Renal/GU Flashcards

1
Q

IgA Nephropathy / Berger Dz

- overview

A
  • immunoglobulin A and C3 deposits in the mesangium
  • MC glomerular dz worldwide, esp Asia
  • M > F
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2
Q

IgA Nephropathy / Berger Dz

- clinical

A
  • gross hematuria 1-2 days after viral URI
  • normal complement
  • elevated Cr and BUN
  • urine: severe proteinuria and hematuria
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3
Q

IgA Nephropathy / Berger Dz

- mgmt

A
  • low risk of progression: monitor

- high risk progression: ACE/ARB to reduce proteinuria and HTN

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4
Q

Hypomg

- clinical

A
  • Neuro: tremor, tetany, seizure, weakness
  • CV: prolonged QTc, wide QRS
  • Hypokalemia
  • Abnl calcium metab
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5
Q

Chancroid vs. Chancre vs. Lymphogranuloma venerum

A
  • Chancroid: painful ulcer, painful inguinal LAD
  • syphilis/chancre: painless ulcer, painless LAD
  • LV: Painless ulcer, painful LAD
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6
Q

Renal Artery stenosis

  • MCC (2)
  • clinical
A
  • atherosclerosis, fibromuscular dysplasia (MC in young F)
  • usu asx
  • recalcitrant HTN
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7
Q

Renal artery stenosis

- dx

A
  • duplex doppler (1st line)
  • CT angiography
  • MR angiography
  • renal arteriography: after other tests are nonconclusive and still high suspicion
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8
Q

Renal artery stenosis

- mgmt

A
  • ACE/ARB for HTN
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9
Q

AKI

- criteria

A
  • serum Cr inc ≥ 0.3 or ≥ 50% in 48 hours
  • serum Cr inc 1.5 x known baseline
  • Urine output <0.5 mL/kg/hour >6 hours
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10
Q

Cryptorchidism

- when descend

A
  • 3-4 months of life
  • descent after 6 months is rare
  • sx orchiopexy recommended ASAP after 4 months and def before 2 years
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11
Q

Chronic bacterial prostatitis

- bugs

A
  • E. coli MC
  • proteus
  • e. faecalis
  • klebsiella
  • pseudomonas
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12
Q

Chronic bacterial prostatitis

- clinical

A
  • recurrent UTI
  • low back / perineal pain
  • urinary retention
  • tender, boggy prostate (or normal!)
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13
Q

Chronic bacterial prostatitis

- dx

A
  • Urine culture prior to and after prostatic massage
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14
Q

Chronic bacterial prostatitis

- mgmt

A
  • bactrim
  • FQ
    X 6 weeks
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15
Q

Prostate cancer screening

  • high risk pts
  • when start screening
A
  • AA
  • fam hx
  • BRCA mutations
  • screen age 40
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16
Q

Prostate cancer screening

- normal risk

A

50-70

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17
Q

Acute Interstitial Nephritis

- overview

A
  • inflammation or allergic response in interstitial of kidney
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18
Q

Acute Interstitial Nephritis

- clinical

A
  • Pyuria
  • WBC casts***
  • hematuria
  • fever
  • rash
  • arthralgia
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19
Q

Acute Interstitial Nephritis

  • common drugs
  • common illness
A
  • PCN & cephalosporins
  • NSAIDS
  • RMSF
  • CMV
  • Sarcoid, Sjogren, Lupus
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20
Q

Overflow incontinence

- causes

A
  • blockage of urethra: BPH, stricture

- Detrusor under activity from nerve damage

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21
Q

Acute prostatitis

- clinical

A
  • fever chills
  • malaise
  • pelvic pain
  • perineal pain
  • cloudy urine
  • irritative and obstructive sx
  • firm, edematous, exquisitely tender prostate on DRE
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22
Q

Acute prostatitis

- dx

A
  • clinical
  • labs: pyuria, bacteriuria, elevated acute phase reactants (ESR, CRP)
  • pos blood cultures
23
Q

Acute prostatitis

- mgmt

A
  • 1st: bactrim, cipro, levofloxacin X 6 weeks

- Inpt: IV cipro +/- aminoglycoside

24
Q

Balanitis

  • overview
  • RF
A
  • inflammation glans penis, MC in uncircumcised with poor hygiene
  • RF: DM, genial trauma, obesity, edematous dz (CHF, cirrhosis, etc)
25
Q

Balanitis

- clinical

A
  • red
  • swelling
  • DC: curdlike or purulent
26
Q

Balanitis

- mgmt

A
  • hygiene

- anti fungal if no response

27
Q

Chancroid

  • bug
  • clinical
  • dx
A
  • Haemophilus ducreyi
  • painful genital ulcer, regional LAD
  • clinical- no good tests (r/o syphilis and herpes)
28
Q

Chancroid

- mgmt

A
  • Ceftriaxone 250 mg IM

- Azithromycin 1 g PO

29
Q

Prerenal AKI

  • Bun:Cr
  • Urine Na
  • FENa
A
  • > 20:1
  • < 20
  • < 1%
30
Q

ATN (intrinsic) AKI

  • BUN:Cr
  • Urine Na
  • FENa
A
  • <20:1
  • > 40
  • > 2%
31
Q

When to treat patient with CKD with EPO

A
  • hgb <10
  • adequate iron
  • epoetin or darbepoetin
32
Q

BPH

- mgmt

A
  • alpha-1-adrenergic antagonists (tamsulosin)
  • 5-alpha-reductase inhibitors (finasteride)
  • TURP
33
Q

Urge incontinence

- mgmt

A
  • antimuscarinics (oxybutynin)

- beta-adrenergic agonists (Mirabegron)

34
Q

Hypokalemia

- EKG

A
  • ST segment depression
  • T wave decreased amplitude
  • U wave amplitude increased
  • Prolonged QT
35
Q

Vesicoureteral Reflux

  • cause congenital/primary
  • cause secondary
A
  • congenital: short intravesical ureter

- secondary: due to high voiding pressure in bladder

36
Q

Vesicoureteral Reflux

- primary: dx

A
  • hydronephrosis on prenatal US

- febrile UTI in child > renal US

37
Q

Vesicoureteral Reflux

- dx

A
  • renal US

- contrast voiding cystourethrogram: better

38
Q

MCC CKD

A
  • DM!

- HTN second

39
Q

Penile Carcinoma

- MC type

A

squamous cell

40
Q

Penile Carcinoma

- RF

A
  • uncircumcised
  • poor local hygiene
  • HPV (16, 18)
  • Age >60
41
Q

Penile Carcinoma

- clincial

A
  • small red lesion,
  • non-healing ulcer
  • purulent or warty growth
  • pain uncommon
42
Q

Penile Carcinoma

- dx

A
  • biopsy of lesion

- MRI to stage

43
Q

Penile Carcinoma

- mgmt

A

surgical excision

44
Q

Urethral stricture

- etiology

A
  • idiopathic

- injuries

45
Q

Urethral stricture

- clinical

A
  • decr stream
  • hx recurrent UTI
  • incomplete bladder emptying
  • urinary spraying
46
Q

Urethral stricture

- dx

A

retrograde urethrogram: IDs location and length of stricture

47
Q

Urethral stricture

- mgmt

A
  • urethral dilation
  • urethrotomy
  • sx reconstruction
48
Q

MCC nephrotic syndrome in children

A

minimal change disease

49
Q

Minimal change disease

- dx

A
  • severe proteinuria >3.5 g/24 hours
  • hypoalbuminemia
  • hyperlipidemia
  • podocyte foot process effacement
50
Q

Minimal change disease

- clinical

A
  • periorbital edema, weight gain, diarrhea, abd pain, decr urinary output
51
Q

Minimal change disease

- mgmt

A
  • prednisone
52
Q

Bladder cancer

- classic presentation

A

painless hematuria - gross or microscopic

53
Q

Bladder cancer

- dx

A
  • cystourethroscopy
  • urinary cytology
  • XR upper GI tract
  • CT with and without