UW3 (11 Nephro) Flashcards
Posterior Urethral Valve
• Symptoms? 3
• US finding?
• Additional study? 2
- Bladder distension
- Weak urine stream
- Recurrent UTI
- L+R Hydronephrosis
- Bladder = thick & dilated
- Proximal urethra dilation
- Voiding CystoUrethrogram
- Cystoscopy
Bacturia / Cystitis @ pregnancy
- Treatment? 4
- Medications to avoid?
1) Amoxicillin / Augmentin
2) Nitrofurantoin (avoid at term / hemolytic anemia)
3) Cephalexin
4) Fosfomycin
5) No FQ or Bactrim
Renal Colic @ pregnancy
- Initial diagnostic? 2
- Management? 3
- US kidney
- US TV
- Observation
- Empiric treatment
- MR/CT urogram
Renal Cell Carcinoma
- Risk factors? 3
- Lab?
- Management?
- Smoking
- Obesity
- Hypertension
• Erythrocytoma (erythropoietin ↑)
- CT abdomen
- Nephrostomy (thick irregular enhanced septa
Asymptomatic
Ca < 12, PTH n↑, UCa ↓
Diagnosis?
Familial HypoCalciuric HyperCalcemia
Electrolyte abnormality
- DTR ↑
- Muscle cramp
- Convulsion
- DTR ↓
- Paralysis
- Nausea
- Vomit
- Asystole
- Weakness
- Rhabdomyo
- CPK ↑
- Ca ↓
- Mg ↑
- K ↑
- PO4 ↓
Kidney Stone (management)
1) Stable < 5mm
2) Stable < 10mm
3) Stable > 10mm
4) Unstable / Persistent pain / AKI / Sepsis
5) Size > 10 + Uncontrolled pain + No passage within 4-6w
1) Spontaneous
2) IVF + Pain med
Alpha blocker / CCB
No admission
3) Lithotripsy
Urethral stent
4) Nephrostomy
Urethral stent
5) Urology consult
Na ↓ @ CHF (management) 2
1) Water restriction
2) Tolvaptan
Post Strep GlomeruloNephritis
- UA result?
- Lab result?
- UA: RBC & WBC cast
* Complement ↓
SLE Nephritis
- UA result?
- Lab test?
- What to do before treatment?
- UA = RBC / Cast
- ProteinUria > 500 mg/d
- Cr ↑ / dsDNA Ab ↑ / Complement ↓
- Biopsy before treatment
RenoVascular Disease
- Indications?
- Diagnostic?
- HTN uncontrolled 3+ meds
- BP > 180/120 + Age > 55y
- Diffuse Atherosclerosis
- Recurrent flash pulmonary edema
- Abdominal bruit
- Cr ↑ > 30% after ACE-I/ARB
• US»_space; CTA/MRI
Patient had recent URTI, now has hematuria and flank pain. Suspecting IgA Nephropathy.
Poor prognosis indication? 2
- Hypertension
* U-protein > 1g/24h
Renal cell carcinoma
Type of surgery for:
- Confined within capsule
- Beyond capsule / Within Gerota’s fascia
- Partial nephrectomy
* Radical nephrectomy
Analgesic Nephropathy
UA results?
• RBC / Protein / WBC / WBC cast
Cyoglobulinemia
- Sympptoms? 2
- Risk? 3
- Lab results? 2
- UA finding? 3
- Palpable purpura
- Peripheral neuropathy
- Hep C / IVDU
- AutoImmune
- Infection
- RF ↑
- Complement ↓
- RBC cast
- WBC cast
- ProteinUria
- Dysuria
- Post void dribble
- Dyspareunia
- Hematuria
- Recurrent UTI
Anterior vaginal mass
• Tender
• Bloody
• Purulent
Diagnosis?
Female Urethral Diverticulum
- UA + UC
- MRI / US-TV
Most common proteinuria @ adolescent
- Diagnosis?
- Test & results?
• Orthostatic ProteinUria
Split 24h urine protein
• Day protein = ↑
• Night protein = n
Iron deficiency anemia @ ESRD
- Management?
- Goat?
- Iron study before treatment
- Fe IV @ Transferrin < 30% / Ferritin < 500
- Erythropoietin @ ESRD + Hb < 10
- Hb↑ 1.5-2 /1m
- Hb 10-11.5
UTI in children
- Diagnostic test indication? 3
- Diagnostic tests? 2
- Age < 24m
- Fever
- 1st UTI
• US kidney & bladder / VCUG
HepatoRenal
- Cause?
- Why do US?
- Why do paracentesis?
- Treatment? 4
- Renal perfusion ↓
- r/o urinary obstruction
- SBP if WBC > 250
1) IVF
2) Octreotide
3) Midodrine
4) Norepinephrine
Bladder cancer
- Risk? 6
- Diagnosis? 3
- Hematuria
- Age > 40
- Male
- Smoker
- Pelvic irradiation
- Aniline dye
1) UA
2) Cystostoscopy
3) US / UT urogem / MRI
Renal transplant complication? Why is this important?
3 causes?
DM2 – mortality ↑
- Steroid use - Insulin sensitivity ↓
- Calcineurin inhibitor - Insulin secretion ↓
- Renal function ↑ - Insulin excretion ↑ & gluconeogenesis ↑
PCKD-AD
- Symptoms? 5
- Management? 4
- HTN
- Hematuria
- Proteinuria
- L+R flank pain/fullness
- Renal insufficiency
1) Counseling US screen
2) ACE-I / Statin
3) Dialysis
4) Kidney transplant
HypoNatremia @ SIADH
- Lab results? 4
- Management? 5
- Na ↓
- Sosm < 275
- Uosm > 100
- U-Na > 40
1) Fluid restriction
2) Salt
3) Loop diuretics
4) Demeclocycline > Lithium
5) 3% NS
Recurrent UTI
Prophylaxis indication? 2
- UTI > 2 / 6m
* UTI > 3 / 1y
HyperThyrodism induced HypoNatremia
Treatment?
- No treatment
* Continue thyroid med
HypoNatremia (evaluation)
1) Sosm > 290 = Gluc ↑/ Kidney failure
2) Uosm < 100 = 1° Polydipsia / Malnutrition
3) U-Na < 25 = Volume ↓ / CHF / Cirrhosis
4) U-Na > 25 = SIADH / Adrenal insufficiency / HypoThyroidism
Urinary retention
SupraPubic cath indication? 3
- Trauma
- Surgery
- Failed Foley cath
