uro/renal (3%) Flashcards
rf for cryptorchidism
premies
low birth weight
where is testicle MC in cryptorchidism
inguinal canal
tx of cryptorchidism
observe if <6mo but repair before 1yo
most testicles descend spontaneously by what age
3mo
what are the long term risks from cryptorchidism
inc risk of testicular Ca, sub fertility, testicular torsion, inguinal hernia
what is the MC cause of painless scrotal swelling
hydrocele
what is the main cause of hydrocele in infants + adults
infants- congenital incomplete obliteration of processus vaginalis
adults- injury, infection, inflam
hydrocele presentation
painless swelling, may inc throughout day
+/-dull ache/heaviness
+ transilumination
how do you tell communicating from noncommunicating hydrocele
communicating = swelling worse w valsalva
tx of hydrocele
usu none needed- resolves by 1yo
what is paraphimosis vs phimosis
para-foreskin retracted + stuck
phimosis- can’t retract foreskin
which is emergent phimosis or paraphimosis and why
paraphimosis- dec circulation to glans
what causes testicular torsion
bell clapper deformity of process vaginalis
congenital
sx of testicular torsion
abrupt onset of scrotal, inguinal or lower and pain + n/v
swollen, tender high-riding testicle w absent cremasteric reflex
blue dot sign
blue dot at upper pole of testicle - indicates torsion of appendix of testes
tx of testicular torsion
euro emergency
orchiopexy w.i 6hrs
what is enuresis
primary monosx bedwetting in pt 5yo+ w no sx of infxn
what drugs can be used to tx enuresis
desmopressin (DDAVP)
TCAs (if all others fail)
what is glomerulonephritis
immune inflame of glomeruli –> protein + RBC leakage into urine
sx of glomerulonephritis
HTN, hematuria (+casts), dependent edema (proteinuria), azotemia (inc BUN)
gold standard for glomerulonephritis dx
renal bx
what is the specific gravity of urine in glomerulonephritis
high (>1.020)
what is another name for IgA nephropathy
berger’s dz
what is the classic presentation of mergers disease (IgA nephropathy)
young males w.i days s/p URI/GI infection –> IgA overproduction –> HTN, hematuria (+casts), dependent edema (proteinuria), azotemia (inc BUN)
what is diagnostic of IgA nephropathy
IgA mesangial deposits
tx of IgA nephropathy
ACEi + corticosteroids
what pathogen is MC in post-infectious glomerulonephritis
GABHS (skin/pharyngeal infxn)
what is the classic presentation of post-infectious glomerulonephritis
2-14yo boy w facial edema 3wks after strep, w scanty cola-colored/dark urine
HTN, hematuria (+casts), dependent edema (proteinuria), azotemia (inc BUN)
what is diagnostic of post-infectious glomerulonephritis
antistreptolysin titers
low serum complement (C3)
what is the tx of post-infectious glomerulonephritis
supportive +/- abx
what causes membranoproliferative/mesangiocapillary glomerulonephritis
SLE, viral hepatitis, hypocomplementemia
what is the presentation of membranoproliferative/mesangiocapillary glomerulonephritis
mixed nephritic-nephrotic picture
what are the 3 types of rapidly progressive glomerulonephritis (RPGN)
goodpastures
microscopic polyangiitis
granulomatosis w polyangiitis
what do you see on bx of rapidly progressive glomerulonephritis (RPGN)
crescent formation
poor prognosis
how do you tx rapidly progressive glomerulonephritis (RPGN)
corticosteroids + cyclophosphamide
what causes goodpastures dz
anti-GBM antibodies –> kidney failure + hemoptysis
how do you dx goodpastures dz
linear IgG deposits
what is microscopic polyangiitis
vasculitis of small renal vessels –> P-ANCA
what is granulomatosis w polyangiitis
wegeners –> C-ANCA
what is the MC organism in cystitis/pyelo
E.coli (S.sapro if sexually active)
tx of uncomplicated cystitis
nitro
FQs
bactrim
tx of complicated cystitis
FQ PO or IV
what is complicated cystitis
pregnant immunocompromised DM indwelling cath anatomic abnormality elderly males
tx of cystitis in pregnant pt
amox, augmentin, keflex, cefpodoxime, nitro
tx of pyelo
FQ PO or IV x14D
