renal exam - study guide Flashcards
IVP (Intravenous pyelogram) - what does it do?
Visualizes urinary tract, shape, size position of kidneys, ureters, & bladder;
IVP detects
Detects cysts, tumors, lesions, obstructions.
IVP contraindicated in who?
Test contradicted for pt with decreased renal function because the contrast media can be nephrotoxic.
Side-effect of metformin is (increases what and stop before..)
increased lactic acid production. This may lead to lactic acidosis & death. Stop taking the metformin 48 hrs before & 48 hrs after the test or when renal function returns back to normal.
meds for IC - Calcium phosphorus - for (IC calcium before it’s too late)
Calcium phosphorus (Prelief)
BPH - If the DRE and PSA levels are abnormal, what is the next step? (visualize it)
then a transrectal ultrasound with possible biopsy is done to R/O prostate cancer.
5α-reductase inhibitors finasteride (Proscar) reduces size of (fin blocks androgens)
prostate gland by suppressing androgens.
α-adrenergic receptor blockers terazosin (Hytrin) & tamsulosin (Flomax) promote (tez and tam relax me)
smooth muscle relaxation in prostate facilitating urinary flow through urethra.
Saw palmetto action is the same as the
α-adrenergic receptor blockers.
Never use what with prostate?
Never use zinc because it stimulates the growth of the prostatic tissues.
TURP - what type of foley catheter?
A three-way foley cath is inserted after surgery. Continuous bladder irrigations are done to flush all the blood out of the bladder to prevent clots from developing.
priapism - complications (need hydro for my priapism)
penile tissue necrosis; Hydronephrosis (kidneys become stretched and swollen) from bladder distention; inability to achieve a normal erection after priapism subsides.
Transillumination is used to (illuminate the fluid)
identify solid tumors/cancer versus fluid in the scrotum
Epididymitis is (one or both sides?)
unilateral
Most common cause of infertility is (vari infertile)
varicocele.
Testicular torsion common in
young boys and is a surgical emergency to untangle the blood supply that is twisted around the vas deferens.
Vasectomy is performed where?
Vasectomy is performed in the MD office.
vasectomy - Should use contraception for
6 weeks or 10 ejaculations to evacuate sperm distal to surgical site.
drug therapy for prostate cancer
Drug therapy is called Hormonal therapy (androgen deprivation therapy – ADT).Goal: reduce the androgen level. Androgen promotes the tumor growth. Causing a castration effect will prevent the release of any androgen. Hence, the cancer will stop growing and begin to shrink in size
ADT is used as (ADP alone isn’t enough)
an adjunct therapy before surgery or radiation.
Complication of ADT is (adt security is bare bones)
osteoporosis
Glomerulonephritis (glum’s basement is damaged)
caused by Ab induced injury to the glomerular basement membrane.
glomerulonephritis - symptoms (glum has a swollen face)
Generalized body edema. May start with periorbital edema & progress to peripheral edema or ascites.
Polycystic kidney disease - both kidneys? is it genetic?
both kidneys and is genetic.
PKD - where are cysts?
Large thin walled cysts develop in cortex & medulla of kidneys. Cysts grow to the size of golf balls & filled with blood or pus. Large cysts compress surrounding tissues & destroy them. May lead to cysts in liver; Affect heart valves;
PKD - aneurysms and diverticulosis? how?
Aneurysms especially cerebral aneurysm (enlarged kidneys have tamponade effect on aorta); Diverticulosis (kidneys grow so large that it applies pressure against intestinal tract).
Elevated creatinine levels indicate
AKI.
pre-renal AKI - when is it reversible? how long?
There is no damage to the parenchyma so with hydration AKI is reversible if rehydrated in 48 hrs.
pre-renal AKI - If no hydration is performed
then the nephrons will eventually
die off and become to stage 2 intrarenal
Intrarenal AKI results from direct damage to the kidneys caused by
prolonged ischemia, nephrotoxins, hemoglobins released from hemolyzed RBCs, or myoglobins released from necrotic muscle cells
causes of acute tubular necrosis (ATN) (ant is caused by SIN)
Ischemia, nephrotoxins, or sepsis
Postrenal is reversible if the obstruction is relieved within
48 hrs.
Prolonged obstruction leads to (the atrophy and fibrosis are prolonged)
tubular atrophy & irreversible kidney fibrosis resulting in CKD.
AKI - oliguric phase - signs of
dehydration, JVD, LE edema, lung congestion
oliguric phase - risk factors - IV fluids
CHF due to over hydrations with IVF for treatment during oliguric phase
Bruises occur when
renal not producing erythropoietin. Pt becomes anemic.