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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
Ca correction?
(4/5) (4.0- albumin) + Ca
25
Types of met alk?
1. Cl sensitive - hypocloremic (urine Cl<20) and hypovolemic. Give saline. 2. Cl resistant - normal Cl. Normal volume. Saline ineffective.
27
Causes of Cl resistant metabolic alkalosis?
Bartter syndrome (defect in TAL Na resorption) Gitelman syndrome Black licorice
28
Renal vein thrombosis leading to pain and gross hematuria most commonly associated with what finding on kidney biopsy?
Membranous GN
29
GN post infection - possibilities? Distinguishing features?
1. IgA nephropathy - ~5 days after infection, normal complement levels. 2. Post-strep GN 10-20 days post infection. Low complement
30
Most common type of GN related to cancer? Exception?
Membranous. Hogkin's related to MCD
31
Pt with chronic renal failure - effect on bleeding time, PT, PTT? Cause? Tx?
increased, no change, no change due to platelet dysfunction from uremic coagulopathy. DDAVP
32
Immunosupressant side effects: cyclosporine vs tacrolimus vs azathioprine vs mycophenylate?
Neuro, Nephro, GI, HTN, gingival hyperplasia, hirstutism as above without gingival hyperplasia and hirstutism diarrhea, leukopenia, hepatotoxicity Marrow supression
33
Symptoms of allergic interstitial nephritis? Causes?
AKI, arthralgias, WBC casts with eosinophils rifampin, penicillian, cephalosporin, bactrim
34
Types of kidney stones: Normal pt? if has a family hx? If has cancer (high cell turnover)? with hx of UTIs?
Ca oxalate; cystene; uric acid; struvite
35
Acylovir - adverse effect on kidney?
renal tubular obstruction
36
tx for uric acid stone?
urine alkylization with potassium citrate
37
Epididymitis in younger vs older males?
Chamydia and gonorrhea vs E coli
38
UA shows: deformed RBCs and casts vs unchanged RBCs?
glomerular vs tubular injury
39
Management of nephrolithiasis?
1. Imaging scan – CT 2. Narcaotics and NSAIDs 3. If stone 2 L per day 4. Consult Uro if anuria, urosepsis or ARF
40
Dietary recommendations for patients with renal calculi?
1. Decrease protein abd oxalate intake 2. Decrease sodium intake 3. Increased fluid intake 4. Increase calcium intake
41
Management of a patient with suspected pyelonephritis?
Blood cultures followed by IV antibiotics
42
Patient with acute prostatitis – Next step?
Culture mid-stream urine sample
43
Cause of renal artery stenosis in lung vs old?
Fibromuscular dysplasa vs artgeromatous plaque
44
Acute interstitial nephritis vs acute renal failure - UA findings? Antibiotics that cause each?
Eosinophils and WBC casts vs epithelial cell casts Aminoglycosides vs penicillins
45
Analgesic abuse - effect on kidneys?
FSGS
46
HIV - effect on kidneys?
FSGS
47
Causes of priapism?
1. Children - Sickle cell and leukemia 2. Trauma 3. Neurogenic (SC injury and cauda equina) 4. Meds - trazadone and prazosin
48
Possibilities if radiograph doesn't show a stone in a pt with a typical renal colic? (and Tx)
1. If urine pH< 3 mm (HCT) | 3. Non-stone causes (clots)
49
First change in diabetic nephropathy? First quantifiable change?
Hyperfiltration; basement membrane thickening
50
Indications for cystoscopy?
``` #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
Membranous Nephropathy Associated with?
``` #Adenocarcinoma #NSAIDS #Hep B #SLE ```
52
Membranoproliferative GN associated with?
``` #Hep C #lipodystrophy ```
53
Minimal Change Disorder associated with?
``` #NSAIDS #Lymphoma ```
54
IgA Nephropathy associated with?
URI
55
Pt with Ca Oxalate stones - recommendations?
``` #increase fluids #Increase Ca intake #decrease Na and oxalate (no chocolate, vit C) #Decrease protein intake ```
56
Meds that cause hyperK?
``` ABCD #ACE inhibitors #Beta blockers #Cardiac glycosides (Digoxin) #[K-sparing] Diuretics (amiloride, spirolactone) #NSAIDS ```

Medicine (106 decks)

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