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Internal Med EOR > Urology 1 > Flashcards

Urology 1 Flashcards

1
Q

mnemonic anion gap metabolic acidosis

A

MUDPILERS

Methanol
Uremia
DKA/alcoholic KA
Propylene glycol
Isoniazid, infection
Lactic Acidosis
Ethylene glycol
Rhabdo/renal failure
Salicylates (presents w respiratory alkalosis then progresses to metabolic acidosis)

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2
Q

non-gap metabolic acidosis mnemonic

A

HARDUPS

Hyperalimentation
Acetozolamide
Renal tubular acidosis
Diarrhea
Uretero-pelvic shunt
Post-hypocapnia
Spironolactone

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3
Q

mnemonic acute respiratory acidosis

A

CHAMPP

CNS depression
Hemo/Pneumothorax
Airway obstruction
Myopathy
Pneumonia
Pulmonary edema

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4
Q

mnemonic metabolic alkalosis

A

CLEVER PD

Contraction
Licorice
Endo (Conn’s Cushing’s)
Vomiting
Excess alkali
Refeeding alkalosis
Post-hypercapnia
Diuretics

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5
Q

mnemonic respiratory alkalosis

A

CHAMPS

CNS disease
Hypoxia
Anxiety
Mech Ventilators
Progesterone
Salicylates/Sepsis

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6
Q

normal pH

A

7.35-7.45

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7
Q

normal PCO2

A

35-45 mmHg

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8
Q

normal HCO3-

A

22-26 mEq/L

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9
Q

risk factors for cystitis /UTI

A

women - sexual intercourse
pregnancy
elderly and postmenopausal
infants

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10
Q

MC cause of cystitis

A

E coli mc
staphylococcus saphrophyticus 2nd most common

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11
Q

dx cystitis

A

UA - pyuria (>10 WBCs/hpf), hematuria, leukocyte esterase, nitrites

Urine culture - definitive; needs to be clean catch; epithelial/squamous cells = contamination; may show >/= 1000 CFU/mL ur-pathogens

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12
Q

tx cystitis

A

1st line - nitrofurantoin or TMP-SMX or fosfomycin
2nd line - fluoroquinolone (Cipro or levofloxacin)

adjunct: phenazopyridine is a bladder analgesic –> turns urine orange

no tx if asx unless pregnancy

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13
Q

MC pathogen in pyelonephritis

A

E coli

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14
Q

Risks pyelo

A

DM
Recurrent UTIs/kidney stones
pregnancy
urinary tract malformations

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15
Q

sx pyelo

A

fever, chills, back/flank pain, nausea and vomiting

dysuria, urgency, frequency

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16
Q

PE pyelo

A

CVA tenderness, fever, tachycardia

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17
Q

dx pyelo

A

UA: pyuria > 10 WBCs/hpf, leukocyte esterase, nitrites, WBC CASTS!!!

urine culture - defintiive

CBC - leukocytosis w left shift

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18
Q

tx pyelo

A

fluoroquinolone - levo or Cipro

pregnancy - IV ceftriaxone

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19
Q

MC causes of prostatitis

A

> 35 - E coli
< 35 - chlamydia and gonorrhea

kids - mumps

chronic - e coli

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20
Q

sx prostatitis

A

frequency, urgency, dysuria,

hesitancy, poor or interrupted stream, straining

acute - spiking fever, chills, perineal pain

chronic - recurrent UTIs or intermittent dysfunction

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21
Q

PE prostatitis

A

boggy (firm, edematous) prostate

acute - exquisitely tender, boggy

chronic - nontender, boggy

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22
Q

dx prostatitis

A

pyuria and bacteriuria in acute; often negative in chronic
avoid prostatic massage –> bacteremia

23
Q

tx prostatitis

A

acute > 35 - fluoroquinolone or TMP-SMX

Acute < 35 or STI likely - ceftriaxone plus doxy (azithromycin alternative to doxy)

refractory - transurethral resection of prostate

24
Q

causes of epididymitis

A

males 14-35 - chlamydia (MC) or neisseria

men > 35 - E coli

25
sx epididymitis
gradual onset (few hours --> days) of localized testicular pain and swelling
26
PE epididymitis
positive prehn sign - relief of pain w scrotal swelling positive (normal) cremasteric reflex - elevation of testicle after stroking inner thigh
27
dx epididymitis
scrotal US best initial - enlarged epididymis and increased testicular blood flow; rules out testicular torsion UA - pyuria, positive leukocyte esterase, bacteriuria NAAT for gonorrhea and chlamydia
28
tx epididymitis
< 35 or STI likely - cover chlamydia and gonorrhea - doxycycline plus ceftriaxone anal intercourse - ceftriaxone plus fluoroquinolone > 35, low risk STI - fluoroquinolone (Cipro or levo)
29
risk testicular torsion
adolescents 10-20 years and neonates at highest risk true urologic emergency
30
sx testicular torsion
abrupt onset of moderate to severe scrotal, inguinal, or lower abdominal pain nausea or vomiting --> torsion
31
PE testicular torsion
swollen, tender retracted testicle (high-riding) negative prehn sign - no relief w scrotal elevation negative (absent) cremasteric reflex on affected side - no elevation in testicle after stroking inner thigh
32
dx testicular torsion
clinical surgical exploration - definitive testicular doppler US - most commonly used imaging; decreased or absent testicular blood flow
33
tx testicular torsion
surgical exploration w urgent detorsion and orchiopexy ideally within 6 hours of pain onset orchiectomy if testicle is not salvageable
34
hydrocele
serous fluid within the parietal and visceral layers of the tunica vaginalis which directly surrounds the testis and spermatic cord
35
what is the MC cause of painless scrotal swelling
hydrocele
36
type of hydrocele
communicating - peritoneal/abdominal fluid enters the scrotum via a patent processus vaginalis that failed to close noncommunicating - derived from fluid from the mesothelial lining of the tunica vaginalis (no connection to peritoneum)
37
sx hydrocele
painless scrotal swelling - may increase throughout the day may complain of heavy sensation
38
PE hydrocele
translucency - scrotal sac transilluminates well swelling worse w valsalva if communicating
39
dx hydrocele
testicular US - rules out tumor, masses, epididymitis, orchitis
40
tx hydrocele
watchful waiting - resolves within 12 months of life in infants; self-limited in adults surgical excision after 1 year
41
spermatocele and epididymal cyst
epididymal cyst (scrotal mass) that contains sperm spermatocele if > 2 cm or larger
42
sx spermatocele/epididymal cyst
painless mass
43
PE spermatocele/epididymal cyst
round soft mass in head of epidermis superior, posterior and separate from testicle freely movable transilluminates
44
tx spermatocele/epididymal cyst
no tx
45
varicocele
cystic testicular mass of varicose veins - pampiniform venous plexus and internal spermatic vein
46
what is the MC surgically correctable cause of male infertility
varicocele
47
why are most varicoceles left sided
increased left renal vein pressure transmitted to left gonadal vein bc it enters theft renal vein at a perpendicular angle
48
sx varicocele
asx testicular atrophy usually painless may have dull ache/heaviness
49
PE varicocele
soft scrotal mass w a bag of worms feel superior to the testicle dilation worsens w patient upright or w valsalva
50
dx varicocele
clinica US - dilation of pampiniform plexus > 2 mm
51
tx varicocele
observation surgery if pain, infertility, delayed testicular growth
52
right sided varicocele associations
retroperitoneal or abdominal malignancy
53
left sided varicocele associations
left sided varicocele in an older man may be due to renal cell carcinoma
54

Internal Med EOR (17 decks)

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