Brainscape's Knowledge GenomeTM

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


See full index

USMLE Step 2 > Renal > Flashcards

Renal Flashcards

You may prefer our related Brainscape-certified flashcards:
USMLE® Step 1 flashcards
1
Q

purpose of voiding cystourethrogram?

A

look for presence of reflux

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

PUV

A

post obstructive urpathy

can see hydro and oligohydramnios on prenatal US

after birth: no UOP, distended bladder

tx= VCUG –> cath –> surgery

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

whast important to know about epi/hypospadias?

A

DO NOT CIRC! need skin to rebuild

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

teenager binge drinks and has colicky abd pain that eventually resolves

A

consider UPJO –> surgery or stent

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

ectopic ureter

A

young girl with nl bladder function but is NEVER dry –> looks like a fistula but she’s too young for that

dx test is radionucleotide scan

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

BUN/cr ratio prerenal vs intrarenal

A

Pre= >20

Intra= <15, FeNA >2%

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

utility or Pr/Cr ratio on UA?

A

will essentially give you 24hour protein but it is easier and more reliable

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

why doesn’t hemolysis cause hyperuricemia?

A

no nuclei in RBC

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

in general, tubular disease is:

A

acuTe and caused by Toxins.

Think of it like an allergic reaction. Remove the insult, correct hypoperfusion. Do not treat with steroids.

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

in general, glomerular disease is:

A

slow, and chronic
-not cause by toxins

tx with steroids but need bx to confirm dx

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

lab findings in RAS

A

Cr inc >30% after initiation of ACE/ ARB

Hypokalemia

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

bug that causes UTI with alkaline pH?

A

proteus

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

treatment for MCD?

A

oral pred x 12 weeks

bonus: if not resolving/immobile sate, consider heparin as loss of ATIII puts pt in hypercoag state

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q 
managment of stones:
<5mm
<7mm
>10mm
>1.5cm
A

<5 - hydrate!

<7 - medical expulsive therapy with dilating agents (bb blockers, alpha bockers

> 10 - proximal= lithotripsy, distal/ overweight= ureteroscopy

> 1.5= surgery

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

patients with untreated VUR at risk for?

A

renal scarring

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

complciation of cyclophasphamide?

A

hemmorhagic cystitis –> tx with MESNA (mercaptopethane sulfonate)

CHOP = chemo combo commonly used in lymphoma

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

treatment for pyleo/complicated pylo?

A

IV FQ 7-14 days inpatient

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

cyanide nitroprusside test

A

confirmatory test for cyteinuria

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

cystinuria

A

AR tubular defect in transpaort of dibasic amino acids (COAL)

  • excrete them through urine
  • causes acidic urine
  • HEXAGONAL crystals
  • dx with nitroprusside test
  • tx with urine alkalinization

***cysteine stones are one of the few stones that DO NOT show up wel on xray

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

classic triad of RCC

A

hematuria –> suggest invasion into collecting sys
flank pain
flank mass

**only 5% of patients present this way, most come in with paraneoplastic complaints

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

paraneoplastic syndromes of RCC

A

hypertension
polycythemia –> flushing, head ache
hypercalcemia –> pth-rp

look for NO RBC casts but +RBC to suggests its not a glomerular cause and you need to look elsewhere

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

chronic tubulointerstitial nephritis

A

why: chronic analgesia –> NSAIDS inhibit prostacylcins –> restrict renal blood flow –> papillary necrosis
imaging: shrunken kidneys, calcifications from papillary necrosis

**multiple myeloma can also cause this, but instead from xs light chains (bence jones protein)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

stones that cause low urine pH?

A

calc ox
uric acid –> radiolucent!
cysteine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

cause of UTIs in pregnancy?

A

progeserone dilates everything, including ureters, –> urinary stasis

This makes women with asyx bacteruria (>100,000 CFU) at greatest risk for ascending infection, so treat

Use cephalexin, augmentin, nitro

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

how does management differ in RAS between fibromuscular dysplasia and atherosclerotic etiologies?

A

fibromuscular dysplasia= PTA w/o stent

athersclerosis= PTA ++++ stent!

both should also be controlled with an ACEi. Just make sure to closely monitor and stop if functoin decreases

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

e coli vs staph sappro UTI?

A

ecoli= + nitrites

staph= - nitrites! cannot convert nitrates to nitrites

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

high blood pressure, pulsatile tinitus, carotid stenosis?

A

no- cerebrovascular FMD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

tx fr pregnant pylo?

A

iv ceftriaxone 10-14 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

treatment for posterior urethral valves?

VUR?

A

PUV = ablation!! (vesicostomy if unable to do ablation)

VUR= reimplantation of the ureter

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

mechanism of AKI with acyclovir

A

crystal deposition nephropathy –> poorly soluble drug that deposits crystals which obstruct tubules

**side note: immunocompromised pt who develops shingles needs inpt IV acyclovir

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

DKA gas

A

metabolic acidosis with attempts towards repiratory compensation (blow ff CO2)

gap acidosis with low bicarb (bicarb becomes rapidly used up to buffer the ketone acids)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

RPGN basics

A

nephritic syndrome
think of: Good pastures (anti GBM), Immune complex ( lupus, PSGN), Wegner’s

treat with steroids
—–> steroids plus plasmapheresis if antiGBM

33
Q

wilms vs beuroblastoma

A

neuroblastoma

  • crosses midline
  • irregular surface
  • presents ~age 2

wilms

  • does NOT cross midline
  • smooth surface
34
Q

urine of nephrtic syndrome

A

frothy
fatty casts (maltese cross)
3.5g/day

35
Q

urinary retention after surgery but everything is normal

A

don’t forget to check the foley for kinking.

36
Q

interstitial cystitis (bladder pain syndrome)

A

noninfectious cause of UTI

  • sx inc urgency/frequency > 6 weeks
  • relief with voiding
  • **dyspaurenia is common too
  • **assoc with psych do
37
Q

tx of urge incont?

A

oxybutinin (anticholinergic) – decrease detrusor tone

first line is bladder training, pelvic floor excercises

due to urethra HYPERMOBILITY

38
Q

approach to management of bladder cancer

A

non muscle invasive

  • low risk: TURBT
  • high risk: TURBT with chemo

muscle invasive with or without nodes
-radical cystectomy

metastatic
-palliative chemo

39
Q

med management of BPH

A

alpha blocker: immediate relief

fin-a5-teride: 5 a reductase inhibitor –> blocks testosterone to dihydrotest which shrinks the prostae

  • – takes a few months to work
  • –can cause sexual side effects
40
Q

scleroderma renal crisis

A

causes MAHA –> dec haptoglobin, inc ldh

41
Q

stages of ATN

A

olig/anuric
polyuric
recovery

muddy brown casts
PRINCIPLE cause of AKI in hospitalized patients

42
Q

AIN

A

eosinophils!!

think of this like an allergic reaction

43
Q

PSGN

A

immune complex deposition

damage to glomerular capilary wall

44
Q

subepithelial deposits along the basement membrane

A

membranous nephropathy
“spike and dome”
nephrotic syndrome

most common in white people!
Hep b!
solid malignancies!

45
Q

assocaitions with ADPKD

A

bilat flank mass with inc Cr

arterial HTN
berry aneursyms
MVProlapse

**many patients have multiple liver cysts or cysts in other locations

46
Q

VHL

A

bilat RCC
pheo
renal/panc cysts

47
Q

mechanism of incont in NPH?

A

compression to periventricular white matter leads to central inhibition of detrussor contraction

48
Q

hep b kidney path?

A

membranous nephropathy –> subepi deposits

membranoproliferative –> basement membrane thickening/ splitting (tram tracks) from IgG and C3 deposits

49
Q

urethral hypermobility

A

most common cause of stress incont

-assoc with post menopause estrogen, childbirth

50
Q

approach to stress incont:

A

conservative measures: kegels, alcohol cessation, pessary

surgery: if above fail –> urethral sling
- -> urethropexy (colposuspension) used to be popular but more invase/ more complications –> used when simultaneous repair of prolapsed organ

51
Q

igA nephropathy

A

generally presents as otherwise asyx microhematuria

  • presents DURING or IMMEDIATELY after mucosal infection
  • presents in 2nd/3rd decade
  • –> use this info to r/o PSGN which from 10-14 days after strep
52
Q

diabetic nephropathy

A
  • kimmelstil wilson nodule- eosinophilic nodular glomerulosclerosis
  • microvascular damage
53
Q

repeated UTIs from sex. Rec?

A

oral bactrim for 6 months

-poistcoital voiding is a sfety measure

54
Q

causes of renal papillary necrosis

A

POSTCARDS

PYELO
obstruction
SICKLE CELL DZ/TRT
tb
cirhossis
ANALGEIA
dm
55
Q

causes of renal papillary necrosis

A

POSTCARDS

PYELO
obstruction
SICKLE CELL DZ/TRT
tb
cirhossis
ANALGEIA
dm

usu presents with colicky bilat flank pain and mild hemturia

56
Q

why does good pasture’s attack lung and kidneys?

A

attacks type IV collagen, which makes up basement membranes

57
Q

orthostatic proteinuria

A

overweight, adolescent boys

  • increased protein as the day gos on
  • resolves with lying down overnight
  • benign
58
Q

alportss

A

ears
eyes
kidneys

abscence of type IV collagen

59
Q

4 glass test is for…

A

chronic prostatitis

60
Q

ADPKD

A

presents in adulthood with:

  • hypertension
  • flank pain
  • hematuria
  • palpable kidneys

assoc with liver cysts and sometime cysts in other places too

61
Q

lithium cause….

A

DI!!!!!!!!!!!!!!!

not siadh

62
Q

unilateral varicocele that does not resolve with standing, with flank pain and fatigue?

A

RCC, or mass in the retroperitoneum, can cause a varicocele by compression of pampiniform plexus

*be suspicious of a right sided one because they are more common on the LEFT

63
Q

OAB after spinal anesthesia, prolonged labor, etc?

Or put another way, oliguria after surgery. What should be the next step?

A

Overflow incont.
If distended, painful bladder –> put in a cath!

If there is no associated pain or distention, do a quick US to r/o post obstructive (this is if they don’t give you lab values to tell you its prerenal due and they just need IVF)

64
Q 
casts:
WBC
Pigmented
Waxy
Fatty
Muddy brown
Hyaline
Fatty
A 
WBC- pyelo
Pigmented- rhabdo --> tamm horsefall
Waxy- non specific
Fatty- nephrotic syndrome
Muddy brown - ATN
Hyaline - non specific, can be seen in healthy people after vigorous exercise or dehydration, TTP!!
65
Q

ESRD tx

A

living donor transplant

better prognosis than cadaver

66
Q

renal bx with congo red shows apply green bif.

A

amyloid

*consider in relation to multiple myeloma.

67
Q

tx for heat stroke?

A

immediate ice water immersion

68
Q

PAN

A

fatigue, myalgia, weight loss, renal involvement, abd pain
-spares lungs!!

effects MEDIUM vessels

69
Q

microscpic polyangitis

A

necrotizing vasc with NO granuloma

  • effects lungs, kidney, skin
  • palpable purpura
  • diff from Wegner’s because of no nasal invovlement and lack of granulomas
70
Q

BUN / Cr effect by orthostatic syncope?

A

elevated BUN

**elevated Cr after LOC is indicative of postictal state

71
Q

tx hypovolemic hypernatremia 2/2 to lithium tox

A

first, correct to euvolemia!! Give NS, then switch to 5% dextrose

if hemodynamically stable: amiloride if lithium cannot be d./c

72
Q

hyperkalemia that require emergent therapy

A

EKG changes, >7, rapidly rising

If <7 and on pot sparing diuretics with no EKG change, just swtich them

73
Q

metformin in AKI?

A

withhold in hospitalized patient with AKI as first step

74
Q

rhabdo and renal failure?

A

ATN due to myoglobin

75
Q

clue to hepatorenal syndrome?

A

very low urine sodium, <10, with renal function that doesn’t improve with appropriate fluid resusc

-poor perfusion of kidneys

76
Q

acute urinary retention risk

A 
post surgical
men
history of BPH
older
MCI
77
Q

dietary recs for renal calculi with calcium oxalate stones

A
  • inc fluids
  • dec sodium (helps with Ca reabsorption –> inc sodium causes inc Ca in the urine)
  • normal calcium
78
Q

presentation of barter’s/gittlemans

A

hypokalemia, normotension, alkalosis, HIGH urine Cl

*contrast to surreptitious vomiting which will have low urine chloride

79
Q

most common kideny stone pres:

A

calcium ox with hypercalciuria and normal blood calcium

encourage increased fluids!

USMLE Step 2 (18 decks)

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