Renal/GU Flashcards
IgA Nephropathy / Berger Dz
- overview
- immunoglobulin A and C3 deposits in the mesangium
- MC glomerular dz worldwide, esp Asia
- M > F
IgA Nephropathy / Berger Dz
- clinical
- gross hematuria 1-2 days after viral URI
- normal complement
- elevated Cr and BUN
- urine: severe proteinuria and hematuria
IgA Nephropathy / Berger Dz
- mgmt
- low risk of progression: monitor
- high risk progression: ACE/ARB to reduce proteinuria and HTN
Hypomg
- clinical
- Neuro: tremor, tetany, seizure, weakness
- CV: prolonged QTc, wide QRS
- Hypokalemia
- Abnl calcium metab
Chancroid vs. Chancre vs. Lymphogranuloma venerum
- Chancroid: painful ulcer, painful inguinal LAD
- syphilis/chancre: painless ulcer, painless LAD
- LV: Painless ulcer, painful LAD
Renal Artery stenosis
- MCC (2)
- clinical
- atherosclerosis, fibromuscular dysplasia (MC in young F)
- usu asx
- recalcitrant HTN
Renal artery stenosis
- dx
- duplex doppler (1st line)
- CT angiography
- MR angiography
- renal arteriography: after other tests are nonconclusive and still high suspicion
Renal artery stenosis
- mgmt
- ACE/ARB for HTN
AKI
- criteria
- 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
Cryptorchidism
- when descend
- 3-4 months of life
- descent after 6 months is rare
- sx orchiopexy recommended ASAP after 4 months and def before 2 years
Chronic bacterial prostatitis
- bugs
- E. coli MC
- proteus
- e. faecalis
- klebsiella
- pseudomonas
Chronic bacterial prostatitis
- clinical
- recurrent UTI
- low back / perineal pain
- urinary retention
- tender, boggy prostate (or normal!)
Chronic bacterial prostatitis
- dx
- Urine culture prior to and after prostatic massage
Chronic bacterial prostatitis
- mgmt
- bactrim
- FQ
X 6 weeks
Prostate cancer screening
- high risk pts
- when start screening
- AA
- fam hx
- BRCA mutations
- screen age 40
Prostate cancer screening
- normal risk
50-70
Acute Interstitial Nephritis
- overview
- inflammation or allergic response in interstitial of kidney
Acute Interstitial Nephritis
- clinical
- Pyuria
- WBC casts***
- hematuria
- fever
- rash
- arthralgia
Acute Interstitial Nephritis
- common drugs
- common illness
- PCN & cephalosporins
- NSAIDS
- RMSF
- CMV
- Sarcoid, Sjogren, Lupus
Overflow incontinence
- causes
- blockage of urethra: BPH, stricture
- Detrusor under activity from nerve damage
Acute prostatitis
- clinical
- fever chills
- malaise
- pelvic pain
- perineal pain
- cloudy urine
- irritative and obstructive sx
- firm, edematous, exquisitely tender prostate on DRE