Term
| If a pt has irritative symptoms (burning, dysuria, frequency), a __ should be ordered. |
|
Definition
|
|
Term
| Dipstick UA hematuria must be followed up with __. |
|
Definition
|
|
Term
| Symptoms of glomerularnephritis: |
|
Definition
- Fever
- Rash
- Lymphadenopathy
- Abdominal/Pelvic mass |
|
|
Term
| Proteinuria is excessive protein in urine, generally greater than ___. |
|
Definition
|
|
Term
| Greater than 1 gram protein/day in urine suggests a __ origin. |
|
Definition
|
|
Term
| Greater than __ grams of protein/day in urine is entering the __ __. |
|
Definition
- 3.5 g protein/day
- nephrotic |
|
|
Term
|
Definition
| 30-150 mg protein in urine/day |
|
|
Term
|
Definition
|
|
Term
| Tubular proteinuria is caused by faulty reabsorption of normally filtered proteins in the __ ___ such as __ __ and ___ __ ___. Causes of this include: |
|
Definition
- proximal tubule
- Beta 2 microglobulins
- immunoglobulin light chains
- acute tubular necrosis
- lead/aminoglycoside injury
- interstitial nephritis
- Wilson's disease
- Fanconi disease |
|
|
Term
| DM may result in __ proteinuria. |
|
Definition
|
|
Term
| Dipstick UA detects __ and __ __ but NOT __ __ __ of ___. |
|
Definition
- albumin
- intact globulins
- NOT positive light chains of immunoglobulins |
|
|
Term
| For patients with undetermined causes of hematuria, what should be done for follow up? |
|
Definition
- Repeat UA and cytology every 6 months
- Repeat Cystoscopy every year |
|
|
Term
| Best to estimate GFR based on __ __, not __ __ b/c this tends to overestimate it. |
|
Definition
- Serum Creatinine
- Creatinine Clearance tends to overestimate it |
|
|
Term
| Any proteinuria on dipstick of 1+ or more, the ___ to __ ratio should be done. |
|
Definition
|
|
Term
| proteinuria screening should be done __ in at risk patients (DM, HTN, etc.). |
|
Definition
|
|
Term
| Hematuria ddx for ages 0-20 y/o: |
|
Definition
- UTI
- Acute Glomerularnephritis
- Congenital
- Trauma |
|
|
Term
| Ages 20-40 ddx for hematuria: |
|
Definition
- UTI
- Trauma
- Stones
- Cancer |
|
|
Term
| Age 40-60 ddx for hematuria: |
|
Definition
|
|
Term
| Greater than 60 ddx for hematuria: |
|
Definition
- UTI
- Cancer
- Vaginal
- Stones |
|
|
Term
| Greater than 60 male, ddx for hematuria: |
|
Definition
- UTI
- BPH
- Cancer
- Stones
- Trauma |
|
|
Term
| Causes of renal cell cancer: |
|
Definition
- Genetics (von Hippel-Lindau)
- Smoking (dose-dependent)
- HTN
- Obesity
- Solvent exposure
- Heavy metal exposure |
|
|
Term
| Types of Renal Cell Cancer tumors from most common to least common: |
|
Definition
- Clear cell (65%)
- Papillary (7-14%)
- Chromophil/phobe (6-11%) |
|
|
Term
| At presentation, __% of pts with renal cell carcinoma are at stage 3 or 4. |
|
Definition
|
|
Term
| Tmt for stage 1 and 2 renal cell carcinoma: |
|
Definition
- Radical nephrectomy
- More conservative excision if tumor less than 4 cm |
|
|
Term
| Tmt for stages 3 and 4 renal cell carcinoma: |
|
Definition
- Resection- cell volume reduction
- Chemo/radiation
- Immunomodulators
- Multikinase inhibitors |
|
|
Term
| 4th MC cancer in men, 9th MC cancer in women: |
|
Definition
|
|
Term
| __% of bladder cancer is associated with environmental exposures. |
|
Definition
|
|
Term
| Risks for Bladder Cancer: |
|
Definition
- Smoking
- Hydrocarbon exposure/solvents: cleaners, industrial manufacturing, dye industry, painters, hairdressers |
|
|
Term
| Types of bladder cancer urothelial tumors from most common to least common: |
|
Definition
- Transitional Cell (90%)
- Squamou Cell (3%)
- Adenocarcinoma (2%) |
|
|
Term
| Locations for bladder cancer from most common to least common: |
|
Definition
- Bladder (90%)
- Renal Pelvis (8%)
- Ureters/Urethra (2%) |
|
|
Term
|
Definition
- Painless gross hematuria
- Irritative symptoms
- Lower abdominal discomfort
- Rectal fullness
- Pain (worrisome) |
|
|
Term
| Bladder cancer superficial disease treatment: |
|
Definition
- Endoscopic resection
- Intravesicular chemo: Bacillus Calmette- Guerin (BCG) |
|
|
Term
| Bladder cancer muscle invasive disease (T2 or greater) treatment? |
|
Definition
- radical cystectomy and pelvic lymphadenectomy
- chemo |
|
|
Term
| Metastatic bladder cancer tmt: |
|
Definition
- radical cystectomy and pelvic lymphadenectomy
- chemo |
|
|
Term
| Where does prostate cancer occur? |
|
Definition
| Peripheral zone (the area you are palpating on DRE) |
|
|
Term
|
Definition
|
|
Term
|
Definition
- decreased force and caliber
- intermittent stream
- urinary hesitancy |
|
|
Term
|
Definition
- frequency
- urgnecy
- nocturia |
|
|
Term
| ACS DRE screening guidelines for the average male: |
|
Definition
| - starting at age 50 in men who are expected to live 10 years or more |
|
|
Term
| ACS DRE screening guidelines for those at high risk for prostate cancer (African Americans and men with one close relative with prostate cancer): |
|
Definition
| - starting at 45 years old |
|
|
Term
| ACS DRE screening guidlines for men with multiple close relatives with prostate cancer: |
|
Definition
|
|
Term
| Most common non-cutaneous cancer in men: |
|
Definition
|
|
Term
| What race is at increased risk for prostate cancer: |
|
Definition
|
|
Term
| Gleason Score is used to stage, grade, and determine aggressiveness of tmt for __ __. |
|
Definition
|
|
Term
| Race at risk for testicular cancer: |
|
Definition
|
|
Term
| Age group most commonly affected by testicular cancer: |
|
Definition
|
|
Term
| 95% of testicular tumors are __ __ __. |
|
Definition
|
|
Term
|
Definition
- Shorter urethra (females)
- Foreskin (uncircumscribed)
- Sexual activity
- Postmenopausal changes
- Foreign substances (diaphragm, spermicide, catheter)
- Pregnancy
- Hospitalization
- Medical conditions: DM, BPH, Neurogenic bladder
- Functional abnormalities: Vesicoureteral Reflux |
|
|
Term
| Medical conditions that increase risk for UTI: |
|
Definition
- DM
- BPH
- Neurogenic bladder
- Vesicoureteral reflux |
|
|
Term
| What type of bacteria with a UTI cause you to consider a struvite stone in your dx? |
|
Definition
- Staph
- Klebsiella
- Proteus
- Pseudomonas |
|
|
Term
| 3 most commonly used antibiotics for UTI: |
|
Definition
- TMP-SMX (Bactrim)
- Fluoroquinolones
- Nitrofuantoin |
|
|
Term
| Antibiotic used to treat psuedomonas UTI: |
|
Definition
| Aminoglycosides (Gentamycin, Streptomycin, Neomycin) |
|
|
Term
| Antibiotics used for UTIs in pregnant women and peds: |
|
Definition
- Penicillins
- Cephalosporins |
|
|
Term
|
Definition
| Phenazopyridine aka Peridium aka Azo Standard |
|
|
Term
| Recurrent UTI definition: |
|
Definition
| - 3 or more episodes in one year after successful treatment |
|
|
Term
| Management of Recurrent UTIs: |
|
Definition
- Antibiotics
- Suppressive Therapy: either 12 month course of abx, post-intercourse prophylaxis, or patient initiated therapy |
|
|
Term
| What type of casts occur with pyelonephritis? |
|
Definition
|
|
Term
| In patient pyelonephritis tmt: |
|
Definition
| IV PCN and Aminoglycoside |
|
|
Term
| Out patient Pyelonephritis tmt: |
|
Definition
| Fluoroquinolones (7-14 days) |
|
|
Term
| Indications for radiologic exam with pyelonephritis: |
|
Definition
Potential ureteral obstruction
e.g. stone, ureteral stricture, tumor
History of calculi, especially infectious (struvite) stones
Concern about papillary necrosis
e.g. pt with sickle cell, analgesic abuse
History of GU surgery that predisposes to obstruction
e.g. ureteral reimplantation or ureteral diversion
Poor response to appropriate antimicrobial after 5 to 6 days of treatment
Diabetes mellitus, Polycystic kidneys, Renal insufficency
Neuropathic bladder
Unusual infecting organisms
(e.g. TB, fungus, or urea-splitting organisms (i.e. Proteus))
These would cause you to order CT. |
|
|
Term
| In patient prostatitis tmt: |
|
Definition
| - IV PCN and Aminoglycoside |
|
|
Term
| Outpatient Prostatitis tmt: |
|
Definition
Fluroquinolones (14-28 days)
(7-14 days for pyelonephritits, 14-28 days for prostatitis) |
|
|
Term
| Tmt of chronic prostatitis: |
|
Definition
- TMP/SMX or Fluoroquinolones for 4-6 weeks
- NSAIDs
- Sitz bath |
|
|
Term
| With non-bacterial prostatitis there is __ but no __ and cultures are __. |
|
Definition
- pyuria
- no bacteriuria
- negative |
|
|
Term
| nonbacterial prostatisis presesnts like __ __ |
|
Definition
|
|
Term
| Management of non-bacterial prostatitis: |
|
Definition
- Empiric antibiotics for 2 weeks, continue for 8 weeks if improving (TMP-SMX or Fluoroquinolones)
- NSAIDs
- Alpha blockers
- Sitz bath
SCREEN FOR PROSTATE CANCER |
|
|
Term
| With ____ there will by pyuria, but with ___ there will NOT be pyuria. |
|
Definition
- Non-bacterial Prostatitis- pyuria
- Prostatodynia- NO pyuria |
|
|
Term
| Prostatodynia and Non-bacterial prostatiis both present like __ __, how can you tell them apart? |
|
Definition
chronic prostatitis
non-bacterial there will be pyruia, prostatodynia no pyuria |
|
|
Term
|
Definition
- Alpha blockers for spasma
- Diazepam for pelvic floor dysfunction
- Sitz bath
(symptom focused treatment) |
|
|
Term
| With non-bacterial prostatitis the UA is __ and the culture is __. With prostatodynia the UA is __ and the culture is __. |
|
Definition
| Non-bacterial prostatitis, UA is positvie and culture is negative. With prostatodynia, the UA and culture are both negative. |
|
|
Term
| Tmt for gonococcal urethriis: |
|
Definition
|
|
Term
| Tmt for non-GC urehtritis: |
|
Definition
| 1 gram Azithromycin + 100 mg Doxy bid x 7days |
|
|
Term
|
Definition
|
|
Term
| Risk factors for acute epididymitis: |
|
Definition
- sex
- strenuous physical activity
- prolonged sitting
- uro surgery
- obstructive uropathy |
|
|
Term
| Acute epididymitis is often associated with ___. |
|
Definition
|
|
Term
| If suspecting epididymitis in a young male, __ __ should always also be on ddx. |
|
Definition
|
|
Term
| If suspecting epididymitis in a young male, __ __ should always also be on ddx. |
|
Definition
|
|
Term
| (-)Prehn's sign, absent cremasteric reflex: |
|
Definition
|
|
Term
| (+)Prehn's Sign, + Cremasteric reflex: |
|
Definition
|
|
Term
| Tmt of acute epididymitis: |
|
Definition
- Fluorquinolone x 14 days
- NSAIDs
- Scrotal support |
|
|
Term
| Clinical syndrome of daytime and nightime increased urinary fequency, urgency, and pelvic pain. |
|
Definition
INTERSTITIAL CYSTITIS
- MC in Caucasion females
- Cystoscopy shows submucosal hemorrhages and ulcers |
|
|
Term
| UA and culture findings with Interstitial Cystitis: |
|
Definition
- UA usually normal but may show hematuria/pyuria
- culture is negative |
|
|
Term
| pregnant women with pyelonephritis should be : |
|
Definition
|
|
