Pc Mod 2

Front 1

AKI stages -names

Back 1

Initiating phase, oliguric phase, diuretic phase, recovery phase

Front 2

Initiating stage (AKI 1)

Back 2

kidney injured, urine volume down, anorexia, lethargy, nausea, HA, muscle cramps, fatigue

Front 3

Oliguric phase (AKI 2)

Back 3

Renal repair begins as tubular cells regenerate; nephrons become obstructed with inflammatory products; decrease in GFR, tubular transport of substances, urine formation, and renal clearance; the longer this stage persists, the poorer the prognosis

5-15 days

Front 4

Diuretic phase

Back 4

BUN falls, urine output >400mL/day

Front 5

Recovery stage (4th stage)

Back 5

Extends from the time BUN is stable and urine output normal to the day the patient returns to normal activity (can take 10 months)

Can progress to chronic renal failure

Front 6

Bladder cancer risk factors

Back 6

smoking, presence of renal tumors, exposure to aromatic amine dyes, arsenic, chronic use of phenacetin-containing analgesics, chronic lower UTI, recurrent nephrolithiasis

Front 7

Bladder cancer symptoms

Back 7

Frequently asymptomatic until hematuria episode

dysuria, frequency, chills, low grade fever, weight loss, urinary urgency, pelvic pain

Front 8

Bladder tumor objective findings:

Back 8

palpable mass or metastatic manifestations

urinalysis: trace to gross hematuria, abnormalities in protein levels, RBC or WBC

Front 9

Bladder cancer gold standard test

Back 9

spiral CT scan

cystoscopy

Front 10

Bladder cancer referral

Back 10

Urologist or surgical oncologist for eval and tx

Front 11

BPH meds

Back 11

Alpha blockers relax smooth muscle of bladder and prostate (Doxazosin, Terazosin)

5alpha reductase inhibitors (Finasteride, Dutasteride)-reduce Prostate size and PSA (50% of total)

Anticholinergics

5PDE inhibitors-block testosterone conversion (Viagra)

Front 12

BPH symptoms

Back 12

urinary frequency, urgency, urge incontinence, nocturia, weak stream, incomplete bladder emptying, post void dribbling, straining to get urine out, possible dysuria

Front 13

BPH objective findings

Back 13

DRE: nodular and unusually firm: prostate ca

Smooth and enlarged: BPH

Gross hematuria, weak stream, distended bladder, increased post residual volume, prostate enlargement (should be walnut sized)

Front 14

Normal PSA levels

Back 14

Age PSA level

40-49 2.0-3.0

50-59 3.0-4.0

60-69 4.0-5.0

>70 6.0

Front 15

Chronic kidney disease symptoms

Back 15

Symptoms do not appear until renal fxn 10-15% f normal

Early signs: anorexia, lassitude, fatiguability, weakness

Pruritis and dry skin, anorexia, hiccuping, n/v, neurological complaints, urine odor to breath and perspiration, a metallic taste to mouth

Front 16

CKD risk factors

Back 16

HTN, DM

Analgesic use, collagen vascular disease, AIDS-related nephropathies, cirrhosis, multiple myeloma, polycystic kidney disease and Alport syndrome (hereditary renal disease)

Front 17

Medications used to halt progression of CKD

Back 17

ACE and ARBS

Front 18

Dysuria

Back 18

Pain or burning on urination

Frequency, urgency, hesitation

Differentials:

A/W bladder problems

Less associated with renal disease

Bladder tumors, CRF, nephrolithiasis, disease of upper urinary system

STI-vaginitis, prostatitis

vaginal discharge or irritation?

Front 19

Epididymitis symptoms

Back 19

Inflammation of epididymis

irritative voiding symptoms, penile/urethral discharge, scrotal swelling, painful and enlarged epididymis, fever

Front 20

Treatment for epididymitis

Back 20

Bedrest, ice packs and scrotal elevation

<35 yo with STI: Chlamydia: Doxy 100mg BID x 10 days + Ceftriaxone 250 mg IM x 1

non STI: Cipro or Levaquin 500mg BID x 10 days or Bactrim DS BID x 10 days

Non infectious: NSAIDs, rest and scrotal support

Treat sexual partners

Front 21

Erectile dysfunction symptoms

Back 21

inability to achieve or sustain erection

Front 22

Erectile dysfunction causes

Back 22

Vascular, neurologic, hormonal, drug induced, psychogenic

monogamous relationship?

Front 23

Erectile dysfunction meds and treatment

Back 23

Sex therapy, vacuum device, penile prosthesis, HRT, PDE-5 inhibitors: Levitra, Viagra, Cialis)

Intracavernosa injections

Switch BP meds to ACE or ARBs, SSRIs to TCAs

Front 24

Erectile dysfxn urology referral

Back 24

-fail PDE-5 inhibitor

-Peyronie's

-hx trauma/surgery

-priapism

-intracavernosal or injection

Front 25

Epididymitis

Back 25

+Prehn's sign (pain relieved with elevation to testes)

-Positive cremasteric reflex

Front 26

Asymptomatic hematuria differentials

Back 26

Bladder, renal ca

Front 27

Asymptomatic hematuria Symptoms

Back 27

Rare-likely from cause: CVA tenderness, mass, suprapubic tenderness, urethral discharge

Front 28

Asymptomatic hematuria signs

Back 28

blood in urine

3 RBC per high power microscopic field

repeat: UA, menses?

Front 29

Asymptomatic hematuria signs

Back 29

blood in urine

3 RBC per high power microscopic field

repeat: UA, menses?

Front 30

Differential priorities for asx hematuria

Back 30

UTI/pyelo/cystitis

renal calculi, trauma, exercise, bladder/kidney tumor, Heparin/Coumadin, glomerulonephritis

Front 31

Work up/lab priorities for asymptomatic hematuria

Back 31

good hx, blood thinners, pnc, sulfa, cytoxan, diet, menses

microscopy, reflex xulture, imaging, refer for cysto>

ANA, IgG, Chem with creat/bun, cbc with plt, ASO titer, VDRL, urine culture

Front 32

Spermatocele

Back 32

Behind testes, hard to find

Front 33

Spermatocele

Back 33

Behind testes, hard to find

Front 34

Hydrocele

Back 34

Water in the testicle, full, tense mass, can transilluminate

Front 35

Spermatocele

Back 35

Behind testes, hard to find

Front 36

Varicocele

Back 36

bluish tint, bag of worms, tender, does not transilluminate

Front 37

Spermatocele

Back 37

Behind testes, hard to find

Front 38

Hydrocele

Back 38

Water in the testicle, full, tense mass, can transilluminate

Front 39

Varicocele

Back 39

bluish tint, bag of worms, tender, does not transilluminate

Front 40

Epididymitis

Back 40

Pain above testes

Front 41

Spermatocele

Back 41

Behind testes, hard to find

Front 42

Hydrocele

Back 42

Water in the testicle, full, tense mass, can transilluminate

Front 43

Varicocele

Back 43

bluish tint, bag of worms, tender, does not transilluminate

Front 44

Epididymitis

Back 44

Pain above testes

Front 45

Testicular torsion

Back 45

Sudden pain

Front 46

Interstitial cystitis aggravating symptoms

Back 46

suprapubic pain relieved voiding small amounts, frequency/urgency, pain with intercourse, pressure/pelvic pain

Front 47

Interstitial cystitis aggravating symptoms

Back 47

suprapubic pain relieved voiding small amounts, frequency/urgency, pain with intercourse, pressure/pelvic pain

Front 48

Interstitial cystitis typical symptoms

Back 48

May be worse 1 week before period

Aggravated by spice food, acidic foods, caffeine

Front 49

Interstitial cystitis aggravating symptoms

Back 49

suprapubic pain relieved voiding small amounts, frequency/urgency, pain with intercourse, pressure/pelvic pain

Front 50

Interstitial cystitis typical symptoms

Back 50

May be worse 1 week before period

Aggravated by spice food, acidic foods, caffeine

Front 51

Interstitial cystitis treatment

Back 51

cystoscopy

Injections into bladder

Front 52

Interstitial cystitis aggravating symptoms

Back 52

suprapubic pain relieved voiding small amounts, frequency/urgency, pain with intercourse, pressure/pelvic pain

Front 53

Interstitial cystitis typical symptoms

Back 53

May be worse 1 week before period

Aggravated by spice food, acidic foods, caffeine

Front 54

Interstitial cystitis treatment

Back 54

cystoscopy

Injections into bladder

Front 55

BUN normal values

Back 55

7-20

Front 56

Interstitial cystitis typical symptoms

Back 56

May be worse 1 week before period

Aggravated by spice food, acidic foods, caffeine

Front 57

Interstitial cystitis treatment

Back 57

cystoscopy

Injections into bladder

Front 58

GFR normal values

Back 58

60 or higher

Front 59

Interstitial cystitis aggravating symptoms

Back 59

suprapubic pain relieved voiding small amounts, frequency/urgency, pain with intercourse, pressure/pelvic pain

Front 60

Interstitial cystitis typical symptoms

Back 60

May be worse 1 week before period

Aggravated by spice food, acidic foods, caffeine

Front 61

Interstitial cystitis treatment

Back 61

cystoscopy

Injections into bladder

Front 62

BUN normal values

Back 62

7-20

Front 63

GFR normal values

Back 63

60 or higher

Front 64

Normal creatinine

Back 64

Men 0.7-1.3

Women 0.6-1.1

Front 65

Interstitial cystitis aggravating symptoms

Back 65

suprapubic pain relieved voiding small amounts, frequency/urgency, pain with intercourse, pressure/pelvic pain

Front 66

Interstitial cystitis typical symptoms

Back 66

May be worse 1 week before period

Aggravated by spice food, acidic foods, caffeine

Front 67

Interstitial cystitis treatment

Back 67

cystoscopy

Injections into bladder

Front 68

BUN normal values

Back 68

7-20

Front 69

GFR normal values

Back 69

60 or higher

Front 70

Normal creatinine

Back 70

Men 0.7-1.3

Women 0.6-1.1

Front 71

Renal calculi s/sx

Back 71

high BP, guarding, unusual sudden onset pain, flank pain, anterior groin pain, nausea, urinary frequency, vomiting, diaphoresis, dysuria, hematuria, weakness, hx of recent/chronic UTI, dietary hx consistent with stone formation

Front 72

Interstitial cystitis aggravating symptoms

Back 72

suprapubic pain relieved voiding small amounts, frequency/urgency, pain with intercourse, pressure/pelvic pain

Front 73

Interstitial cystitis typical symptoms

Back 73

May be worse 1 week before period

Aggravated by spice food, acidic foods, caffeine

Front 74

Interstitial cystitis treatment

Back 74

cystoscopy

Injections into bladder

Front 75

BUN normal values

Back 75

7-20

Front 76

GFR normal values

Back 76

60 or higher

Front 77

Normal creatinine

Back 77

Men 0.7-1.3

Women 0.6-1.1

Front 78

Renal calculi s/sx

Back 78

high BP, guarding, unusual sudden onset pain, flank pain, anterior groin pain, nausea, urinary frequency, vomiting, diaphoresis, dysuria, hematuria, weakness, hx of recent/chronic UTI, dietary hx consistent with stone formation

Front 79

Renal calculi treatment priorities

Back 79

Pain management (NSAIDS, narcotics)

Antispasmodics, warm compresses, focused breathing, diversional activities

KUB, then CT if stone not visualized

Front 80

Interstitial cystitis aggravating symptoms

Back 80

suprapubic pain relieved voiding small amounts, frequency/urgency, pain with intercourse, pressure/pelvic pain

Front 81

Interstitial cystitis typical symptoms

Back 81

May be worse 1 week before period

Aggravated by spice food, acidic foods, caffeine

Front 82

Interstitial cystitis treatment

Back 82

cystoscopy

Injections into bladder

Front 83

BUN normal values

Back 83

7-20

Front 84

GFR normal values

Back 84

60 or higher

Front 85

Normal creatinine

Back 85

Men 0.7-1.3

Women 0.6-1.1

Front 86

Renal calculi s/sx

Back 86

high BP, guarding, unusual sudden onset pain, flank pain, anterior groin pain, nausea, urinary frequency, vomiting, diaphoresis, dysuria, hematuria, weakness, hx of recent/chronic UTI, dietary hx consistent with stone formation

Front 87

Renal calculi treatment priorities

Back 87

Pain management (NSAIDS, narcotics)

Antispasmodics, warm compresses, focused breathing, diversional activities

KUB, then CT if stone not visualized

Front 88

Overactive bladder sx

Back 88

urgency, frequency, nocturia a/w involuntary contractions of detrusor muscle (contracts before full)

Front 89

Interstitial cystitis aggravating symptoms

Back 89

suprapubic pain relieved voiding small amounts, frequency/urgency, pain with intercourse, pressure/pelvic pain

Front 90

Interstitial cystitis typical symptoms

Back 90

May be worse 1 week before period

Aggravated by spice food, acidic foods, caffeine

Front 91

Interstitial cystitis treatment

Back 91

cystoscopy

Injections into bladder

Front 92

BUN normal values

Back 92

7-20

Front 93

GFR normal values

Back 93

60 or higher

Front 94

Normal creatinine

Back 94

Men 0.7-1.3

Women 0.6-1.1

Front 95

Renal calculi s/sx

Back 95

high BP, guarding, unusual sudden onset pain, flank pain, anterior groin pain, nausea, urinary frequency, vomiting, diaphoresis, dysuria, hematuria, weakness, hx of recent/chronic UTI, dietary hx consistent with stone formation

Front 96

Renal calculi treatment priorities

Back 96

Pain management (NSAIDS, narcotics)

Antispasmodics, warm compresses, focused breathing, diversional activities

KUB, then CT if stone not visualized

Front 97

Overactive bladder sx

Back 97

urgency, frequency, nocturia a/w involuntary contractions of detrusor muscle (contracts before full)

Front 98

Overactive bladder meds

Back 98

TCAs *Elavil, Tofranil)

Anticholinergics: Detrol LA, Ditropan, Vesicare

Watch out for narrow angle eye glaucoma

Front 99

Interstitial cystitis aggravating symptoms

Back 99

suprapubic pain relieved voiding small amounts, frequency/urgency, pain with intercourse, pressure/pelvic pain

Front 100

Prostate tests if symptomatic

Back 100

PSA< UA, post void residual

Front 101

Interstitial cystitis typical symptoms

Back 101

May be worse 1 week before period

Aggravated by spice food, acidic foods, caffeine

Front 102

Interstitial cystitis treatment

Back 102

cystoscopy

Injections into bladder

Front 103

BUN normal values

Back 103

7-20

Front 104

GFR normal values

Back 104

60 or higher

Front 105

Normal creatinine

Back 105

Men 0.7-1.3

Women 0.6-1.1

Front 106

Renal calculi s/sx

Back 106

high BP, guarding, unusual sudden onset pain, flank pain, anterior groin pain, nausea, urinary frequency, vomiting, diaphoresis, dysuria, hematuria, weakness, hx of recent/chronic UTI, dietary hx consistent with stone formation

Front 107

Renal calculi treatment priorities

Back 107

Pain management (NSAIDS, narcotics)

Antispasmodics, warm compresses, focused breathing, diversional activities

KUB, then CT if stone not visualized

Front 108

Overactive bladder sx

Back 108

urgency, frequency, nocturia a/w involuntary contractions of detrusor muscle (contracts before full)

Front 109

Overactive bladder meds

Back 109

TCAs *Elavil, Tofranil)

Anticholinergics: Detrol LA, Ditropan, Vesicare

Watch out for narrow angle eye glaucoma

Front 110

Interstitial cystitis aggravating symptoms

Back 110

suprapubic pain relieved voiding small amounts, frequency/urgency, pain with intercourse, pressure/pelvic pain

Front 111

Prostate tests if symptomatic

Back 111

PSA< UA, post void residual

Front 112

Prostate exam

Enlarged and smooth

Nodule and firm

Back 112

Enlarged and smooth: BPH

Nodule and firm: prostate cancer

Front 113

Interstitial cystitis typical symptoms

Back 113

May be worse 1 week before period

Aggravated by spice food, acidic foods, caffeine

Front 114

Interstitial cystitis treatment

Back 114

cystoscopy

Injections into bladder

Front 115

BUN normal values

Back 115

7-20

Front 116

GFR normal values

Back 116

60 or higher

Front 117

Normal creatinine

Back 117

Men 0.7-1.3

Women 0.6-1.1

Front 118

Renal calculi s/sx

Back 118

high BP, guarding, unusual sudden onset pain, flank pain, anterior groin pain, nausea, urinary frequency, vomiting, diaphoresis, dysuria, hematuria, weakness, hx of recent/chronic UTI, dietary hx consistent with stone formation

Front 119

Renal calculi treatment priorities

Back 119

Pain management (NSAIDS, narcotics)

Antispasmodics, warm compresses, focused breathing, diversional activities

KUB, then CT if stone not visualized

Front 120

Overactive bladder sx

Back 120

urgency, frequency, nocturia a/w involuntary contractions of detrusor muscle (contracts before full)

Front 121

Overactive bladder meds

Back 121

TCAs *Elavil, Tofranil)

Anticholinergics: Detrol LA, Ditropan, Vesicare

Watch out for narrow angle eye glaucoma