work?

diabetic nephropathy microalbuminuria 30-300 mg/d which progresses to proteinuria

what is a common sequelae of acute tubular necrosis (ATN)

acute renal failure UA - proteinuria, hematuria, RTE and RTE casts

what's important about acute tubointerstitial nephritis

acute onset of dec renal function UA reveals NO bacteria, eosinophiluria often present

what are the 4 common causes of chronic tubulointerstitial nephritis

obstructive uropathy reflux nephropathy analgesic nephropathy (sloughed papillae in urine) lead nephropathy

fanconi syndrome presents with ___ in adults or ____ in kiddos

osteomalacia in adults hypophosphatemic rickets in kiddos polyuria and polydipsia make you think DM

what is the classic triad of renal cell carcinoma?

gross hematuria flank pain palpable abd mass

what should be suspected in patients presenting with unexplained hematuria?

BLADDER CANCER