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33 Cards in this Set
- Front
- Back
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how do you make the diagnosis of acute interstitial nephritis?
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allergic reaction to med/recent infection
rash fever acute renal insufficiency eosinophilia |
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what are the characteristics of type 1 (distal) renal tubular acidosis?
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decr in ECF volume
hypokalemia renal stones/nephrocalcinosis (rickets/osteomalacia in children) |
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what causes Hartnnup syndrome and what is the problem?
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defective amino acid transporter
decr renal reabsorption of neutral amino acids (tryptophan -> nicotinamide def) |
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what is the defect in type 1 (distal) renal tubular acidosis?
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inability to secrete H+ at the distal tubule
(new bicarb cannot be generated) |
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what is the defect in type 2 (proximal) renal tubular acidosis?
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inability to reabsorb HCO3- at the proximal tubule
(incr excretion of bicarb into urine) |
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what are the clinical features of Hartnup syndrome?
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similar to pellagra:
- dermatitis - diarrhea - dementia (psychiatric disturbances) - ataxia |
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what do you give to treat a symptomatic Hartnup syndrome pt?
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nicotinamide
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what vascular problem is assd with adult polycystic kidney disease?
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berry aneurysm
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what is the gold standard for diagnosis of renal artery stenosis?
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renal arteriogram
(dye is nephrotoxic, don't use in renal failure) |
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what test can you use to diagnose renal artery stenosis in a pt with renal failure
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MRA
(magnetic dye not nephrotoxic) |
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what is the definitive study to diagnose renal vein thrombosis?
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selective renal venography
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where is the mc site of nephrolithiasis impaction?
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ureterovesicular junction
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which types of kidney stones are not visable on plain films?
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uric acid stones
cystine stones |
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what is the most sensitive test for detecting kidney stones?
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spiral CT (w/out contrast)
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how long should you wait on a kidney stone before you consider surgery?
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3 days of severe pain
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what size kidney stone is unlikely to pass spontaneously?
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>1cm
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when should extracorpeoreal shock wave lithotripsy be used vs percutaneuous nephrolithotomy to remove a kidney stone?
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shock wave (<2cm)
nephrolithotomy (>2cm) |
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what is the gold standard for diagnosis of a ureteral obstruction?
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intravenous urogram (IVP)
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what are the indications for transrectal ultrasonography?
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PSA >10 ng/mL (regardless of DRE)
PSA velocity >0.75 ng/mL in a year DRE is abnl (regardless of PSA) (PSA <4.0 + normal DRE - annual f/u) |
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what are the (4) stages of prostate cancer?
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stage A: nonpalpable, confined to prostate
stage B: palpable nodule, confined to prostate stage C: extends beyond capsule w/out metastasis stage D: metastatic disease |
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which type of testicular cancer has elevated B-hCG?
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choriocarcinoma
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which (2) types of testicular cancers never have elevated AFP?
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choriocarcinoma
seminoma |
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which type of testicular cancer is extremely radiosensative?
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seminoma
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what is renal tubular acidosis characterized by?
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non-anion gap hyperchloremic metabolic acidosis
decreased H+ excreted in the urine - acidemia - urine alkalosis) |
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what are the effects of type 1 renal tubular acidosis?
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increased excretion of ions:
- renal stones (incr Ca and Ph excretion into alkaline urine) - decr ECF volume - hypokalemia - rickets/osteomalacia in children |
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what causes type 4 renal tubular acidosis?
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from any condition that is assd w/ hypoaldosteronism or resistance to aldosterone
- decr Na absorption - decr H and K secretion |
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how is type 4 RTA different than other types?
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hyperkalemia and acidic urine
(still a non-anion gap metabolic acidosis) |
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what drugs are contraindicated in renal artery stenosis?
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ACE-I's
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what are the 1st and 2nd mc causes of ESRD in the US?
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diabetes
hypertensive nephrosclerosis |
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what drugs can be used for the treatment of pts with kidney stones and hypercalciuria?
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thiazide diuretics
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what drugs can be used for the treatment of pts with kidney stones and elevated uric acid levels in the urine?
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allopurinol
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what is the gold standard for the diagnosis of ureteral obstruction?
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intervenous urogram (IVP)
(contraindicated if pregnant, allergic to contrast or in renal failure) |
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what are the mc offending organisms in epididymitis?
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children/elderly - E.coli
sexually active - gonorrhea/Chlamydia |
