Urology Flashcards
mnemonic anion gap met acidosis
MUDPILERS
methanol
uremia
DKA/alcoholic KA
Propylene glycol
Isoniazid,infection
lactic acidosis
ethylene glycol
rhabdo/renal failure
salicylates
mnemonic non-gap metabolic acidosis
HARDUPS
hyperalimentation
acetazolamide
renal tubular acidosis
diarrhea
uretero-pelvic shunt
post-hypocapnia
spironolactone
mnemonic acute respiratory acidosis
CHAMPP
CNS depression (drugs, CVA)
hemo/pneumothorax
airway obstruction
myopathy
pneumonia
pulmonary edema
mnemonic metabolic alkalosis
CLEVER PD
contraction
licorice
endo (cushings, conns)
vomiting
excess alkali
refeeding alkalosis
post-hypercapnia
diuretics
mnemonic respiratory alkalosis
CHAMPS
CNS disease
hypoxia
anxiety
mech ventilators
progesterone
salicylates/sepsis
normal value pH
7.35-7.45
normal value PCO2
35-45
normal value HCO3-
22-26
findings for acute tubular necrosis
muddy brown casts
findings for acute interstitial nephritis
WBC and white cell casts
tx for cystitis
nitrofurantoin
TMP-SMX
fosfomycin
MCC orchitis
mumps (viral)
tx for epididymitis and prostatitis
< 35 - doxy + cef
(can use azithromycin instead of doxy)
> 35 - fluoroquinolone
What is priapism
prolonged erection lasting longer than 4 hours without sexual stimulation
what can be used to distinguish between ischemic and non-ischemic priapism
penile blood gas
Ischemic priapism will have a blood gas with pH < 7.25, pCO2 > 60 mm Hg, and pO2 < 40 mm Hg
tx ischemic priapism
corporal aspiration with intracavernosal phenylephrine
if does not work –> surgical shunting performed by urologist
tx for nonischemic priapism
observation
assuming pH > 7.3 (normal)
tx nephrolithasis
< 5 mm - fluids and analgesics (NSAIDS)
> /=5 mm - tamsulosin; lithotripsy
> /=10 mm - nephrolithotomy
MC type of kidney stone
calcium oxalate
most common cause of acute urinary retention in men
BPH
poststreptococcal glomerulonephritis is caused by
immune complex deposition in the kidney
what infection can cause post strep GMN
beta-hemolytic Streptococcus pyogenes, typically involving the pharynx or skin
two most common serologic markers used to diagnose post strep GMN
antistreptolysin O or anti-DNAse B titers
UA for post strep GMN
red blood cell casts and proteinuria
labs post strep GMN
decreased C3 levels
tx post strep GMN
supportive
BUN and creatinine ratios of <10:1 are suggestive of an
intrinsic renal problem (tubular, interstitial, or glomerular injuries)
BUN and creatinine ratios of 10-20:1 are suggestive of
post-renal pathology due to obstruction of flow (neurogenic bladder, mass, stricture, prostate enlargement)
BUN/Creatinine ratio of > 20:1 is suggestive of
Prerenal causes of renal failure (cardiogenic shock, hemorrhage, sepsis) –> decreased renal perfusion
dx kidney stone
UA - may show pH < 5; blood
Noncontrast CT of abdomen and pelvis
KUB XR can show calcium and struvite stones
How much water should a patient with a detected kidney stone drink within the first 24 hours?
2L
Balanitis has a wide range of causes but is most related to
inadequate hygiene in uncircumcised men
MC infectious cause of balanitis
candidiasis
tx balanitis due to candidiasis
topical clotrimazole
Sx in UTI vs pyelonephritis
UTIs - limited to the genitourinary system and include dysuria, urgency, frequency, hematuria, and suprapubic abdominal pain
pyelonephritis - constitutional symptoms such as fever, vomiting, and malaise and may also have back and flank pain
tx pyelonephritis
Fluoroquinolones
Trimethoprim-sulfamethoxazole
Third- or fourth-generation cephalosporins
