Term
| What are the four general ways that renal blood flow is regulated? |
|
Definition
| Autoregulation (juxtaglomerular apparatus), Neural (sympathetic nervous system, baroreceptors), RAAS (increases BP), ANP (inhibits renin) |
|
|
Term
| What do RBC casts suggest? |
|
Definition
|
|
Term
| What do WBC casts suggest? |
|
Definition
|
|
Term
| What do hyaline casts suggest? |
|
Definition
|
|
Term
|
Definition
|
|
Term
| How are serum creatinine and GFR related? |
|
Definition
|
|
Term
| What does a BUN/Cr ration of >20:1 suggest? |
|
Definition
| Prerenal disease (problems with blood flow) |
|
|
Term
| What does a BUN/Cr ration of 10-20:1 suggest? |
|
Definition
| Normal or postrenal problems |
|
|
Term
| What does a BUN/Cr ratio of <10:1 suggest? |
|
Definition
|
|
Term
| What is the gold standard test for nephrolithiasis? |
|
Definition
|
|
Term
| What test should be performed to evaluate abnormal tissues/masses (malignancy)? |
|
Definition
|
|
Term
| What in general does an IVP look for (when should it be used)? |
|
Definition
| Inject contrast IV and watch it as it travels through urinary system; used to look for obstruction (rarely used) |
|
|
Term
| What in general does a VCUG look for/when should it be used? |
|
Definition
| Inject contrast into bladder and watch for reflux |
|
|
Term
| What is a contraindication for VCUG? |
|
Definition
|
|
Term
| What is the gold standard for urine sample collection? |
|
Definition
|
|
Term
| When you run a urine dipstick what does positive "blood" mean? |
|
Definition
| RBC, hemoglobin, myoglobin |
|
|
Term
| What should normally not be found in urine? |
|
Definition
| Hemoglobin, nitrites, WBC's, RBC's, Glucose, Ketones, Protein, Bilirubin |
|
|
Term
| Most likely cause of hematuria in a patient <40 years old |
|
Definition
|
|
Term
| Most likely cause of hematuria in patient >40 years old |
|
Definition
|
|
Term
| Gross hematuria is usually (pre-renal, intra-renal, post-renal) in origin |
|
Definition
|
|
Term
| If after centrifuging the urine sample the sediment is red, what does this mean? |
|
Definition
|
|
Term
| If after centrifuging the urine the supernatant is red and the dipstick for "blood" is negative what does this mean? |
|
Definition
|
|
Term
| If after centrifuging the urine the supernatant is red and the dipstick for "blood" is positive and the plasma color is clear what does this mean? |
|
Definition
|
|
Term
| If after centrifuging the urine the supernatant is red and the dipstick for "blood" is positive and the plasma color is red what does this mean? |
|
Definition
|
|
Term
| What is the RBC requirement for hematuria? |
|
Definition
|
|
Term
| What does RBC's and proteinuria indicate? |
|
Definition
|
|
Term
| What are the main characteristics of glomerular hematuria? |
|
Definition
| Dysmorphic RBC's, RBC casts, brown/cola-colored |
|
|
Term
| Are extraglomerular hematuria RBC's (ureters, prostate, urethra) normal or dysmorphic? |
|
Definition
|
|
Term
| What are the differences in the color of extraglomerular and glomerular urine samples if they are macroscopic? |
|
Definition
| Extraglomerular is red/pink and glomerular is red/smoky brown/cola-colored |
|
|
Term
| Are clots possibly present in extraglomerular or glomerular hematuria? |
|
Definition
|
|
Term
| What does the proteinuria look like in extraglomerular vs. glomerular hematuria? |
|
Definition
Extraglomerular: <500
Glomerular: >500 |
|
|
Term
| What is the RBC morphology in extraglomerular versus glomerular hematuria? |
|
Definition
| Extraglomerular RBC's usually look normal, glomerular RBC's are dysmorphic |
|
|
Term
| Are RBC casts present in extraglomerular or glomerular hematuria? |
|
Definition
|
|
Term
| What are three risk factors for bladder cancer? |
|
Definition
| Smoking, male, occupation |
|
|
Term
| Whis is the most common type of bladder cancer? |
|
Definition
| Transitional cell carcinoma |
|
|
Term
| What is the gold standard for diagnosis of bladder cancer? |
|
Definition
|
|
Term
| What is the treatment for renal cell carcinoma? |
|
Definition
| Nephrectomy (usually refractory to chemotherapy) |
|
|
Term
| What are risk factors for renal cell carcinoma? |
|
Definition
| Smoking, obesity, tuberous sclerosis, genetics (vonHippel-Lindau syndrome) |
|
|
Term
| Triad of symptoms for renal cell carcinoma |
|
Definition
| Hematuria, abdominal/flank pain, abdominal mass |
|
|
Term
| Most important tool for diagnosing renal cell carcinoma? |
|
Definition
|
|
Term
| Most common renal malignancy in children |
|
Definition
|
|
Term
| Risk factors for Wilms tumor |
|
Definition
| WT1 gene, congenital syndromes |
|
|
Term
| Classic presentation of Wilms tumor |
|
Definition
| Abdominal mass or swelling without other symptoms |
|
|
Term
| What should you not do to a Wilms tumor |
|
Definition
|
|
Term
| What is the diagnostic test of choice for Wilms tumor? |
|
Definition
|
|
Term
| What are the two different staging methods for Wilms tumor? |
|
Definition
| National Wilms Tumor Study Group (NWTS) and International society of pediatric oncology (SIOP) |
|
|
Term
| What is the general treatment for Wilms Tumor? |
|
Definition
|
|
Term
| What is the most common cancer in American men? |
|
Definition
|
|
Term
| Who should begin screening at age 40-45 for prostate cancer? |
|
Definition
| Black males, positive family history, BRCA gene |
|
|
Term
| When should men without risk factors begin screening for prostate cancer? |
|
Definition
|
|
Term
| What can cause an elevated PSA? |
|
Definition
| BPH, prostatitis, prostate biopsy, ejactulation, prostate cancer |
|
|
Term
| What is the normal range for PSA? |
|
Definition
|
|
Term
| What are three other forms of PSA testing? |
|
Definition
| PSA velocity, Free PSA, PSA density |
|
|
Term
| What should you do if DRE/PSA/physical exam findings are consistent with prostate cancer? |
|
Definition
| Transrectal ultrasound guided prostate biopsy |
|
|
Term
| What is the mainstay of treatment for local prostate cancer? |
|
Definition
|
|
Term
| What drug therapies are available for prostate cancer? |
|
Definition
| Androgen deprivation therapy (ADT), gonadotropin releasing hormone agonist |
|
|
Term
| What are the two histological types of testicular cancer? |
|
Definition
|
|
Term
| What is the most common type of testicular cancer? |
|
Definition
|
|
Term
| What is the main risk factor for testicular cancer? |
|
Definition
|
|
Term
| What is the main presentation of testicular cancer? |
|
Definition
| Painless testicular mass (discomfort, swelling, heavy sensation) |
|
|
Term
| What is the main diagnostic tool for testicular cancer? |
|
Definition
|
|
Term
| What is the main treatment for testicular cancer? |
|
Definition
| Orchiectomy (also radiation for nodes) |
|
|
Term
| What are three bladder defenses? |
|
Definition
| Emptying, mucus, urine pH/osmolarity |
|
|
Term
| What are the three classic symptoms of UTI? |
|
Definition
| Frequency, urgency, dysuria |
|
|
Term
| What population is more likely to have asymptomatic UTI? |
|
Definition
|
|
Term
| What is the most common symptom of UTI in the elderly? |
|
Definition
|
|
Term
| What symptoms are males more likely to present with for UTI? |
|
Definition
|
|
Term
| What is a likely presentation for a child with a UTI? |
|
Definition
|
|
Term
| What is a complicated UTI? |
|
Definition
| Abnormal anatomy, function or pre-existing condition |
|
|
Term
| What is the gold standard for UTI diagnosis? |
|
Definition
| 10^6 colonies of a single species on urine culture |
|
|
Term
| What are signs of a UTI on UA? |
|
Definition
| Positive nitrites, leukocyte esterase, pyuria, bacteriuria |
|
|
Term
| When should you get a urine culture? |
|
Definition
| Old/young, pregnancy, DM, immunosuppression, urinary tract abnormality, gross hematuria, symptoms > 3 days, fevers, chills, flank pain, recurrent/unresolved Sxs after treatment, treatment within 2 weeks, nosocomial infection, catheter, history of childhood infections |
|
|
Term
| What symptom commonly accompanies UTI in children? |
|
Definition
|
|
Term
|
Definition
| Males; Females with relapsing infections, childhood infections, painless hematuria |
|
|
Term
| Treatment for isolated UTI |
|
Definition
| Antibiotics, analgesics, fluids, optional to repeat UA |
|
|
Term
| Treatment for recurrent UTI |
|
Definition
| Antibiotics, investigate cause, pre and post treatment UC |
|
|
Term
| Treatment for UTI with catheter |
|
Definition
| Replace it, treat only if symptomatic |
|
|
Term
| Treatment for persistent UTI |
|
Definition
| Review contraception, investigate atrophy, pre and post treatment UC |
|
|
Term
| What is pathognomonic for pyelonephritis? |
|
Definition
|
|
Term
| If you have UTI or pyelo and kidney stones what are the most likely pathogens? |
|
Definition
|
|
Term
| Who should be treated inpatient for pyelonephritis? |
|
Definition
| Pregnancy, extremes of age, acute distress/sepsis, persistent vomiting/pain, comorbidities, lack of improvement |
|
|
Term
| When should you repeat the UC for pyelo? |
|
Definition
| 1, 4 and possible 12 weeks |
|
|
Term
| What are the key features of chronic pyelo |
|
Definition
| Irregular renal outline, reduction in renal size, clubbed (dilated) calyces |
|
|
Term
| Serous, fluid filled sac surrounding a testicle that results in swelling |
|
Definition
|
|
Term
| Where does a hydrocele occur? |
|
Definition
|
|
Term
| What are the two types of hydrocele? |
|
Definition
| Communicating and non-communicating |
|
|
Term
| What is commonly associated with communicating hydrocele? |
|
Definition
|
|
Term
| What is diagnosis of hydrocele? |
|
Definition
| Transillumination, cremasteric reflex intact |
|
|
Term
| What is the treatment for hydrocele |
|
Definition
| Observation, surgery if symptomatic |
|
|
Term
| Cystic swelling or diverticulum of epididymis |
|
Definition
|
|
Term
| Diagnosis of spermatocele |
|
Definition
| Transilluminate, cremasteric reflex intact, can be separated from testes |
|
|
Term
| Treatment for spermatocele |
|
Definition
| Observation, surgery if symptomatic |
|
|
Term
| Are hydroceles and spermatoceles associated with infertility? |
|
Definition
|
|
Term
| Abnormal dilation of pampiniform plexus |
|
Definition
|
|
Term
|
Definition
|
|
Term
| Which side is more likely to be affected with varicocele? |
|
Definition
|
|
Term
| What is the treatment for varicocele? |
|
Definition
|
|
Term
| Can a varicocele affect fertility? |
|
Definition
|
|
Term
| Inflammation of epididymis |
|
Definition
|
|
Term
| What population is most likely to be affected by epididymitis? |
|
Definition
| Sexually active young males |
|
|
Term
| What are the most likely pathogens for epididymitis? |
|
Definition
<35: gonorrhea, chlamydia
>35: enterobacteriaceae, pseudomonas |
|
|
Term
| What should you look for if epididymitis doesn't resolve with treatment? |
|
Definition
|
|
Term
| Diagnosis of epididymitis |
|
Definition
| Acute pain with palpation, Prehn sign positive, positive gram stain of urethral secretions |
|
|
Term
| In what coniditon is the Prehn sign positive? |
|
Definition
|
|
Term
| What is the treatment for epididymitis |
|
Definition
| Doxycycline/tetracycline possibly plus ceftriaxone (for gonorrhea) |
|
|
Term
| Acute inflammation of testes |
|
Definition
|
|
Term
|
Definition
|
|
Term
| What is the treatment for orchitis? |
|
Definition
| Antibiotics, supportive (may be associated with infertility) |
|
|
Term
| At what age should you treat cryptorchidism? |
|
Definition
|
|
Term
| Absent cremasteric reflex and negative Prehn sign |
|
Definition
|
|
Term
| Treatment for testicular torsion |
|
Definition
| Manual detorsion, orichidoplexy |
|
|
Term
| Pain over upper pole of testes, blue appearing lesion over upper pole of testis |
|
Definition
|
|
Term
|
Definition
|
|
Term
| Two labs for testicular cancer |
|
Definition
| Alpha-feto protein (AFP), Beta-human chorionic gonadotropin (B-hCG) and both point to nonseminoma |
|
|
Term
| Recovery of bacteria from prostatic fluid, purulence of fluid, systemic signs and symptoms |
|
Definition
| Acute Bacterial Prostatis |
|
|
Term
| Recovery of bacteria from prostatic fluid, no systemic signs |
|
Definition
| Chronic Bacterial Prostatis |
|
|
Term
| No bacteria in prostatic fluid, purulence, possible urgency/dysuria/discomfort |
|
Definition
| Nonbacterial prostatis or prostadynia |
|
|
Term
| Treatment for Acute bacterial prostatis |
|
Definition
Antibiotics for 4 weeks
Doxycycline and possibly ceftriaxone for <35
Cipro or TMP/SMX for >35 |
|
|
Term
| Treatment for chronic bacterial prostatis |
|
Definition
Antibiotics for 6-12 weeks (possible alpha-blocker)
Cipro or TMP/SMX |
|
|
Term
| Treatment for nonbacterial prostatis or prostadynia |
|
Definition
|
|
Term
|
Definition
5a-reductase inhibitors (finasteride, dutasteride)
Alpha blockers (terazosin)
Saw palmetto |
|
|
Term
| When should you start DRE and when should you start PSA? |
|
Definition
|
|
Term
| What is the most common type of prostate cancer? |
|
Definition
|
|
Term
| What are the two types of urethritis? |
|
Definition
| Gonococcal and non-gonococcal |
|
|
Term
| What are the possible causes of non-gonococcal urethritis? |
|
Definition
| Chlamydia, trichamonas, mycoplasma, adenovirus, HSV, caffeine, spermatocides, lotions, soaps, condoms |
|
|
Term
| urethral discharge or dysuria and urethral inflammation documented by mucopurulent discharge or leukocytes on gram stain |
|
Definition
| non-gonococcal urethritis |
|
|
Term
| What is a risk factor for pathogen negative non-gonococcal urethritis? |
|
Definition
|
|
Term
|
Definition
| Azithromycin or doxy (possibly metronidazole if those fail) |
|
|
Term
| Inflammation of glans penis |
|
Definition
|
|
Term
| Often occurs in conjuntion with posthitis |
|
Definition
|
|
Term
| Poor hygiene, Smegma, sloughed cells |
|
Definition
|
|
Term
|
Definition
| candida, poor hygiene, skin diseases |
|
|
Term
| Foreskin is too to retract |
|
Definition
|
|
Term
| Foreskin is too tight to get back (tourniquet) |
|
Definition
|
|
Term
| Risk factors for penile cancer? |
|
Definition
| HPV, smoking, treatment of penile lesions |
|
|
Term
| Most common type of penile cancer? |
|
Definition
|
|
Term
| Often present with leukoplakia |
|
Definition
|
|
Term
|
Definition
| DM, atherosclerosis, drugs |
|
|
Term
| Causes of vasculogenic ED |
|
Definition
| Decreased parasympathetic tone, aging, hypoxia, hyperlipidemia |
|
|
Term
|
Definition
| Spinal cord lesions (lower are worse), MS, DM, alcholic |
|
|
Term
| Causes of endocrinologic ED |
|
Definition
| Low testosterone, high prolactin |
|
|
Term
|
Definition
|
|
Term
| First line therapy for ED |
|
Definition
| phosphodiesterase 5 inhibitors (PDE5 inhibitors) |
|
|
