Urology/Renal Flashcards
Inflammation of the foreskin and head of the penis
pain, redness, and a foul-smelling discharge from under the foreskin
Balanitis
Balanitis Tx
topical antifungals BID x 1-3 weeks (clotramazole 1%, miconazole 2%)
Drugs to avoid in BPH…
anticholinergics and antihistamines
BPH Tx to decrease prostate size…
finasteride (5 alpha reductase inhibitors)
discharge from the penis or vagina, painful or more frequent urination, cervicitis, PID, lymphogranuloma venereum, or infertility
Chlamydia
Chlamydia Dx?
NAAT
Tx of chlamydia?
azithromycin 1 g PO + ceftriaxone 250 mg IM x 1
or
doxycycline BID x 7 days + IM ceftriaxone
UTI Tx in pregnancy
macrobid 100 mg PO BID x 7 days
OR
Keflex 500 mg BID x 7 days
dysuria, unilateral dull aching scrotal pain that can radiate up the ipsilateral flank
(+) Prehn’s sign
epididymitis
Dx of epididymitis…
UA
Tx of epididymitis over 35…
supportive care + levaquin 500mg QD x 10 days
Tx of epididymitis UNDER 35…
doxycycline 100 mg PO BID x 10 d
PLUS
ceftriaxone 250mg IM x 1 dose
edema + HTN + hematuria + RBC Casts/dysmorphic RBCs + proteinuria 1-3.5 g/day + azotemia
Nephritic Syndrome
Severe proteinuria > 3.5 g/day
Massive edema
Fatty casts with “maltese cross” sign
Hypoalbuminemia, hyperlipidemia, and lipiduria
Oval fat bodies
Nephrotic Syndrome
MC cause of acute glomerulonephritis…
IgA Nephropathy
What type of nephritic glomerulonephritis?
Young males
Hx of URI/GI Infx 24-48 hours ago
IgA nephropathy
What type of nephritic glomerulonephritis?
10-14 days after infection - diagnosed with ASO titers and low serum complement - treatment is supportive + antibiotics
Post-strep
What type of nephritic glomerulonephritis?
due to SLE, viral hepatitis
membranoproliferative
What type of nephritic glomerulonephritis?
(+) anti-GBM antibodies, dx linear IgG deposits
goodpasture’s syndrome
Tx for goodpastures syndrome
high dose steroids
plasmapheresis
cyclophosphamide
What type of nephritic glomerulonephritis?
lack of immune deposits (+) ANCA antibodies
vasculitis
(+) C ANCA
Granulomatosis with polyangiitis / Wegener’s
(+) P ANCA + nephritic sxs
microscopic polyangitis
urinary excretion of > 3 g of protein in a 24-hour urine sample due to a glomerular disorder plus edema and hypoalbuminemia…
Nephrotic syndrome
MC nephrotic syndrome in non-diabetic adults, a/w malignancy…
Membranous nephropathy (immune complex formation in glomerulus)
What cause of nephrotic syndrome?
most common cause in kids.
child with sudden onset idiopathic nephrotic syndrome 2 weeks after illness, improves after treatment with corticosteroids.
minimal change disease
What cause of nephrotic syndrome?
obese patients, heroin, and HIV+ black males.
focal segmental glomerulosclerosis
Most common secondary causes of glomerulonephritis? (3)
Lupus
DM (nephrotic)
Pre-eclampsia
Dysuria, urinary frequency, and purulent yellow-green discharge
post-coital bleeding at cervical os
Gonorrhea
Dx of gonorrhea
NAAT of first voided urine
Gram negative diplococci on urine Cx
gonorrhea
Tx of gonorrhea…
250 mg IM Ceftriaxone + 1g oral azithromycin
Passage of intestine through the external inguinal ring at Hesselbach triangle, rarely enters the scrotum
direct inguinal hernia
Passage of intestine through the internal inguinal ring down the inguinal canal, may pass into the scrotum
indirect inquinal hernia (MC)
Gold standard for nephrolithiasis…
Non-contrast CT
Stones < ___mmm have an 80% chanace of spontaneous passage…
5mm
Tx for kidney stones 5-10mm
elective lithotripsy
Tx for kidney stones > 10mm
nephrostomy (gold standard) or ureteral stent
Unilateral swollen testicle/tenderness with erythema and shininess of the overlying skin, fever/tachycardia
Orchitis
What is orchitis usually seen in presentation with?
epididymitis
If no epididymitis, but orchitis, what is often the etiology?
mumps
Sudden onset of fever, chills, and low back pain combined with urinary frequency, urgency, and dysuria
Tender prostate on DRE
Prostatitis
If prostatitis is suspected, what can happen if prostate is massaged?
sepsis
Tx of prostatitis in men < 35 yo
GC tx
Tx of prostatitis in men > 35 yo
FLQ or Bactrim x 6 weeks
Outpatient Tx of Pyelonephritis
cipro/levaquin or bactrim x 1-2 weeks
Inpatient tx of pyelonephritis
IV FLQ, 3/4th gen ceph, extended spectrum PCN
firm, painless, non-tender testicular mass and a feeling of heaviness in the scrotum
testicular CA
MC type of testicular CA?
Seminoma
Tumor markers for testicular CA?
AFP, b HCG
painful, burning, or frequent urination or a discharge from the urethra
Positive leukocyte esterase on urine dipstick or having ≥ 10 WBC/HP
Urethritis (G/C)
