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Primary Care > Urology > Flashcards

Urology Flashcards

1
Q

Umbilical hernias in kids usually resolve by age ___. Surgical repair warranted if persistent by age ____.

A

Resolve by 2

Repair by 5

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2
Q

Children and neonates are prone to pyelonephritis due to _____ reflux.

A

Vesicourethral

*E COLI MC etiology

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3
Q

S&S of pyelonephritis include:

A

Fever, Tachycardia, back/flank pain, (+) CVA tenderness, N/V

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4
Q

UA for UTI shows:

A
  1. Pyelonephritis–> WBC casts!
  2. Dipstick: leukocyte esterase, nitrites, hematuria
  3. Urine culture: definitive dx! Used for complicated UTI, infants/kids, elderly, males, urologic abnormalities, refractory to tx, and catheterized patients
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5
Q

Treatment options for UTI:

A
  1. Uncomplicated: Nitrofurantoin, Cipro, Bactrim
  2. Complicated: Cipro PO or IV, Aminoglycosides
  3. Pregnant: Amoxicillin or Nitrofurantoin
  4. Pyelonephritis: Cipro PO or IV, Aminoglycosides
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6
Q

Inflammation of glomeruli causing PROTEIN and RBC leakage into urine is known as ______.

A

Glomerulonephritis

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7
Q

What are key S&S of Glomerulonephritis?

A

HTN, HEMATURIA, DEPENDENT EDEMA (PROTEINURIA), AND AZOTEMIA!!

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8
Q

Common etiologies of Glomerulonephritis include:

A
  1. IgA Nephropathy (Berger’s Disease)
    - MC CAUSE OF AGN IN ADULTS WORLDWIDE
    - Tx: ACEI +/- corticosteroids
  2. Post Infectious
    - MC after GABHS
    - Scanty, coca-cola colored urine (hematuria and oliguria)
    - Dx: increased ASO titers
    - Tx: supportive +/- ABX
  3. Membranoproliferative Mesangiocapillary
    - SLE, viral Hep
  4. Rapidly Progressive Glomerulonephritis (RPGN)
    - Poor prognosis, rapid progression to ESRD
  • Good Pasture’s Disease- found with RPGN. Often occurs after URI. KIDNEY FAILURE AND HEMOPTYSIS.
  • Linear IgG deposits
  • Tx: high dose corticosteroids

**Vasculitis

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9
Q

Glomerulonephritis is usually self-limited with a good prognosis

A

:)

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10
Q

_____ is MC type of nephrolithiasis.

A

Calcium oxalate and phosphate

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11
Q

Pain location and stone location related

A
  1. Proximal ureter= flank
  2. Mid-ureter= mid-abdominal
  3. Distal ureter= groin
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12
Q

Best initial test for kidney stones is ____. However, the gold standard test is _____.

A

1st= Non-contrast CT

Gold Standard= IV Pyelography (extend of obstruction)

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13
Q

Treatment related to size of stone.

A

-Stones < 5mm diameter= 80% chance of spontaneous passage. Give fluids, analgesics, antiemetics, and Tamsulosin

  • Stones >7mm= 20% chance of passage. Can try:
    1. Extracorporeal Shock Wave Lithotripsy
    2. Ureteroscopy +/- stent: immediate relief of an obstructed or at-risk kidney
    3. Percutaneous nephrolithotomy: for stones >10mm, struvite, or failed other modalities
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14
Q

What are the DRE findings for BPH?

A

Uniformly enlarged, firm, rubbery prostate

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15
Q

Treatment of BPH involves 2 classes of medication. What are they?

A
  1. 5-a Reductase Inhibitors: Finasteride & Dutasteride
    - MOA: Inhibits conversion of testosterone to DHT which SUPPRESSES PROSTATE GROWTH and reduces bladder outlet obstruction.
    - Does NOT provide immediate relief
  2. a1 Blockers: Tamsulosin (Flomax), and the -Zosins
    - MOA: smooth muscles relaxation of prostate and bladder neck
    - DOES provide RAPID SYMPTOM RELIEF, but no effect on clinical course of BPH
  3. Surgical: TURP
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16
Q

_____ is prostate inflammation secondary to ascending infection.

A

Prostatitis

> 35y: MC cause is E coli
<35y: MC cause is GC/Chlam
Kids: Mumps

17
Q

S&S of acute prostatitis:

A

Fever/chills, malaise, arthralgias, perineal pain
(also all the other symptoms associated with BPH)

*S&S milder in chronic

18
Q

PE findings for ACUTE prostatitis?

A

TENDER, boggy prostate

*AVOID prostatic massage (bacteremia…)

19
Q

PE findings for CHRONIC prostatitis?

A

NONtender, boggy prostate

20
Q

Treatment options for acute and chronic prostatitis?

A

Acute:
>35y- FQs, Bactrim
<35y- Rocephin + Azithro or Doxy

Chronic:
FQs, Bactrim
TURP if refractory!

21
Q

Epididymitis is usually ____ (bacterial/viral) and Orchitis is usually _____ (bacterial/viral).

A

Epididymitis- bacterial

Orchitis- viral

22
Q

In kids w/ orchitis the MC culprit is mumps. Orchitis usually preceded by ____ (another mumps symptom) by 3-10 days.

A

Parotitis

23
Q

PE findings for epididymitis/orchitis:

A

Epididymal tenderness and induration

  • POSITIVE PREHNS SIGN
  • POSITIVE (NORMAL) CREMASTERIC REFLEX
24
Q

Dx for epididymitis/orchitis:

A
  • Scrotal US- enlarged epididymis and INCREASED TESTICULAR BLOOD FLOW
  • UA: pyuria (inc. WBCs)
  • STD testing: GC/Chlam, RPR, HIV
25
Q

How do you treat children with acute epididymitis?

A

Cephalexin or Amoxicillin

26
Q

_____ is the MC overall bacterial cause of STDs in US

A

Chlamydia

27
Q

Reiter’s syndrome is associated with Chlamydia. What is Reiter’s syndrome?

A

Urethritis, Conjunctivitis/Uveitis, and Arthritis

28
Q

____ is the MC cause of urethritis in men <30y.

A

Gonorrhea

*Dissemination: arthritis-dermatitis syndrome

29
Q

What test is the most sensitive and specific for GC/Chlam?

A

Nucleic Acid Amplification

30
Q

Inflammation of the glans penis is known as ____.

A

Balanitis

  • Can be fungal or bacterial in nature
  • *Tx- topical creams, if cellulitis–> Ceph or sulfa drug
31
Q

MC solid tumor in young men 15-40y is _____.

A

Testicular Ca

32
Q

_____ leads to a 40x increased risk for testicular cancer and is MC found on the right side.

A

Cryptochordism

33
Q

Types of testicular tumors:

A
  1. Germinal Cell Tumors (97%)- usually malignant
    - Seminoma: men 30-40. Think about the 4 S’s= Simple (lack tumor markers), Sensitive (to radiation), Slower growing, Stepwise spread

-Nonseminomatous: boys <10y. Embyronal cell carcinoma

  1. Non-Germinal Cell Tumors (3%)- can cause pulm sym
    - Leydig cell tumors
    - Sertoli cell tumors
    - Gonadoblastoma, testicular lymphoma
34
Q

How is testicular cancer diagnosed?

A
  • Scrotal US
  • Alpha-fetoprotein, b-hCG, LDH

*Tx- orchiectomy +/- radiation and chemo (for low to high grade Seminomas)

Primary Care (12 decks)

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