Clinical Medcine
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| Acute Tubular Necrosis is cause by what drug? | Gentamycin, Aminogylcosides
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| Acute Nephritic Syndrome is assoc w/ what type of HTN? | Malignant HTN
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| Azotemia is? | AUCTE RENAL FAILURE. Increase in both Blood Creatine and BUN but still INncrease BUN:Creat. Blood flow is bypassing the Nephron and nothing is filtering through therefore all blood levels go up and urine output drops ie Na Urine drops.
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| Causes of Acute Renal Failure? | MC- Decr Volume d/t diuretics or Decr Flow d/t poor pump ie CHF. Obstruction
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| Hyaline Clast are indicative of? | Kidney Damage
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| MC cause of Nepthrotic Syndrome in Peds? | Minimal Change Disease.
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| Minimal Change Dz urine findings? | Proteinuria, Maltesecrosses
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| Tubular Renal Failure is caused by? | Caused by hypoperfusion to the kidney. MC Blood loss d/t Surgey, Shock, Trauma
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| Large Muddy Brown Casts hallmark of? | Acute Tubular Necrosis (pos. d/t gentamycin)
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| Acute Interstitial Nephritis is d/t ? | Drug Induced. MC Abx (bactrim, methicillin), NSAIDS
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| Proximal, Descending, Ascending, Distal Tubules, Collecting Duct absorbs/effected by? | Ascending- Gluc Na, Cl. Descending reabsorbs H20 (water falls down) to follow solute. Ascending Na Cl (remaining solutes follow water). Distal effected by Aldosterone. Collecting duct affected by ADH
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| earlist sign of chorinc kidney disease | Proteinuria
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| ACE-I work how on the kideny | dilates efferent arteriole and decrease GFR. Therefor in renal artery stenosis GFR is droped twice as much with an ACE-I (too much)
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| Gluc Level of what leads to glucosuria? | >180
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| Unilateral small kidney on u/s ->? | Renal artery stenosis- atrophy of one leads to hypertrophy of the other
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| Thiazide effect on Ca and K | reabsorbs Ca and Excretes K
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| How do you distinguish b/w Acute and Chronic Renal Failure? | In Chronic K rises as GFR Starts to decrease
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| MC and 2nd MC cause of Chronic Renal Failure? | 1st Diabetes, 2nd HTN
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| Glomerulonephritis classic u/a findings? | RBC Casts
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| Pathognomonic for Nephrotic Syndrome (MCD)? | Fat Oval Bodies
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| MC inherited disorder in humans? | Polycystic Kidney Disease
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| Cystitis 1st and 2nd line Therapy? Pregnancy? | 1st-Bactrim. 2nd Cipro. Prego-Nitrofurantoin
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| Renal Cell Cancer Shows what type of Anemia? | Normochromic/ Normocystic Anemia
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| Age line and Pathogen diff in urethritis/ prostatitis/epidiymitis and tx? | <35 yo Chlamydia and Gonorrhoeae (ceft and doxy). >35 yo E. Coli and Pseudomonas (cipro)
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| Orchitis is associated with what viral infection? | Mumps. MC unilateral orchitis presents
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| At what size will kidney stones need surgical help? | 5mm or greater (flomax 4 women maybe approp)
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| Risk Factor for Testicular Torsion? | Bell Clapper Deformity. inappropriately high attachment of the tunica vaginalis ->free rotation. 6hr window b4 salvage rate drops
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| Hyrdoceles occur how? Associated with ? | defect in the tinica vaginalis of the scrotom leads to collection of serous fluid. (Transluminates) Assoc w/ Hernias
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| Varicocele is assoc with what? | 40 % of infertile males
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| First second and third line drug for pain in kidney stones? | 1 Toradol. 2 Morphine sulfate. 3 Demerol
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| HTN and Generalized Weakness what condition should you consider? | Renal Artery Stenosis on an ACE-I
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| MC cause of nephrotic syndrome in adults? | DM
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| What blood findings are elev in dehydration and what are low? | K is high, Creatine is High, GFR is low
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| Urea Nitrogen (BUN) nml values? | BUN: 7 - 18 mg/dL;
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| BUN/Creatinine Ratio nml values? | BUN:Creatine 5 - 35
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| Creatine nml values? | 0.6 - 1.2 mg/dL
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| GFR nml values? | 120±25 mls/min
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| K diff in acute and chronic renal failure? | acute-Incr K, chronic-Decr K
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| Acute Tubular Necrosis is d/t what drug? | Gentamycin, Aminoglycosides
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| prostatic massage is contraindicated in? | acute bacterial prostatitis -> septecemia
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| Small echogenic kidneys bilaterally? | Chronic kidney failure. <10cm
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| Hyrdonephrosis MC pathology? | Stones blocking collecting ducts
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| What type of anemia is assoc c/ CHRONIC renal dz? | Anemia of CHRONIC dz
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| Chronic Renal Dz presents with what Ca and Phos Levels and acidosis or alkalosis? | hypocalcemia, hyperphosphatemia, and metabolic acidosis.
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| smoking and presents with painless hematuria? | Bladder Ca
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| When and how does IgA Nephropathy typically occur? | After an upper respiratory tract infection and presents with hematuria and proteinuria.
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| Restricted diet of what will decr incidence of Kidney Stones? | Sodium and Protein. Advise in pt w/ recurrent stones
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| Incr consumption of what will decrease Renal Stones? | Fluids, Bran
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| Coffen Lids on U/A and Staghorn calculus on KUB, Proteus patho in UTI? | Struvite Stone
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| Intervention for Struvite Stones? | Percutaneous Nephyrolithotomy
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| Laser Lithotripsy is indicated when? | Stones 5mm-3cm
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| What dietary changes need to occur with Uric Acid Stones? | Low Purine Diet (drop meats)
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| In Persistent Nocturia what drug will alleviates symptoms but is not currative? | Desmopressin (DDAVP, ADH)
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| Should Asymptomatic bacteriuria be treated in pregnancy ? | Yes. Nitrofurantoin. To prevent development of complications, such as premature labor, fetal morbidity, and premature mortality.
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| In Terminal hematuria, blood at the end of the urinary stream where anatomically is the source of the blood? | bladder neck or prostatic urethral source.
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| Presence of blood at the beginning of the urinary stream suggests what location of bleed? | an anterior (penile)urethral source.
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| Total hematuria, blood throughout the urinary stream, suggests what location of bleed? | a bladder or upper urinary tract source.
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| squamous epithelial cells on u/a indicates what? | contaminated specimen
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| solid renal mass, hematuria, flank pain. what is your dx? | Renal Ca. Radical Nephrectomy w/o radio or chemo if no sign of metastasis
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| When is Radiation therapy indicated in Renal Ca? | Never. It is not effective in the treatment of renal cell cancer and may lead to damage of the surrounding vital organs.
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| What is the pathology behind urge incontinence and in who is it seen the most? | Detrusor overactivity. Elderly
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| s/sx of urge incont and tx? | urge to urinate but leakage before making it to bathroom. Oxybutynin
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| What is the pathology behind stress incont? s/sx? tx? | Relaxed pelvic muscles. leakage upon coughing/sneezing ect. Kegel exercises. Estrogen cream is used when evidence of atrophic vag or urethra is assoc.
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| What should be given when a potassium level of 6.5-7 in the blood is reached? | IV Calcium gluconate. This stimulates K to enter the cells and be excreted out. Ca chases K out of the system. K also follow insulin and glucose.
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| What is given to correct HyperCalcemia? | Bisphosphonates ie Zometa, Zolendrenic Acid.
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| Ischemia ->Acute tubular necrosis and Drug Rxn are causes of pre, intrinsic, or post renal azotemia? | Intrinsic
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| Postrenal azotemia mc cause? | obstruction
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| PreRenal azotemia mc cause? | hypotension
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| + Phren's Sign ? | Epididimitis.
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| In pyelonephritis when can you switch from IV abx to PO abx? | 24 hrs after becoming afebrile
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| cola-colored urine, oliguria, and edema of the face and eyes in the morning. | Glomerulonephritis. can occur 1-3 wks post strep infection
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