Witwer GUT Flashcards
Normal adrenal glands shape?
Note the normal Inverted Y or lambda shape of the Adrenal Gland
This disease releases large amts of catecholamines and causes these symptoms:
headaches, hypertension, tachycardia and diaphoresis (sweating)
Pheochromocytoma
60 YO MALE WITH HYPERTENSION AND HYPOKALEMIA should make you suspicious for what condition?
Conn Tumor causing primary hyperaldosteronism
These are symptoms of what?
fatigue, high blood pressure, and hypokalemia.
Conn Tumor causing primary hyperaldosteronism
Primary adrenal carcinoma is rare, but metastases to the adrenal gland are common, from common tumors, ie ______, ______, ______, ______
melanoma, lung, colon, breast.
In the peds population, two causes of VUR are?
1) Immature short ureteral tunnel which usually resolves with age,
2) Congenital anomaly at the Ureterovesical junction
What is the imaging for VUR?
VCUG or radionuclide cystogram
A lesion above the brainstem causes what?
- Involuntary bladder contractions
- Spincter relaxation
- Urge incontinence and a sudden, strong urge to urinate
A complete lesion of the spinal cord above T12 vertebral body causes what?
- Detrusor hyperreflexia and spastic external spincter (basically involuntary detrusor contractions)
- residual urine and reduced bladder capacity
A lesion to the spinal micturition reflex causes what?
- Loss of a sense of fullness
- Weak and unsustained contractions
- incomplete bladder emptying with large amts of residual urine
Treatment for hyperreflexive bladder
- Alpha blockers
- TURP
- botox
Treatment for areflexive bladder
- behavior mod to facilitate complete emptying
- Crede (push on bladder and lean forward when peeing)
- TURP
What to avoid in neurogenic bladder?
Try to avoid chronic indwelling catheters, infection.
what are the three main hold up places for a stone in the renal/ureter?
the ureteropelvic junction (UPJ), the ureterovesical junction (UVJ), and the crossover of the common iliac arteries.
Symptoms are severe pain in the back, flank, groin, or labia or scrotum.
Kidney stone
Imaging choice for kidney stone?
Non contrast spiral CT is the test of choice to evaluate for stone
Swelling of one or both kidneys. Kidney swelling happens when urine can’t drain from a kidney and builds up in the kidney as a result. This can occur from a blockage in the tubes that drain urine from the kidneys (ureters) or from an anatomical defect that doesn’t allow urine to drain properly.
Hydronephrosis
What can cause renal papillary necrosis?
Occurs with analgesic abuse (acetaminophen), pyelonephritis (infection of the kidney and pelvis), renal ischemia, diabetes mellitus, Sickle disease.
What are the two forms of nephrocalcinosis? Describe them
Cortical-acute cortical necrosis, posioning, prolonged hypercalcemia
Medullary- hyperparathyroidis
What can cause nephrocalcinosis?
Too much serum calcium
A congenital condition with dilated renal tubules. Usually asymptomatic but predisposes to infection and stone formation.
Medullary sponge kidney
Autosomal dominant condition with multiple cysts causing massive non-functioning kidneys. Seen with cysts in liver and pancreas. Renal failure usually occurs later in life, 40 to 50s. Relatively common.
Adult polycystic kidney disease
Rare finding, lower poles (bottom) of the kidneys are fused across the abdominal midline. Found incidentally but may have obstructions or stones as this patient has.
Horseshoe Kidney.
Treatment for atherosclerotic renal artery stenosis?
meds initially then balloon angioplasty
