obinno59's version from 2015-12-13 23:23


Question Answer
ADPKD=Autosomal dominant disease (90% chromosome____ mutation)
When do cyst show up?
1. 16
2.Patients do not have cysts at birth
Kidney function is usually retained until the third or fourth decade of life
RCC in ADPKDRenal cell carcinoma does NOT occur more frequently in ADPKD patients compared to the general population. However, when renal cell carcinoma does develop in ADPKD patients, it often behaves more aggressively and presents at an earlier age.
syphilis is a/w ___ nephropathy? Characteristics?1. Membranous glomerulopathy
2. "spike and dome"
High school athlete has asymptomatic proteinuria= Next step?1. Repeat dipstick on another occasion.= If following dipstick is negative then it was a transient proteinuria
2. if positive again then do 24 hour urine collection
If a child is symptomatic and has proteinuria is found on UAx what is the best next step?1. ML= MCD
2. Steroids= proteinuria is enough for empiric tx
Nephropathy a/w Solid tumorsMembranous glomerulonephritis "Meatballs"
Nephropathy a/w LymphomasMCD
K abnormality a/w muscle cramps and weakness? N?V?1. Muscle weakness= HyPOkalemia
2. N/V=HYPERkalemia
Trimethoprim effect onKTrimethoprim may cause hyperkalemia through competitive inhibition of epithelial sodium channels in the collecting tubule. This is a similar mechanism of action to the diuretic amiloride
Serum calcium level is correct by the following equation:Measured total calcium + 0.8 (4.0 g/dL - measured serum albumin level).
Hypovolemic Hyponatremic txNS
Hypervolemic hyponatremic txADH antag
Euvolemic Hyponatremia with <100 Urine mOsmPolydipsia or Decre Na intake in old ppl
Euvolemic Hyponatremia with >100 Urine mOsm next step? Tx?R/O Hypothryoid and Adrenal insufff then check UNa= If >20 Mcc is SIADH
-Tx: fluid restric if Neuro problems then Hypertonic solution(3%) + Loops if fluid overload
If Na overshoots the NL mark when correcting for Hyponatremia with NS what should you do?Swtich from .9 to .45(1/2NS) slowly to reduce risk of central edema
HYpovopemic HYponatremia txNS
Tx for Asymptomatic bacteriuriaAsymptomatic bacteriuria is defined as >100,000 colony-forming units of bacteria without symptoms of a UTI. The following patients do NOT require treatment for asymptomatic bacteriuria:
- The elderly
- Diabetics
- Nonpregnant, premenopausal women
- Spinal cord injury patients
- Patients with chronic, indwelling urinary catheters

These patients DO require treatment for asymptomatic bacteriuria:
- Pregnant
- Urologic intervention
- Hip arthroplasty
Coffin-lid shaped crystals composed of ____ in UTI setting are seen in ____ urine suspicious of ____1.Struvite.
2. Alkaline
Ca levels during Serology levels during RhabdoSerology
creatine phosphkinase (CPK)
values > 20,000 are diagnostic
hypocalcemia=result of calcium binding to damaged muscle
does not require intervention
Rhabdo Urine labsthe presence of substantial myoglobin in the urine will lead to a positive blood dipstick urinalysis but no RBCs will be visible on microscopy.
Radiolucent stones on XrayUric acid
Risk factors for uric acid stones include gout (which this patient has), myelo- and lymphoproliferative malignancy, chemotherapy, and xanthine oxidase deficiency.
Tender swollen testicles with transverse lie and
abscent cremasteric reflex on affected side next step?
A 16-year-old male presents to the emergency room with a 6-hour history of scrotal pain of sudden onset. The patient’s past medical history is insignificant, though upon questioning he reports sleeping with several women in the prior three month period. On physical examination the testes appear to have a horizontal lie and the scrotum is neither swollen nor step?Testicular ultrasound is appropriate to rule out testicular torsion when all clinical signs point to epidymitis..if BF is low then torsion.
Right-sided or bilateral varicocele as well as varicocele that fails to disappear upon lying supine... what nextRaises concern for IVC obstruction
A CT abdomen with contrast is warranted in these cases for potential detection of IVC thrombosis or compression
RPN assoc conditions IVP?diabetes mellitus
chronic NSAID use
MCC is acetominophen + aspirin
sickle cell anemia
acute pyelonephritis

IVP=shows "ring defect" where necrosed papilla used to reside
Epididymitis An infection of the epididymis
Pathogen varies by patient age
< 35 years old=_____

> 35 years old=_____

Also a/w ____ and ____
1.N. gonorrhoeae, C. trachomatis
2. E. coli, P. aeruginosa
3. TB
4.AIDS= CVM, Toxoplasma, Salmonella infections
Epididymitis vs Testicular torsion PEPhysical exam
scrotal swelling, tenderness, and erythema
testicle is not elevated in the scrotum=seen in testicular torsion

Prehn's sign
decrease in pain with scrotal elevation =negative in testicular torsion
Epididymitis Txciprofloxacin or levofloxacin
if< 14 or greater than 35 years old

doxycycline + ceftriaxone
empiric treatment for N. gonorrheae and C. trachomatis
if between 14 to 35 years old
Recombinant erythropoiesis s/eside effects
flu-like symptoms