RENAL & UROLOGY Flashcards by Bao Truong

A tight prepuce that is retracted over the glans to the level of the corona.
What is the condition?

Paraphimosis

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Inability to retract a tight, often scarred prepuce.
What is the condition?

Phimosis

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Abnormal location / configuration of the urethra
What is the finding called?

Hypospadias

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What is cryptorchidism?

Undescended testicle

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What is another name of Type 1 RTA ? What are 2 issues associated with this type?

“Distal” RTA
Associated with nephrolithiasis and nephrocalcinosis

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What is another name of Type 2 RTA ? What is a distinctive issue associated with this particular type?

“Proximal” RTA
Associated with Fanconi syndrome

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Which type of RTA associated with hyperkalemia?

Type 4 RTA
(mineralocorticoid deficiency, aldosterone dependent)

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What are the molecules in urine in Fanconi syndrome? (4)

1 - Bicarb
2- Phosphate
3- Glucose
4- Amino acids

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Scrotal mass that enlarges when assumes an upright position and during Valsava, with dilated veins readily visible. Normal testicular size

What is the condition? What is the management?

Varicocele

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What is this condition? What is the first-line treatment?

Urethral prolapse

Estrogen cream + Sitz bath

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Treatment for diabetic patients with microalbuminuria

ACE inhibitor

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How to distinguish IgA nephropathy from PIGN, MPGN, and lupus?

IgA nephropathy has normal C3.
Other causes of glomerulonephritis associated with low C3

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How to distinguish PIGN from MPGN and lupus?

PIGN has normal C4
(MPGN and lupus have low C4)
(All 3 have low C3, although C3 returns to normal within 6 weeks for PIGN - i.e. acute)

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In rhabdomyolysis, what are the values of ?
- Potassium
- Phos
- Calcium
- Uric acid
- Albumin

HIGH potassium
HIGH phos
LOW calcium (as calcium phosphate was deposited within the injured muscle)
HIGH uric acid
LOW albumin

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Abused substance that causes type 1 RTA

Toluene

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By which age a child with undescended testes should be referred for surgical evaluation?

6 months

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What is the first step of evaluation for an adolescent with secondary enuresis

Screen for stress and abuse

Which serum lab values are elevated in nephrotic syndrome? (2)

Serum cholesterol
Serum triglyceride

Undescended testes, GU anomalies, hypoplasia of abdominal musculature
What is the condition?

Prune belly syndrome

Most common causes of morbidity / mortality in patients with prune belly syndrome? (2)

Hypoplastic lungs -> respiratory insufficiency
Renal failure

Abdominal U/S shows enlarged, uniformly hyperechogenic kidneys with poor corticomedullary differentiation in an infant.

What is the condition?
What is the common cause of death in neonate with this condition?
What is the universal complication when this infant grows up?

ARPKD
(autosomal recessive polycystic kidney disease)

Common cause of death in infants = pulmonary hypoplasia (from severe oligohydramnios)

Liver involvement is universal in patients with this disorder

What is the treatment of patient with HUS who presents with signs of fluid overload, anuria, or hypertension ? (thus preclude aggressive hydration)

Dialysis

What are the complications associated with nephrotic syndrome?

Thromboses
(due to loss of proteins regulating clotting, such as protein C and protein S)

What is the “silk glove sign” associated with?

Inguinal hernia

(when layers of the hernia sac are palpated, sliding over each other, it mimics the feeling of a silk glove - arguing against the differential which is hydrocele)

Hearing loss, microscopic hematuria What is the diagnosis? What is the late-stage renal complications? (2)

Alport syndrome (aka hereditary nephritis) Late-stage complications = **end-stage kidney disease** and **proteinuria**

Dystrophy of thumbnails + Hypoplastic patellae What is the associated abnormal lab? What is the condition? What is the late stage complication?

Nail-patella syndrome Abnormal lab = proteinuria Late-stage = end-stage kidney disease

Electrolyte abnormality associated with shortened QT interval

HYPERcalcemia

Electrolyte abnormality associated with prolonged QT interval and AV block

HYPOcalcemia AV block

Electrolyte abnormality associated with prolonged QRS interval, prolonged QT, and ST-T wave changes

HYPOkalemia

Nasal and oral ulcers, bilateral conjunctival injection, chest XR shows increased lung markings with no consolidation, fever/cough for couple weeks. What is the condition? What are 2 diagnostic criteria?

Granulomatosis with polyangiitis (GPA) Diagnosis criteria - must meet 2 or more: - Abnormal chest imaging - Hematuria / red-cell cast - Vascular granulomatous inflmmation on biopsy

What is the type of antibody found in GPA?

ANCA

A young baby with thin, translucent membrane extending from posterior fourchette to below the clitoris, asymptomatic What is the condition? What is the treatment?

Labial adhesion Apply topical estrogen cream to the membrane

Which renal disease associated with bilateral sensorineural hearing loss?

Alport syndrome

Flattened nose, recessed chin, low-set ears, prominent epicanthal folds What is the underlying issue? What is the cause?

Potter sequence Caused by oligohydramnios from decreased fetal urine output due to some renal issues (or chronic leakage of amniotic fluid)

Besides kidney and hearing loss, what is another organ involved in Alport syndrome?

Ocular defects

When a varicocele needs surgical repair? (3 conditions)

1 - affected testicle to be smaller than the other 2- reduced sperm count 3 - causing significant pain

What are 2 indications or surgical intervention of hydrocele?

1 - **Hydrocele that presents past 1 year of age** (normally the communication between the inguinal canal and the abdominal compartment should close by then) 2 - **Acquired hydrocele** (not there before)

Hypospadia + undescended testes What is the concern? What labs should be sent? (6)

C/f defects in **sexual differentiation** Labs: 1 - FSH 2 - LH 3 - Testosterone 4 - Karyotype 5 - Urine 17-ketosteroids 6 - 17-hydroxycorticosteroids

Abnormal location of urethral opening What is this called?

Hypospadia

What is the appropriate time window for hypospadia surgical repair?

3 months - 18 months