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UWorld - GU Flashcards

0
Q

Patient with nephrotic syndrome has an increased risk of developing?

A

Stroke or MI because they are hypercoagulable

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1
Q

Patient on dialysis most likely to die from?

A

Cardiovascular disease >Infection >dialysis withdrawal

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2
Q

Complicated cystitis versus uncomplicated?

A

Very young, very old, diabetic, immunocompromised, pregnant, abnormal anatomy

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3
Q

When are you worried about contrast induced nephropathy? Consider using?

A

Diabetes or baseline creatinine >1.5.

Consider using non-ionic contrast

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4
Q

FSGS associated with?

A

African-American, HIV heroin use, obesity

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5
Q

Patient history of rheumatoid arthritis presents with proteinuria. Likely kidney pathology?

A

Amyloidosis

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6
Q

Treatment of Goodpasture’s?

A

Emergency plasmapheresis

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7
Q

Think of rhabdomyolysis with this lab finding?

A

CPK > 20,000

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8
Q

Lab findings suggest ATN?

A
  1. Urine osmolality < 350
  2. Urine sodium > 40
  3. FEna> 2%
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9
Q

Side effects of EPO?

A
  1. HTN
  2. Headaches
  3. Flu-like
  4. RBC aplasia
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10
Q

Crystalloid vs colloid solutions?

A

Saline vs albumin

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11
Q

Signs of RCC?

A

Triad: hematuria, flank pain, palpable abdominal mass

Also can see: scrotal varicocele, ectopic EPO

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12
Q

Pt with C3 deposition in kidneys? Mech?

A

Membranoproliferative GN type II (IgG antibodies aka C3 nephritic factor against C3 convertase)

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13
Q

Causes of euvolemic hypoNa?

A

SIADH, hypothyroid, hypoadrenal, psychogenic polydipsia

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14
Q

Drug that causes ADH resistance?

Drug that sensitized kidneys to ADH?

A

Li

Carbamazepine

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15
Q

Tx of psychogenic polydipsia?

A

Water restriction

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16
Q

ways to correct hyperK? (Quickest first)

A
  1. Ca
  2. Glucose + insulin (15-20 min)
  3. Kayexalate takes 1-2 hours
  4. Beta-2 agonists
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17
Q

Hypophosphatemia can cause?

A

Rhabdo, paresthesias, respiratory failure

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18
Q

Possible cause of difficult to correct hypoK?

A

HypoMg

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19
Q

Smoke inhalation can cause what acid-base disorder?

A

Met acidosis: CO binds to heme, decreased O2 to tissues, lactic acidosis

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20
Q

Met alk - formula to assess compensation?

A

PaCO2 = .9*bicarb +16 +/-2

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21
Q

Vomiting - mech of alk?

A

Volume loss triggers RAAS

Na/H antiporter activated

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22
Q

Tx of euvolemic hyperNa vs hypovolemic hyperNa?

A

D5W vs NS then D5W

23
Q

Adrenal tumor causing virilization releases?

A

DHEA-S (-S variant only comes from adrenal gland)

24
Q

Ca correction?

A

(4/5) (4.0- albumin) + Ca

25
Q

Types of met alk?

A
  1. Cl sensitive - hypocloremic (urine Cl<20) and hypovolemic. Give saline.
  2. Cl resistant - normal Cl. Normal volume. Saline ineffective.
27
Q

Causes of Cl resistant metabolic alkalosis?

A

Bartter syndrome (defect in TAL Na resorption)
Gitelman syndrome
Black licorice

28
Q

Renal vein thrombosis leading to pain and gross hematuria most commonly associated with what finding on kidney biopsy?

A

Membranous GN

29
Q

GN post infection - possibilities? Distinguishing features?

A
  1. IgA nephropathy - ~5 days after infection, normal complement levels.
  2. Post-strep GN 10-20 days post infection. Low complement
30
Q

Most common type of GN related to cancer? Exception?

A

Membranous. Hogkin’s related to MCD

31
Q

Pt with chronic renal failure - effect on bleeding time, PT, PTT? Cause? Tx?

A

increased, no change, no change

due to platelet dysfunction from uremic coagulopathy.

DDAVP

32
Q

Immunosupressant side effects: cyclosporine vs tacrolimus vs azathioprine vs mycophenylate?

A

Neuro, Nephro, GI, HTN, gingival hyperplasia, hirstutism

as above without gingival hyperplasia and hirstutism

diarrhea, leukopenia, hepatotoxicity

Marrow supression

33
Q

Symptoms of allergic interstitial nephritis? Causes?

A

AKI, arthralgias, WBC casts with eosinophils

rifampin, penicillian, cephalosporin, bactrim

34
Q

Types of kidney stones:

Normal pt? if has a family hx? If has cancer (high cell turnover)? with hx of UTIs?

A

Ca oxalate; cystene; uric acid; struvite

35
Q

Acylovir - adverse effect on kidney?

A

renal tubular obstruction

36
Q

tx for uric acid stone?

A

urine alkylization with potassium citrate

37
Q

Epididymitis in younger vs older males?

A

Chamydia and gonorrhea

vs

E coli

38
Q

UA shows: deformed RBCs and casts vs unchanged RBCs?

A

glomerular vs tubular injury

39
Q

Management of nephrolithiasis?

A
  1. Imaging scan – CT
  2. Narcaotics and NSAIDs
  3. If stone 2 L per day
  4. Consult Uro if anuria, urosepsis or ARF
40
Q

Dietary recommendations for patients with renal calculi?

A
  1. Decrease protein abd oxalate intake
  2. Decrease sodium intake
  3. Increased fluid intake
  4. Increase calcium intake
41
Q

Management of a patient with suspected pyelonephritis?

A

Blood cultures followed by IV antibiotics

42
Q

Patient with acute prostatitis – Next step?

A

Culture mid-stream urine sample

43
Q

Cause of renal artery stenosis in lung vs old?

A

Fibromuscular dysplasa vs artgeromatous plaque

44
Q

Acute interstitial nephritis vs acute renal failure - UA findings? Antibiotics that cause each?

A

Eosinophils and WBC casts vs epithelial cell casts

Aminoglycosides vs penicillins

45
Q

Analgesic abuse - effect on kidneys?

46
Q

HIV - effect on kidneys?

47
Q

Causes of priapism?

A
  1. Children - Sickle cell and leukemia
  2. Trauma
  3. Neurogenic (SC injury and cauda equina)
  4. Meds - trazadone and prazosin
48
Q

Possibilities if radiograph doesn’t show a stone in a pt with a typical renal colic? (and Tx)

A
  1. If urine pH< 3 mm (HCT)

3. Non-stone causes (clots)

49
Q

First change in diabetic nephropathy? First quantifiable change?

A

Hyperfiltration; basement membrane thickening

50
Q

Indications for cystoscopy?

A 
#Hematuria without signs of infection of glomerular disease, or with risk of malignancy
#Recurrent UTIs
#Obstructive symptoms (signs of bladder stone)
#abnormal bladder imagine of urine cytology
51
Q

Membranous Nephropathy Associated with?

A 
#Adenocarcinoma
#NSAIDS
#Hep B
#SLE
52
Q

Membranoproliferative GN associated with?

A 
#Hep C
#lipodystrophy
53
Q

Minimal Change Disorder associated with?

A 
#NSAIDS
#Lymphoma
54
Q

IgA Nephropathy associated with?

55
Q

Pt with Ca Oxalate stones - recommendations?

A 
#increase fluids
#Increase Ca intake
#decrease Na and oxalate (no chocolate, vit C)
#Decrease protein intake
56
Q

Meds that cause hyperK?

A 
ABCD
#ACE inhibitors
#Beta blockers
#Cardiac glycosides (Digoxin)
#[K-sparing] Diuretics (amiloride, spirolactone)
#NSAIDS

Medicine (106 decks)

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