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Step 2 > Renal/GU > Flashcards

Renal/GU Flashcards

1
Q

Rate of correction of chronic hyponatremia and hypernatreima and consequence

A

Hypernatremia correction-> cerebral edema
Hyponatremia correction-> central pontine myelinolysis
0.5meq/L

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2
Q

Presents with thirst, neuro sx, doughy skin

A

hypernatremia

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3
Q

presents with confusion, lethargy, muscle cramp, hyporeflexia, nausea

A

hyponatremia

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4
Q

presents with n/v, intestinal colic, areflexia, weakness, flaccid paralsis, arrythmia paresthesia

A

hyperkalemia

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5
Q

presents with fatigue, muscle weaknes, ileus, hypotension, yporeflexia, rhabdo, asc paralysis

A

hypokalemia

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6
Q

EKG for hypokalemia

A

T wave flattening, U waves, ST-segm depr

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7
Q

treatment hypercalcemia

A

IV hydration + furosemide, avoid thiazide diuretics

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8
Q

Type I vs II vs IV RTA: Defect, K+, urine pH, tx

A

Type I: H+ secr (distal), urine ph >5.3, replace HCO3
Type II: HCO3 reabs (proximal), urine ph 5.3 initially, thiazides and volume depletion
Type IV: aldost def (distal), high K, urine ph

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9
Q

indications of pre renal AKI (FeNa, UNa, Spec grav, BUN/Cr)

A

FeNa 1.02, BUN/Cr >20

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10
Q

Consequences of AKI

A

metabolic acidosis, hyperkalemia–> arrythmia

HTN, volume overload

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11
Q

Definition CKD (time and GFR); when symptomatic?

A

> 3mo, GFR

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12
Q

Consequences and tx of CKD

A

Metabolic derangement: azotemia, metabolic acidosis, hyperkalemia, ACD, hypocalcemia, hyperphosphatemia, impaired coag
Tx: ACEi/ARB, DDAVP for abn bleeding, low fluid/Na/K/PO diet, PO4/calcitriol, EPO

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13
Q

Nephritic syndrome: sx and workup

A

hematuria, mild proteinemia

Complement, ANA, ANCA, anti-GBM

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14
Q

Ca levels loop vs thiazide diuretcs

A

Loop: decr Ca
Thiazide: Incr Ca

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15
Q

Nephrotic syndrome: sx and workup

A

proteinuria (>3.5), edema, hypoalb, hyperlip

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16
Q

Low serum C3, lumpy-bumpy immunofluorescence: dx and tx

A

PSGN, nephritic; supportive/diuretics

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17
Q

microscopic hematuria following resp or GI infxn; normal C3: dx and tx

A

IgA nephropathy; Tx: glucocort, ACEIs

18
Q

cANCA+, segmental necrotizing glomerulonephritis: dx and tx

A

Wegener’s, high-dose corticosteroids, cytotoxic agents

19
Q

linear anti-GBM deposid, hemosiderin-filled macrophages in sputum

A

Good pasture

plastma exchange + steroids

20
Q

GBM splitting on EM: dx and tx

A

Alport’s, progresses to renal failure

21
Q

microscopic hematuria, bx shows sclerosis in capillary tufts; hx HIV/ IVDU: dx and tx

A

dx: FSGS
Tx: prednisone, cytotoxic, ACE/ARB

22
Q

renal bx: spike and dome appearance, HBV/ syphilis: tx and dx

A

dx: membranous nephropathy
tx: prednisone and cytotoxic

23
Q

thickened GBM and mesangial matrix: dx and tx

A

diabetic nephropathy
Type 1: ACEi
Type 2: ARB

24
Q

Mesangial prolif, subendothel/epithl IC deposition: dx and tx

A

lupus nephritis

prednisone and cytotoxic

25
Q

nodular glomerulosclerosis, apple-green birefringence with Congo red stain

A

renal amyloidosis

prednisone melphalan

26
Q

tram track appearance, hx of HCV, SLE, endocarditis

A

membranoproliferative nephropathy

corticosteroids and cytotoxic

27
Q

Stones: square shape, radio opaque: dx and tx

A

calcium oxalate/PO4

hydration, Na, thiazide diuretic

28
Q

Stones: staghorn calculi, assoc with infxn, rectangle crystal, radioopaque

A

dx: struvite
tx: treat infxn, surgical removal, hydration

29
Q

stones: diamond shape crystal , radiolucent, hx gout

A

uric acid crystal

hydration, alkalinize with citrate, purine restriction

30
Q

Stones: hexagon, radioopaque: dx, workup, tx

A

cystine
+cyanide nitroprusside
hydration, alk urine, pnicillamine

31
Q

When treat kidney stone?

A

> 0.5cm

32
Q

Other sites of cyst in PKD

A

spleen, liver, pancreas

33
Q

male infant with distended, palpable bladder and low UOP

A

posterior urethral valves

34
Q

Recurrent UTIs in children: dx and tx

A

voiding cystourethrogram

daily prophylactic abx (amoxicillin for

35
Q

hydrocele vs varicocele: sx, tx

A

hydrocele: transluminaes, treat for hernia or >12-18mo
varicocele: “bag of worms”, may disappear when supine, does not transluminate, treat if symptomatic, varicocelectomy or ligation or embolization
dx with ultrasound

36
Q

Painful scrotal swelling: dx if pain improves with scrotal elevation vs no

A

improves with elevation: epididymitis tx with abx (tetracyclines, flouroquinolones)
Does not improve: testicular torsion: immediate surgery within 6hr, orchipexy of both testes to prevent torsion

37
Q

Tx options for BPH

A

terazosin, finasteride, TURP or open prostatectomy

38
Q

workup for prostate cancer

A

dx with ultrasound-guided transrectal bx

CXR and bone scan for mets (osteoblastic lesion)

39
Q

Dx and tx for bladder cancer

A

Dx: cystoscopy with bx, UA, cytology, MRI, CT, bone scan
Tx: intravesicular chemo, complete transurethral resection, mitomycin C or BCG, radical cystectomy or radiotherapy

40
Q

workup and tx: testicular mas

A

Dx: testuclar ultrasound, CXR, tumor markers (Bhcg- choriocarcinoma, AFP- nonseminomatous GCT)
Tx: radical orchiectomy, seminoma: radiosens, pt based chemo for seminomaotus GCT

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