Quiz 5 - Urogenital Flashcards Preview

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Flashcards in Quiz 5 - Urogenital Deck (39)
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1
Q

which enzyme is responsible for regulating blood pressure in the kidney?

A

renin

2
Q

which kidney is lower?

A

right

3
Q

which PMHx are common in the renal patient?

A

lupus
DM
hypertension

4
Q

what are associated ROS for renal dz?

A
general: fever, wt loss, fatigue
CV - dypnes, chest pain, edema
GI - anorexia, NV cramps
GU - polyuria, dysuria, hematuria
Skin - rash, puritis
5
Q

what does deep breathing suggest

A

metabolic acidosis

6
Q

what are red flag symptoms of urinary frequency

A

fever
back pain
lower extremity weakness

7
Q

what are red flag symptoms of dysuria?

A
fever
flank pain
recent instrumentation
immunocompromised
recurrence
8
Q

what is involuntary bed wetting after age 5

A

nocturnal enuresis

9
Q

what are the three types of urinary incontinence

A

inability to hold urine due to:

overflow
stress
urge

10
Q

what are the red flags of polyuria?

A
abrupt onset
night sweats
cough
weight loss
psychiatric disorder
11
Q

what is oliguria?

A

decreased urine output

12
Q

anuria is?

A

urine output

13
Q

microscopic hematuria should be investigated when

A

then presence of any RBCs >1

14
Q

when painless urination is seen - what should be considered?

A

tumors of bladder, kidney, prostate - until proven otherwise

15
Q

what are red flags in regards to hematuria?

A

gross hematuria
persistant microscopic in elderly
hypertension
edema

16
Q

what is the most common cause of renal colic and what are red flag symptoms?

A

most often caused by passage of renal calculi

red flags:
fever
oliguria
anuria

17
Q

what is commonly used for STI testing

A

NAAT PCR

18
Q

which bacterial UTI is common in kiddos?

A

kelbsiella enterobacter

19
Q

what host defenses reside in the uroepithelium and renal tubules?

A

tamm-horsfall glycoproteins

  • IgA local antibodies also exist in the uroepithelium
20
Q

in regards to urethritis, which organisms are responsible?

A

Gonococcal urethritis - 50% cases, yellow green d/c

NGU - non gonococcal urethritis - most are Chlamydia, whitish-mucoid d/c

  • urgency, frequency, tingling with urination
21
Q

what is a good ddx for recurrent UTI

A

bladder cancer
DM
prostate obstruction

22
Q

what is unique to cystitis?

A

NO FEVER

  • usually asx in kiddos and elderly
  • run a UA
23
Q

patient ptc with history of LUT infection, quickly have acquired chills, fever and tachycardia.. what condition is this and what is expected on lab work?

A

Acute Pyelonephritis

CBC - elevated WBC w left shift

UA - WBCs, pos LE, nitrites

** if protein is present on UA sign of nephron destruction

24
Q

what are glitter cells and what do they represent?

A

PMNs with cytoplasmic granules in state of Brownian motion

seen in acute pyelonephritis

25
Q

what is a common complication of acute pyelonephritis

A

renal abscess

26
Q

what is key in regards to chronic pyelonephritis

A

can take over 20 years to develop
usually asymptomatic

Decreased SG is seen sometimes on UA

Image with KUB (kidney ureter bladder X-ray)

27
Q

how is a definitive dx for glomerular disorder discovered?

A

renal biopsy

28
Q

what is the classic presentation of nephritic syndromes?

A
PHAROH
proteinuria
hematuria
azotemia
RBC casts
oliguria
HTN
29
Q

what is the most common cause of post-infectious glomerulonephritis?

A

group A beta hemolytic strep

  • coca cola colored urine.

if untreated could lead to nephrotic syndrome, acute kidney injury, htn encephalopathy

30
Q

what are the 3 rapidly progressive glomerulonephritis conditions and what concomitant symptoms distinguish them?

A

goodpasture’s syndrome - pulmonary hemorrhage

henoch-schonlein purpura - skin lesions

wegener’s granulomatosis (ANCA -assocaited)

31
Q

what is the most common cause of glomerulonephritis worldwide?

A

BERGER’S DZ

- IgA nephropathy,

32
Q

nephrotic syndromes present with?

A

severe proteinuria
- foamy urine

DDX with other illnesses that present with edema
CHF, liver failure, PN, malignant HTN

33
Q

what is the most common cause of nephrotic syndrome and ESRD (end stage renal disease) in the US? what is commonly seen on lab work?

A

diabetic nephropathy

microalbuminuria 30-300 mg/d which progresses to proteinuria

34
Q

what is a common sequelae of acute tubular necrosis (ATN)

A

acute renal failure

UA - proteinuria, hematuria, RTE and RTE casts

35
Q

what’s important about acute tubointerstitial nephritis

A

acute onset of dec renal function

UA reveals NO bacteria, eosinophiluria often present

36
Q

what are the 4 common causes of chronic tubulointerstitial nephritis

A

obstructive uropathy
reflux nephropathy
analgesic nephropathy (sloughed papillae in urine)
lead nephropathy

37
Q

fanconi syndrome presents with ___ in adults or ____ in kiddos

A

osteomalacia in adults

hypophosphatemic rickets in kiddos

polyuria and polydipsia make you think DM

38
Q

what is the classic triad of renal cell carcinoma?

A

gross hematuria
flank pain
palpable abd mass

39
Q

what should be suspected in patients presenting with unexplained hematuria?

A

BLADDER CANCER