Renal Diagnostics Flashcards
PSA level blood test should be done BEFORE what exam and why?
Following a prostate manipulation of some kind because it will raise levels
What can be a quick test for dehydration?
Increased BUN
Increased protein in the urine is an early sign of what?
Glomerular disease
RBC casts equal what?
Glomerulonephritis
WBC casts equal what?
Acute pyelonephritis
Epithelial cell casts (tubular) are signs of what?
Acute tubular necrosis (most common type of acute renal disease)
Urine that is positive for LE, nitrites, and WBCs should be sent for what?
culture and sensitivity
What is a 24 hour urine culture used for?
quantitative protein
Nephrotic syndrome has greater than 3g of protein in the urine in 24 hours. Nephritic is what amount?
less than 3g
What is the ONE type of radioleucent stone? What study will you NOT see it on?
Uric Acid stone. Can’t see it if it’s around a bone because they would both be leucent, KUB (radiography)
What is the appropriate initial test in patients with renal failure of unknown etiology? What is it the test of choice for?
Renal ultrasonography; to excude urinary obstruction
Doppler U/S is used if you’re worried about what? What would you follow it up with?
Anything that is involving BLOOD and vasculature; CTAngio is next
If you order a CT for kidney stone, what kind do you get?
a NON-CONTRAST CT because the contrast will hide it, will even pick up uric acid stone, Contrast is considered an exogenous toxin anyway
When is a CT useful in renal dx?
to distinguish between benign and malignant cysts, find a stone you couldn’t get on KUB
What disease will allow you to palpate the kidney (only one)?
Polycystic kidney disease
What is used if US or CT is nondiagnostic?
MRI, watch Gadolinium toxicity in Stage 3 renal failure
What is the intravenous pyelogram used for?
Size and shape of the kidneys, ureters, and bladder, highly sensitive and specific for kidney stones, CT is still used before this one, though
What does hematuria mean in an adult (until proven otherwise)?
Bladder cancer, terminal stream hematuria is sometimes related to enlarged prostate. DO A CYSTOSCOPY TO LOOK FOR CANCER
What is renal angiograph used for?
Pre-op vasculature eval. Renal angiography can show you stenosis, but not used that often because other things are available
What is a cystourethrogram used to evaluate?
vesicoureteral reflux up into the urine from the bladder, also can be used to evaluate voiding
What is the indication for a cystoscopy?
To assess bladder and ureteral involvement due to malignancies
How is a prostate ultrasound and biopsy performed?
transrectally
What stage of CKD is associated with a GFR less than 15?
5, renal failure
What stage of CKD is associated with GFR of 15-29?
4, severe GFR decrease
What stage of CKD is associated with GFR of 30-59?
3, moderate GFR decrease
What stage of CKD is associated with GFR of 60-89?
2
What stage of CKD is associated with GFR of 90-119?
1
If you have a decreased GFR, what are some tests that might tell you the cause?
ANA, ANCA, anti-glomerular basement membrane AB, Hep B&C antibodies, antistreptolysin O
RF, complement, or SPEP
When are urinary eosinophils seen most often?
in acute interstitial nephritis
What urine test do you perform if you suspect multiple myeloma?
urine immunoelectrophoresis
What is the test of choice for nephrolithiasis?
Non-contrast CT
You see bilateral hypodense streaks on a non-contrast CT. What do you suspect?
bilateral pyelonephritis
What test would you do to follow up with a renal doppler ultrasound to evaluate vascular disease?
CTA
When is MRI gadolinium contraindicated?
in stage 4 chronic renal failure and any type of acute renal failure
What should you suspect if you see a “string of pearls” on renal angiography?
fibromuscular dysplasia
What is used to evaluate renal mass, nephrotic syndrome, acute nephritic syndrome, any unexplained acute renal failure, and transplant rejection eval?
Renal biopsy +/- U/S
What are three main indications for using a cystoscopy?
To assess bladder and renal involvement due to malignancies, to diagnose intrinsic bladder disease, to evaluate urogynecological conditions
What is a testicular u/s used for?
testicular torsion dx
What is a TRUS? When is it indicated?
transrectal ultrasound; to detect prostate cancer in pts with high PSA
