Urology/Renal (5%)

Question 1

Acute glomerulitis is an immunologic inflammation of the glomeruli causing ____ and _____ leakage into the urine

Answer 1

protein and RBCs

Question 2

If a pt has HTN, hematuria (RBC casts), dependent edema (proteinuria), and azotemia, what underlying condition is present?

Answer 2

Acute glomerulonephritis

^{Azotemia is a medical condition characterized by abnormally high levels of nitrogen-containing compounds (<em>urea, creatinine, various body waste compounds, and other nitrogen-rich compounds</em>) in the blood}

Question 3

What is the most common cause of AGN in adults, worldwide?

Answer 3

IgA Nephropathy (berger’s disease)

Question 5

_________ is a similar disease to IgA nephropathy (berger’s disease) but associated with generalized IgA vasculitis

Answer 5

Henoch schonlein purpura

Question 8

Berger’s disease often affects young (males/females) within days after _______ or _______ infection

Answer 8

males

URI or GI

Question 9

Post infectious glomerulonephritis classically presents as a ____-____ y/o (boy/girl) with ______ edema up to 3 weeks after Strep with scanty, ________ urine

Answer 9

2-14 y/o

boy

facial

cola-colored/dark

Question 10

Rapidly progressive glomerulonephritis (RPGN) is associated with a (poor/good) prognosis with _____ formation on bx

Answer 10

poor

crescent

^{crescents formed due to fibrin & plasma protein deposition collapsing the crescent shape of Bowman’s capsule}

Question 12

How to treat IgA nephropathy?

Answer 12

ACE Inhibitors, +/- Corticosteroids

Question 13

What two body systems does Goodpasture’s dz affect?

Answer 13

Kidney

Lung

Question 14

Post infectious acute glomerulonephritis is most commonly seen after what infxn?

Answer 14

GABHS

Question 15

What two conditions present with + ANCA antibodies and a ack of immune deposits?

Answer 15

Microscopic Polyangiitis (vasculitis of small renal vessels): +P-ANCA

Granulomatosis with Polyangiitis (Wegener’s): necrotizing vasculitis +C-ANCA

Question 19

Tx for rapidly progressive glomerulonephritis?

Answer 19

Corticosteroids + Cyclophosphamide

Question 20

Any cause of AGN can present with RPGN, which 2 ONLY PRESENT with RPGN?

Answer 20

Goodpasture’s dz

Vasculitis

Question 22

How to tx Goodpasture’s dz?

Answer 22

High dose corticosteroids + cyclophosphamide + plasmaphersis

Question 24

How to dx a pt with acute glomerulonephritis?

Gold standard?

Answer 24

Urinalysis (UA): hematuria (RBC casts), dysmorphic RBCs, proteinuria (usually <3g/d but may be in the nephrotic range), high specific gravity > 1.020 osm, ± WBCs

Increased BUN, increased Creatinine to varying degrees

Renal biopsy gold standard (not needed if poststrep suspected)

Question 25

T/F: Glomerulonephritis is usually self-limited with a good prognosis

Answer 25

TRUE

except in cases of RPGN

Question 26

What are risk factors associated with cystitis in children/neonates?

Answer 26

vesicourethral reflux, newborns with FUO (fever of unknown origin)

Other: DM, catheter

Question 27

What is the most common organism to cause cystitis?

Answer 27

E. coli

Question 28

What are some sx a pt may experience with cystitis?

Answer 28

dysuria, increased frequency, urgeny, hematuria, suprapubic discomfort

Question 29

In a pt with pyelonephritis, what sx may be present?

Answer 29

fever, tachycardia, back/flank pain, +CVA tenderness, N/V

Question 30

How to dx a pt with cystitis?

Answer 30

UA

Diptick

Question 31

What are medication options for management of uncomplicated cystitis?

Answer 31

Nitrofurantoin

Fluoroquinolones

Trimethoprim-sulfamethoxazole

Question 32

What is complicated cystitis?

Answer 32

underlying condition with risk of therapeutic failure: sx >7 days, pregnancy, DM, immunosuppression, indwelling catheter, anatomic abnormality, elderly, males

Question 33

Tx for complicated cystitis?

Answer 33

Fluoroquinolone PO or IV, Aminoglycosides

Question 34

If a pt with cystitis is pregnant, what tx options are there?

Answer 34

Amoxicillin, Augmentin, Cephalexin, Cefpodoxime, Nitrofurantoin, Fosfomycin, Sulfisoxazole is safe except in last days of pregnancy (Increased kernicterus)

Question 35

Tx for pyelonephritis?

Answer 35

Fluoroquinolone PO or IV, Aminoglycoside x14 days (7 days may be used in healthy, young women)