Urology/Renal Flashcards
Hesitation, dribbling, straining, nocturnal urination, incomplete emptying
BPH
Ascending infxn - gram neg rods
UA: pyuria
Swollen, tender prostate
Bacterial prostatitis
Bacterial prostatitis tx
Abx (culture 1 wk after abx)
Why avoid vigorous prostate exam for bacterial prostatitis?
Can cause sepsis
Causes of resp acidosis? (acute vs. chronic)
Chronic: COPD
Acute: narcotics, benzos, alcohol, barbiturates
Causes of resp alkalosis?
Anxiety, PE, salicylates, cirrhosis/ascites
Metabolic compensation is (fast/slow)
Respiratory compensation is (fast/slow)
Metabolic compensation: slow
Respiratory compensation: fast
Causes of WAGMA
MUDPILES
Causes of WAGMA: \+ Blindness? \+ Kidney problems? \+ Calcium oxalate crystals? \+ Hearing prob/tinnitus?
Methanol: blindness
Uremia: kidney problems
Ethylene glycol: calcium oxalate crystals
Salicylate OD in elderly: hearing prob/tinnitus
How to calculate anion gap
AG = Na - (bicarb + Cl)
Causes of NAGMA
Diarrhea
Renal tubular acidosis
Peaked T waves, long PR
Hyperkalemia
Hyperkalemia tx
C BIG K Drop A (lot)
- Calcium
- Bicarb
- Isulin
- Glucose
- Kayexalate
- Diuretics
- Albuterol
Causes of ARF (pre, renal, post)
Pre: NSAID, hypoTN, ACEI/ARB
Renal: GN, ATN
Post: obstructive
Stages of CKD (GFR)
1: GFR >90
2: 60-90
3: 30-60
4: 15-30
5: <15
CKD stages 1-4 tx
ACEI, diuretic, BP control, glycemic control
Indications for dialysis
AEIOU
- Acidosis
- Electrolytes
- Intoxication
- Overload
- Uremia
Hematuria, RBC casts, azotemia, cola urine, HTN, some proteinuria
Nephritic syndrome
Nephritic syndrome tx
Fluid restriction
May need diuretics, dialysis, steroids
Hematuria following URI
IgA nephropathy
Lungs and kidneys (nephritic syndrome)
Goodpasture’s
Proteinuria (>3.5 g), HLD, edema, HTN, azotemia
Nephrotic syndrome
Nephrotic syndrome tx
ACEI, diuretics, fluid restriction, statin, steroids
Nephrotic syndrome
Enlarged glomeruli, thickened capillaries
Membranous nephropathy
Nephrotic syndrome
Sclerosis in some glomeruli, others appear normal
HIV, heroin
Focal segmental glomerulosclerosis
Nephrotic syndrome
Normal biopsy appearance
Kids
Minimal change dz
Patchy, irregular interstitial infiltration with inflam cells
ATN
Irritative sx: freq, urgency, dysuria
UTI
UTI 1st line tx
Bactrim
Signs of UTI on UA
+ nitrites
+ leukocytes
+ bacteria
Unilateral colicky flank pain
Nephrolithiasis
Kidney stone tx
What size is likely to pass spontaneously?
<5 mm: likely to pass
>5 mm: less likely - lithotripsy, ureteroscopy, nephrostomy
Triple struvite (Mg, ammonium, phosphate)
Proteus
Increased urine pH (ammonia)
Staghorn calculi
Palpable nodular kidney
Causes kidney failure
Polycystic kidney dz
Causes of unilateral vs. bilateral hydronephrosis
Bilateral: BPH
Unilateral: ureter obstruction
ED tx
PDE-5 inhibitor (sildenafil, tadalafil)
Swollen testicle
Transilluminates
Hydrocele
Bag of worms
Does not transilluminate
Varicocele
Which side is varicocele more likely? Why?
Usually on left, testicular joins renal vein at right angle
Absent cremaster reflex
Blue dot sign
Testicular torsion
Positive Prehn sign
Epididymitis
Epididymitis causes in young vs. old
Young: chlamydia, gonorrhea
Older: e. coli
Painless hematuria
Bladder cancer
Triad: hematuria + flank pain + palpable mass (only seen in 10%)
Renal cell carcinoma
Uncontrolled HTN + pulm edema + worsening renal fxn
Renal artery stenosis
Resting tachy + orthostatic hypoTN
Hypovolemia (dehydration)
