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Clinical Med II Exam 3 (Annie and Lauren) > Urologic Cases > Flashcards

Urologic Cases Flashcards

1
Q

What will the pain of a kidney stone be like

A

Sharp, stabbing

Constant pain but severity waxes and wanes (3-8/10)

Flank pain that radiates to groin***

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2
Q

What symptoms other than pain will a pt with a. Kidney stone have

A

Dysuria

Dark urine

Hematuria

Nausea

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3
Q

What are the 5 types of stones?

A

Calcium oxalate

Calcium phosphate

Struvite

Uric acid

Cystine

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4
Q

What is the most common type of stone

A

Calcium oxalate

Calcium phosphate second most

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5
Q

Which type of kidney stones are radiolucent

A

Uric acid

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6
Q

What are the risk factors for kidney stones

A

Hx of prior stone

Family hx

Decreased fluid intake

Malabsorption that causes increased oxalate excretion in urine (ex, bariatric surg)

Hyperparathyroidism, HTN, DM, obesity, gout, excessive running (marathon)

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7
Q

What is the preferred imaging technique for kidney stones

A

Non-contrast low radiation CT

Contrast decreases the sensitivity for small stones.

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8
Q

What is the 2nd best imaging technique for kidney stone

A

Ultrasound.

Less sensitive than CT. Might need to get a CT anyways if the US is negative

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9
Q

Who needs a referral to urology for kidney stones?

A

Referral:
Stone >10mm

Failure to pass stone

Significant obstruction

URGENT referral:
Infection

AKI

Anuria

Unyielding pain, N/V

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10
Q

What is the surgical treatment of choice for kidney stones

A

Shock Wave Lithotripsy

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11
Q

Do all stones need surgical removal

A

Only 10-20%

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12
Q

What are the 3 options for surgical removal of stones

A

Lithotripsy

Ureteroscopy

Percutaneous nephrolithotomy

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13
Q

After a stone is removed/passed, do you need to do anything with it

A

Send for analysis

Patient may need to pee through a strainer to collect stones

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14
Q

How could a patient prevent stones

A

Increase hydration

Decrease Na intake

Allopurinol if gout

HCTZ to reduce calcium in urine

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15
Q

If you get a non-contrast CT for a kidney stone what would it mean if you saw “perinephritic stranding”

A

Inflammation/obstruction

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16
Q

What medication will facilitate passage of kidney stones

A

α-blocker

17
Q

What is the classic triad of renal cell carcinoma

A

Hematuria

Flank pain

Palpable abdominal mass

(Present in 9% of patients)

18
Q

Does cigarette smoking increase risk for renal cell carcinoma

A

Yes

Also being an old guy

19
Q

How will a patient present if they have Polycystic Kidney disease

A

Mild urine discoloration/blood

History of stones and UTIs

Mild abdominal pain/feeling of “fullness”

Elevated BP*

Palpitations

Mid systolic click*

Large palpable kidneys

20
Q

What are some complications of PKD

A

Infection of cyst

Cyst hemorrhage

Kidney stones

21
Q

What are some of the extrarenal manifestaions of PKD

A

Hepatic/splenic/pancreatic cysts

Heart valve abnormalities (mitral valve prolapse)

Intracranial aneurysm (worst headache of my life)

22
Q

Which casts are in pyelonephritis

A

WBC casts

23
Q

Which casts are in glomerulonephritis

A

RBC casts

24
Q

Which casts are in acute tubular necrosis (intrinsic kidney injury)

A

Muddy brown/renal tubular casts

25
Q

What do hyaline casts signify

A

Benign and found in normal urine (also present in concentrated urine…exercise/diuretics)

26
Q

___________is the HALLMARK of progressive kidney disease

A

Declining GFR

27
Q

Name that stage of CKD:
Kidney damage with normal or increased GFR

GFR 90+

A

Stage 1

28
Q

Name that stage of CKD:

Kidney damage with mildly decreased GFR

GFR 60-89

A

Stage 2

29
Q

Name that stage of CKD:
Mild-moderate decreased GFR

GFR 45-59

A

Stage 3a

30
Q

Name that stage of CKD:

Moderate-severe decrease GFR

GFR 30-44

A

3b

31
Q

Name that stage of CKD:
Severely decreased GFR

GFR 15-29

A

Stage 4

32
Q

Name that stage of CKD:

Kidney failure

GFR <15 or dialysis

A

Stage 5 (add D if on dialysis)

Clinical Med II Exam 3 (Annie and Lauren) (5 decks)

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