Term
| rapidly deteriorating glomerular filtration rate with the accumulation nitrogenous wastes (urea and creatinine) referred to as azotemia |
|
Definition
|
|
Term
| hypotension is indicative of what kind of ARF? |
|
Definition
|
|
Term
| S&S of post renal failure |
|
Definition
| distended bladder, CVA tenderness, enlarged prostate |
|
|
Term
| kidney smaller than what indicates chronic problems? |
|
Definition
|
|
Term
| decreased BUN/Cr (< 15:1) indicates what? |
|
Definition
|
|
Term
| pre renal causes of renal failure (5) |
|
Definition
hypovolemia
hypotension
ineffective circulating volume
aortic aneurysm
renal artery stenosis or embolic disease |
|
|
Term
| intrinsic causes of renal failure (5) |
|
Definition
acute tubular necrosis
nephrotoxins (NSAID, aminoglycosides, radiologic contrast)
interstitial diseases (acute interstitial nephritis, SLE, infection)
glomerulonephritis
vascular diseases (polyarteritis nodosa, vasculitis) |
|
|
Term
| causes of post renal failure (2) |
|
Definition
tubular obstruction
obstructive uropathy (urolithiasis, BPH, bladder outlet obstruction) |
|
|
Term
| when should short term dialysis be initiated in ARF? |
|
Definition
serum creatinine > 5-10 mg/dL
other indications include:
unresponsive acidosis
electrolyte disorders
fluid overload
uremic complications |
|
|
Term
| how is chronic kidney disease classified? |
|
Definition
| 5 stages based on estimated GFR |
|
|
Term
| what are the 5 stages of kidney disease? |
|
Definition
1 = kidney damage with normal GFR (>90)
2 = kidney damage with minor decrease in GFR (60-89)
3 = moderate decrease in GFR (30-59)
4 = severe decrease (15-29)
5 = kidney failure GFR < 15 |
|
|
Term
| MCCs of chronic renal failure (4) |
|
Definition
DM
HTN
glomerulonephritis (GN)
polycystic kidney disease (PKD) |
|
|
Term
| gold standard for dx of CKD? |
|
Definition
|
|
Term
| what is the marker for kidney disease? |
|
Definition
|
|
Term
| what medications help to slow the progression of renal dysfunction, particularly in proteinuric patients |
|
Definition
|
|
Term
| tea or cola colored urine, edema of the face and eyes present in the morning |
|
Definition
|
|
Term
|
Definition
|
|
Term
exretion of > 3.5g of protein in 24 hrs.
S&S = hypoalbuminemia, lipiduria, hypercholesterolemia, and edema |
|
Definition
|
|
Term
| nephrotic syndrome can predispose the pt to |
|
Definition
| thrombosis due to loss of proteins S and C and antithrombin III |
|
|
Term
| ascites, edema, HTN, othrostatic hypotension, retinal sheen, skin striae, proteinuria, lipiduria, glycosuria, hematuria, foamy urine |
|
Definition
|
|
Term
| microscopic UA reveals oval fat body |
|
Definition
|
|
Term
|
Definition
ACEI
judicious use of diuretics
decrease sodium and fluid intake |
|
|
Term
| more aggressive form of PKD |
|
Definition
|
|
Term
| other than the kidneys where can cysts be found in PKD? |
|
Definition
| liver, pancreas, and other locations |
|
|
Term
| diagnostic method of choice for PKD? |
|
Definition
|
|
Term
|
Definition
|
|
Term
| what renal stone is radiopaque? |
|
Definition
CCS
calcium, cystine, struvite |
|
|
Term
| imaging modality of choice for nephrolithiasis |
|
Definition
|
|
Term
| stones what size pass spontaneously? |
|
Definition
|
|
Term
| tx for stones measuring 5-10mm |
|
Definition
less likely to pass on their own, increased fluids and analgesics are necessary.
elective lithotripsy can be performed |
|
|
Term
| tx for stones measuring > 10mm |
|
Definition
tx inpatient if the pt is unable to maintain adequate oral intake.
if renal function is jeopordized, gold standard = percutaneous nephrostomy |
|
|
Term
| lithotripsy should be used for stones of what size? |
|
Definition
renal stones < 2cm
ureteral stones < 1cm |
|
|
Term
| percutaneous nephrolithotomy can be used when? |
|
Definition
|
|
Term
|
Definition
|
|
Term
| review electrolyte disorders |
|
Definition
|
|
Term
| review acid base disorders |
|
Definition
|
|
Term
| decreased pH, increased PCO2, increased HCO3 |
|
Definition
|
|
Term
| increased pH, decrased PCO2, decreased HCO3 |
|
Definition
|
|
Term
| decreased pH, decreased CO2, decreased HCO3 |
|
Definition
|
|
Term
| increased pH, increased CO2, increased HCO3 |
|
Definition
|
|
Term
|
Definition
Na - (HCO3 + Cl)
normal = 8 -12 |
|
|
Term
| pneumonic for elevated anion gap acidosis |
|
Definition
|
|
Term
|
Definition
| PCO2 = (1.5 x HCO3) + 8 +/-2 |
|
|
Term
|
Definition
|
|
Term
| pyuria, bacteriuria, and varying degree of hematuria |
|
Definition
|
|
Term
|
Definition
| flouroquinalone or bactrim |
|
|
Term
| fever, flank pain, shaking chills, and irritative voiding sxs |
|
Definition
|
|
Term
|
Definition
outpt = quinalone or bactrim
inpt = IV quinalone or ampicillin + gentamycin |
|
|
Term
T/F
follow up urine cultures are mandatory with pyelonephritis |
|
Definition
|
|
Term
|
Definition
|
|
Term
| sudden onset high fever, chills, and low back and perineal pain, irritative bladder symptoms |
|
Definition
|
|
Term
| what are irritative bladder sxs? |
|
Definition
| frequency, urgency, dysuria |
|
|
Term
| difference in tx of acute and chronic protatitis? |
|
Definition
| chronic is treated for up to 3 months |
|
|
Term
| testicular swelling and tenderness, usually unilateral, fever, and tachycardia. U/A = pyruia and bacteriuria |
|
Definition
|
|
Term
|
Definition
| if caused by bacteria tx like epididymitis |
|
|
Term
|
Definition
|
|
Term
| MCC of epididymitis < 35 or > 35 |
|
Definition
< 35 = chlamydia and gonorrhea
> 35 = E. Coli |
|
|
Term
| heaviness and dull aching, discomfort in the affected hemiscrotum which can radiate up the ipsilateral flank |
|
Definition
|
|
Term
| relief of pain with scrotal elevation |
|
Definition
Prehn's sign
classic sign of epididymitis |
|
|
Term
| what system is used to asses BPH? |
|
Definition
| American Urological Association (AUA) |
|
|
Term
| what are the scores on the AUA associated with sx wise? |
|
Definition
0-7 = mild
8-19 = moderate
20-35 = severe |
|
|
Term
|
Definition
mild - moderate = watch and wait
medical therapy = alpha adrenergic agonists and 5a-reductase inhibitors |
|
|
Term
| results from bladder contractions that cannot be controlled by the brain |
|
Definition
|
|
Term
| caused by dysfunction of the urethral sphincter, allowing urine to leak wih increased intra-abdominal presssure |
|
Definition
|
|
Term
| occurs when urinary retention leads to bladder distention and overflow of urine through the urethra |
|
Definition
|
|
Term
| untimely urination caused by physical or cognitive disability, preventing a person from reaching a toilet |
|
Definition
|
|
Term
| combination of elements from both stress and urge incontinence |
|
Definition
|
|
Term
| principle sx of urge incontinence |
|
Definition
| strong desire to void followed by loss of urine |
|
|
Term
| principle sx of stress incontinence |
|
Definition
| leakage of urine with increased intra-abomdinal pressure (coughing, laughing, sneezing) |
|
|
Term
| untreated overflow incontinence can lead to |
|
Definition
| hydronephrosis and obstructive nephropahty |
|
|
Term
| what is used to measure urinary retention? |
|
Definition
|
|
Term
|
Definition
| tolterodine and oxybutynin |
|
|
Term
| tx of overflow incontinence |
|
Definition
|
|
Term
| most effective tx for stress incontinence |
|
Definition
|
|
Term
|
Definition
| anticholinergic meds such as oxybutynin |
|
|
Term
| histologic grading of prostate cancer is via |
|
Definition
| Gleason scale with a higher score indicating worse prognosis |
|
|
Term
| tx of stage A and B prostate cancer |
|
Definition
| radical retropubic prostatectomy, brachytherapy, or external beam radiation |
|
|
Term
| tx of stage D prostate cancer |
|
Definition
| tx with hormonal maniupulation and palliative therapy |
|
|
Term
| MC presenting sx of bladder cancer |
|
Definition
|
|
Term
| MC type of renal malignancy |
|
Definition
|
|
Term
| often called the "internists tumor" |
|
Definition
|
|
Term
| RCC is associated with paraneoplastic syndromes including (4) |
|
Definition
erythrocytosis
hypercalcemia
hypertension
hepatic dysfunction in the absence of hepatic mets |
|
|
Term
| grading scale for renal cell carcinoma |
|
Definition
|
|
Term
| MC solid renal tumor in childhood |
|
Definition
| Wilm's tumor (nephroblastoma) |
|
|
Term
asx abdominal mass found by a family member or during a physical in a child.
Anorexia, N/V, fever, abdominal pain, hematuria, HTN |
|
Definition
|
|
Term
| initial study of choice for nephroblastoma |
|
Definition
|
|
Term
| MC malignancy in young men |
|
Definition
|
|
Term
| painless, solid testicular swelling with a heaviness. |
|
Definition
|
|
Term
| inabilty to retract foreskin over the glans penis |
|
Definition
|
|
Term
| entrapment of the foreskin behind the glans penis |
|
Definition
|
|
Term
|
Definition
manual reduction
inability to reduce = emergeny urology consult
pt should be circumcised to prevent recurrence |
|
|
Term
| consistant inability to maintain an erect penis wiht sufficient rigidity to allow sexual intercourse. |
|
Definition
|
|
Term
| normal erections require intact |
|
Definition
| parasympathetic and somatic nerve supply, unobstructed arterial flow, adequate venous constriction, hormonal stimulation, psychological desire |
|
|
Term
| what can be used to differentiate between organic and psychogenic impotence? |
|
Definition
| nocturnal tumescence testing |
|
|
Term
|
Definition
| behviorally oriented sex therapy |
|
|
Term
| PDE-5 inhibitors are contraindicated with what? |
|
Definition
|
|
Term
| mass of the fluid filled remnants of the tunica vaginalis usually resutling from a patent processus vaginalis |
|
Definition
|
|
Term
| which testicular masses transilluminate? |
|
Definition
|
|
Term
| should you needle aspirate a hydrocele? |
|
Definition
|
|
Term
| testis is abnormally twisted on it's spermatic cord thus compromising arterial supply and venous drainage of the testis leading to testicular ischemia. Loss of cremesteric reflex |
|
Definition
|
|
Term
| formation of venous varicosity within the spermatic vein (pampiniform plexus) |
|
Definition
varicocele
increases in size with valsalva
decreases in size with elevation of the scrotum or supine position |
|
|
Term
|
Definition
|
|
