RENAL & UROLOGY Flashcards
A tight prepuce that is retracted over the glans to the level of the corona.
What is the condition?
Paraphimosis
Inability to retract a tight, often scarred prepuce.
What is the condition?
Phimosis
Abnormal location / configuration of the urethra
What is the finding called?
Hypospadias
What is cryptorchidism?
Undescended testicle
What is another name of Type 1 RTA ? What are 2 issues associated with this type?
“Distal” RTA
Associated with nephrolithiasis and nephrocalcinosis
What is another name of Type 2 RTA ? What is a distinctive issue associated with this particular type?
“Proximal” RTA
Associated with Fanconi syndrome
Which type of RTA associated with hyperkalemia?
Type 4 RTA
(mineralocorticoid deficiency, aldosterone dependent)
What are the molecules in urine in Fanconi syndrome? (4)
1 - Bicarb
2- Phosphate
3- Glucose
4- Amino acids
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
What is this condition? What is the first-line treatment?
Urethral prolapse
Estrogen cream + Sitz bath
Treatment for diabetic patients with microalbuminuria
ACE inhibitor
How to distinguish IgA nephropathy from PIGN, MPGN, and lupus?
IgA nephropathy has normal C3.
Other causes of glomerulonephritis associated with low C3
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)
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
Abused substance that causes type 1 RTA
Toluene
By which age a child with undescended testes should be referred for surgical evaluation?
6 months
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
