Renal

Question 1

HTN, palpable bilateral abd masses, microhematuria

• dx
• associated with

Answer 1

ADPCKD

• intracranial berry aneurysms
• hepatic cysts
• MVP, AR
• colonic diverticula
• hernias

Question 2

angiography shows string of beads in renal artery. dx?

Answer 2

fibromuscular dysplasia

Question 3

anticholinergics - mechanism on bladder

Answer 3

detrussor inactivity

Question 4

cause of initial hematuria

Answer 4

lesion in urethra (ex: urethritis)

Question 5

causes of terminal hematuria

Answer 5

prostate or

bladder (do cystoscopy)

Question 6

causes of total hematuria (throughout urinary cycle)

Answer 6

ureter or kidney (glomerular diseases)

Question 7

mechanism of stress incontinence

Answer 7

urethral hypermobility / loss of urethral support

intraabdominal pressure exceeds urethral pressure

Question 8

mechanism of urge incontinence

Answer 8

detrussor overactivity

Question 9

mechanism of overflow incontinence

Answer 9

impaired detrussor contractility

bladder outlet obstruction

Question 10

workup of urethral hyper mobility (which causes stress incontinence)

Answer 10

Q tip test (for urethrovesical angle)

Question 11

normal post void residual

Answer 11

less than 150 females

less than 50 males

Question 12

obese minority with HIV and heroin use, what renal dz?

Answer 12

FSGS

Question 13

Hep B associated w/ what renal dz?

Answer 13

membranous

membranoproliferative

Question 14

most common nephrotic syndrome

Answer 14

FSGS

Question 15

associations w/ amyloidosis

Answer 15

multiple myeloma

chronic inflammatory disease (rheumatoid arthritis, bronchiectasis)

Question 16

noninflammatory vs inflammatory chronic prostatitis

Answer 16

both have normal UA and prostatic culture

inflammatory has prostatic leukocytes greater than 10 WBC per HPF

Question 17

air in urine, fecal matter in urine, or recurrent UTIs with mixed flora

• dx
• imaging

Answer 17

rectovesical fistula

abd CT with oral or rectal contrast AND colonoscopy to r/o malig

Question 18

emphysematous pyelonephritis (pyelo due to gas producing infection) is more likely in what type of patient

Answer 18

diabetic

Question 19

suspect BPH. order what?

Answer 19

urinalysis (look for hematuria)

creatinine

Question 20

BPH and elevated creatinine. next step?

Answer 20

renal ultrasound to look for hydronephrosis

Question 21

indications for cystoscopy

Answer 21

microscopic hematuria with risk of cancer
gross hematuria but no glomerular disease or infection
recurrent UTIs
obstructive symptoms
irritative symptoms w/o UTI
abn bladder imaging or urine cytology

Question 22

most important risk factor for bladder cancer

Answer 22

smoking

Question 23

patient using analgesics, WBC casts

- dx

Answer 23

tubulointerstitial nephritis

Question 24

tx of uric acid stones

Answer 24

alkalinize urine with potassium citrate

Question 25

evaluation of uric acid stones

Answer 25

CT or IVP or US

Question 26

high riding prostate, blood at urethral meatus…

• dx
• next step

Answer 26

posterior urethral injury
retrograde urethrogram (before Foley insertion)

Question 27

anterior urethral injury

- next step

Answer 27

surgical repair

Question 28

bladder injury

- next step

Answer 28

retrograde cystogram with post void films

Question 29

management of penile fracture

Answer 29

retrograde urethrogram (assess urethral injury)
then surgery of penis (evacuate hematoma, repair tunica albuginea)

Question 30

management of renal artery stenosis and HTN

Answer 30

ACEi
surgery only if...
- HTN not controlled with meds
- flash pulm edema
- heart failure from HTN