Renal Flashcards
HTN, palpable bilateral abd masses, microhematuria
- dx
- associated with
ADPCKD
- intracranial berry aneurysms
- hepatic cysts
- MVP, AR
- colonic diverticula
- hernias
angiography shows string of beads in renal artery. dx?
fibromuscular dysplasia
anticholinergics - mechanism on bladder
detrussor inactivity
cause of initial hematuria
lesion in urethra (ex: urethritis)
causes of terminal hematuria
prostate or
bladder (do cystoscopy)
causes of total hematuria (throughout urinary cycle)
ureter or kidney (glomerular diseases)
mechanism of stress incontinence
urethral hypermobility / loss of urethral support
intraabdominal pressure exceeds urethral pressure
mechanism of urge incontinence
detrussor overactivity
mechanism of overflow incontinence
impaired detrussor contractility
bladder outlet obstruction
workup of urethral hyper mobility (which causes stress incontinence)
Q tip test (for urethrovesical angle)
normal post void residual
less than 150 females
less than 50 males
obese minority with HIV and heroin use, what renal dz?
FSGS
Hep B associated w/ what renal dz?
membranous
membranoproliferative
most common nephrotic syndrome
FSGS
associations w/ amyloidosis
multiple myeloma
chronic inflammatory disease (rheumatoid arthritis, bronchiectasis)
noninflammatory vs inflammatory chronic prostatitis
both have normal UA and prostatic culture
inflammatory has prostatic leukocytes greater than 10 WBC per HPF
air in urine, fecal matter in urine, or recurrent UTIs with mixed flora
- dx
- imaging
rectovesical fistula
abd CT with oral or rectal contrast AND colonoscopy to r/o malig
emphysematous pyelonephritis (pyelo due to gas producing infection) is more likely in what type of patient
diabetic
suspect BPH. order what?
urinalysis (look for hematuria)
creatinine
BPH and elevated creatinine. next step?
renal ultrasound to look for hydronephrosis
indications for cystoscopy
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
most important risk factor for bladder cancer
smoking
patient using analgesics, WBC casts
- dx
tubulointerstitial nephritis
tx of uric acid stones
alkalinize urine with potassium citrate
evaluation of uric acid stones
CT or IVP or US
high riding prostate, blood at urethral meatus…
- dx
- next step
posterior urethral injury retrograde urethrogram (before Foley insertion)
anterior urethral injury
- next step
surgical repair
bladder injury
- next step
retrograde cystogram with post void films
management of penile fracture
retrograde urethrogram (assess urethral injury) then surgery of penis (evacuate hematoma, repair tunica albuginea)
management of renal artery stenosis and HTN
ACEi surgery only if... - HTN not controlled with meds - flash pulm edema - heart failure from HTN
