Renal / Genitourinary / Gynecology

Question 1

Urinalysis with +blood but no RBCs

Answer 1

Think rhabdomyolysis

Question 2

Kidney disease with low C3 and normal C4

Answer 2

Postinfectious glomerulonephritis

Question 3

Kidney disease with low C3 and low C4

Answer 3

Lupus glomerulonephritis

Question 4

Persistent microscopic hematuria with a family history of stones

Answer 4

Hypercalciuria (get a urine Ca:Cr ratio)

Question 5

Bilateral hydronephrosis in a male infant

Answer 5

Posterior urethral valves

Question 6

Which stones are radiopaque?

Answer 6

Anything with minerals:
- calcium oxalate
- calcium phosphate
- Mag-Ammonium-Phos (struvite)

Question 7

What do WBC casts indicate?

Answer 7

Tubular disease (e.g., acute tubular necrosis)

Question 8

Patient with nephrotic syndrome develops fever and abdominal tenderness

Answer 8

Spontaneous bacterial peritonitis (likely S. pneumoniae)

Question 9

Testicular pain relieved by lifting testicle

Answer 9

Epididymitis

Question 10

Sexually active female with pleuritic right upper quadrant pain

Answer 10

Fitz-Hugh-Curtis syndrome (gonorrhea)

Question 11

Triad: Thrombocytopenia, microangiopathic hemolytic anemia, and acute kidney injury

Answer 11

Hemolytic-uremic syndrome

• Bonus: commonly a/w Shiga toxin producing E. coli (STEC) infections such as E. Coli O157:H7

Question 12

Patient with fever and rash who recently started new medication.
Labs:
- increased serum creatinine and eosinophils
- UA with WBC, WBC casts and eosinophils.

Diagnosis?

Answer 12

acute interstitial nephritis (AIN)

Question 13

Electrolyte abnormalities in rhabdomyolysis: Ca, K, Phos

Answer 13

Low Ca
High K
High Phos