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PrepU Questions > Renal/Genitourinary > Flashcards

Renal/Genitourinary Flashcards

1
Q

What is SIADH

TX

A

Excess increased of ADH from the pituitary gland or ectopic source which leads to increase in free water retention and impaired water excretion
Leads to concentrated urine and hyponatremia

Tx: Restrict Water, Demeclocycline to inhibit ADH in severe cases

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2
Q

What is Epididymitis
Sx
Dx
Tx

A

In men <35 yrs caused by Chlamydia or Gonorrhea
In men >35 usually E.Coli, Klebsiella

Sx: Gradual onset of scrotal pain, erythema and swelling, dysuria, urgency, frequency, fevers, chills
Positive Prehn’s sign (relief of pain with elevation of testicles), Positive Cremaste Reflex (normal)

Dx: Ultrasound, UA may show pyuria or bacteriuria

Tx: Azithromycin and Ceftriaxone

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3
Q

What is Acute Orchitis
Sx
Dx
Tx

A

Usually viral, Mumps, Rubella, Coxsackie

Sx: Gradual onset of scrotal pain, erythema and swelling, dysuria, urgency, frequency, fever, chills

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4
Q

What is Prostatitis
Sx
Dx
Tx

A

Prostate gland inflammation usually secondary to ascending infection
E.Coli, Pseudomonas
Chlamydia/Gonorrhea in young men

Sx: Fevers, Frequency, Urgency, Dysuria, Hesitancy, perineal pain, Tender, Hot, boggy prostate

Dx: UA and Culture (don’t do prostate massage in acute state)

Tx: Fluoroquinolones, Bactrim
If Chlamydia/Gonorrhea Azithromycin and Ceftriaxone

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5
Q

What is a major side effect of Phosphodiesterase-5 (PDE-5).
What is it used for
What drug interaction should be careful with as a result of this SE
Examples of PDE-5

A

Hypotension
Used for Erectile Dysfunction
Careful with use with Nitrates which also lower BP
Sildenafil, Tadalafil

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6
Q

What is the most common component of kidney stones

A

Calcium

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7
Q

Why should you correct hyponatremia slowly

At what rate

A

May lead to osmotic demyelinating syndrome (Central Pontine Myelinolysis)
No more than 0.5 mmol/L

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8
Q

What defines Nephrotic Syndrome
What are Examples of Nephrotic Syndromes
Dx
Tx

A

Proteinuria, Hypoalbumineuremia, Hyperlipidemia and Edema
Minimal Change Disease: Most common in Children
Focal Segmental Glomerulosclerosis
Membranous Nephropathy
Dx: 24 urine with >3.5g/d GOLD STANDARD, Proteinuria, Hypoalbauminemia
Tx: Steroids in Minimal Change, Diuretics, Ace-I/ARB

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9
Q

What are features of Acute Glomerulonephritis
What are types of Nephrotic Syndromes
Dx
Tx

A 
Protein and blood leakage into urine
IGA Nephropathy
Post Infectious
Membranoproliferative
Goodpasture's
Vasculitis
Sx: Hematuria (cola colored urine), Edema, HTN, Fevers, Oliguria
Dx: UA with RBC casts, proteinuria
Tx: Ace-I, Diuretics, Steroids
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10
Q

RBC Casts with Hematuria

A

Acute Glomerulonephritis

Vasculitis

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11
Q

Muddy Brown (Granular) or Epithelial Cell Casts

A

Acute Tubular Necrosis

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12
Q

White Blood Cell Casts, Pyuria

A

Acute Interstitial Nephritis

Pyelonephritis

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13
Q

Waxy Casts

A

End Stage Renal Disease

Chronic Acute Tubular Necrosis

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14
Q

Hyaline Casts

A

Nonspecific

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15
Q

What is Actue Tubular Necrosis
Sx
Dx
Tx

A

Neprhon damage due to prolonged prerenal, hypotension, gout, rhabdomyolysis
Dx:Renal Tubular Epithelial cell casts and muddy brown casts, low specific gravity
Tx: Remove offending agents, IV fluids, Furosemide

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16
Q

What is Acute Tublointerstitial Nephritis
Sx
Dx
Tx

A

Inflammoatry or allergic response in interstitium with sparing of glomeruli and blood vessels, Drug hypersnsitivity
Sx: Fever, Esoinophilia, maculopapular rash
UA: WBC casts, Urine Eosinophils
Tx: Remove offending agent

17
Q

Gradual onset of scrotal pain, Erythema, Swelling
Positive Prehn’s Sign, Positive Cremasteric Reflex
Pyuria

A

Epididymitis

18
Q

Sudden onset of scortal pain, nausea, vomiting
Swollen, tender, Retracted testicle
Negative Prhen’s Sign, Negative Cremasteric Reflex

A

Testicular Torsion

19
Q

Painless scrotal swelling
Testicular mass
Dull ache or heavy sensation
Does transilluminate

A

Hydrocele

20
Q

Painless mass, may have dull ache or heavy sensation
Bag of Worms
Mass is reduced when supine
Mass enlarges with valsalva

A

Varicocele

21
Q

What is the most common Testicular Cancer

A

Seminoma

22
Q 
What is testicular cancer
Risk factor
Sx
Types/Dx
Tx
A

Found in young men
Cryptorchidism
Seminoma: They are Simple and Sensitive (No tumor markers, and are sensitive to radiation)
Non-Seminoma: High Alpha-Fetoprotein and High Beta-HcG, Radio-resistant
Tx: Nonseminoma: Orchiectomy with lymph node dissection
Seminoma: Orchiectomy followed by radiation, or debulking chemo followed by orchiectomy and radiation

23
Q

What labs do you see with Cystitis vs. Pyelonephritis

A

Cystitis: Leukocyte Esterase, Nitrites
Pyelonephritis: WBC Casts, Leukocyte Esterase, Nitrites

24
Q

What is Phimosis

A

Inability to retract foreskin over the glans
Not an emergency
Tx is circumcision

25
Q

What is Paraphimosis

A

Foreskin becomes trapped behind corona of glans and forms tight band, constricting penile tissue
This is an emergency
Tx: Manual reduction, if this fails, injection of hyaluronidase, incision

26
Q 
What is Prostatitis
What is most commonly caused by
Sx
Dx
Tx
A

Prostate gland inflammation usually due to ascending infection
E.Coli and Pseudomonas in older men
Chlamydia/Gonorrhea in young men
Sx: Fevers, Frequency, Urgency, dysuria, hesitancy, poor or interrupted stream, perineal pain
Dx: UA and culture, don’t do prostate massage in acute
Tx: Acute: Fluoroquinolones, Bactrim
Chronic: Same Abx plus Transurtehral resection (TUPR)

27
Q

What is Benign Prostatic Hypertrophy
Sx
Dx
Tx

A

Prostate Hyperplasia
Sx: Frequency, Urgency, Nocturia, Hesitancy, Weak/intermittent stream
Dx: DRE shows uniformly enlarged, firm rubbery prostate
Tx: 5-alpha Reductase Inhibitors (Finasteride, Dutasteride) which help reduce size and slow progression
Alpha-1 Blockers like Tamsulosin (Flomax), Alfuzosin, which relieve symptoms but no effect on clinical course
TURP

PrepU Questions (7 decks)

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