acute interstitial nephritis

3-5 days after drugs, inc eosinophil in blood/urine

C-ANCA present in what conditions?

granulomatosis with vasculitis. these pts have normal serum complement levels
pneumonitis- chemical injury and inflammation of lung parenchyma due to inhalation of strong gastric contents. h/o vomiting; resp distress 2-5 h after inhalation. no infection tx no abx; pneumoniaa- infection of lung parenchyma due by microbes in oral cavity

diff of aspiration pneumonitis and aspiration pneumonia?

drugs that cause isolated increase of of serum creatinin

cimetidine, probenecid, trimethoprim (PTC) they dec tubular secretion of creatinin

hepatic, pancreatic, splenic, pulmo cyst; cerebral aneurysm, aortic aneurysm, diverticulosis, MVR , inguinal hernia

extrarenal manifestation of PKD

goal of bp control of ADPKD?

130/80 no need for us or CT screening

how analgesic nephropathy presents

massive proteinuria, granular cast, US neg

how to differentiate IgA neprphopathy and AGN?

AGN: 10 days gaps from skin/pharynx infection, complememt dec, RBC cast IgA: dysmorphic RBC, URI

how to dx acute prostatis?

dysuria. pain on ejabulation, tender prostate on exam. caused by same organissm cause uti, tx bactrim
cx of prostate secretion >30 wbc and no organism together with other features of prostatitis tx sitz bath, no antibiotic

how to dx nonbacterial prostatitis?

how to dx urethral diverticulum?

look for hx of mutliple birth trauma, insrumentaion, postvoid dribbling, dysuria, pain on deep penetration during sex

how to dx urethral diverticulum?

urethroscopy and transvaginal US

how to dx urethral stress incontinence?

q-tip test. a cotton swab placed inside the urethra when pt strains.

how to dx vesicovaginal fistula?

instillation of methylene blue to bladder via catheter; vaginally placed tampoon is dyed blue confirm dx

how to screen family for ADPKD

Ultrasound; if neg PKD gene screening

how uncontrolled htn affects kidney

progressinve decline of gfr, creatinine is getting worse very gradually, takes several years. urine protein. if proteinuria present tx with ACE I or ARB

hypertension with inc creatinin, next step?

if renal cell ca confined in renal capsule?

do partial nephrectomy

indications for alpha blockers (prazosin,, terazosin

bph and htn, also used in DM pt to increase insulin sensitivity; dec cholesterol and inc HDL inc K release from cells, met acidosis, hyperglycemia, inc tissue catabolism, exercise

major causes of hyperkalemia

most common long term complication of TURP?

retrograde ejaculation, as bladder neck fails to close after ejaculation and enables sperm to backflow to bladder. happens in 70% cases

muddy brown cast in urine

ATN...brown for necrosis

organisms involved in aspiration pneumonia

gm pos cocci, gm neg rods, anerobes tx clinda

pt has renal failure, inc creat..how to dx ureteral tumor/stone

retrograde pyelogram

pt p/w high PSA >4, next step?

transrectal prostate biopsy

red cell cast, dysmorphic RBC

glomerulonephritis

renal artery stenosis, how to dx?

give ACE inhibitor, if serum creat inc.. confirms dx; ace inhib lower angiotensin 2 which decrease GFR, which inc creatinine

suspicion about bladder ca?

single episode of painless hematuria ...blader ca until proven otherwise. dx cystoscopy

flank pain, night sweats, costovertebral tenderness, RUQ mass, inc hemoglobin and hematocrit due to inc erythopoetin,

suspicion for renal cell ca?

unilateral urinary calculus, bun/cr?

normal

use of prostate massage to dx acute prostatitis

no way.. pt may develop bacterimia

what antibiotics penetrate prostate

fluroquinoloe and trimethosulphamethoxaxole thromboembolism (sickle cell), neurogenic dysfunction, neoplasis, truma, medication

what causes priapism?

what drugs are helpful to reduce chronic bladder outlet outlet obstruction?

terazosin

what drugs are not given prior to IV contrast study

metformin nsaid

what drugs cause analgesic nephropathy? how to dx?

a for a . aspirin acetaminophen and another phen is phenacetin. dx sterile urine cx, RBC, WBC and WBC cast in urine. tx. stop drug

what factor determies tx option of renal cell ca?

whether or not it extends through renal capsule but not beyond Gerota's fascia

what is gold standard to dx neprolithiasis?

non-contrast ct scan

what is mech of hepatorenal syndrome?

Pt with cirrhosis develop dec PVR due to splanchnic vasodilation---dec renal blood flow/perfusion---hepatorenal syndrome

what is more sensitive to ds ureteral stone?

CT not us; xray detect calcium stones. 20% of kidney stones dont' contain calcium

what is scleroderma

abnormal deposition of collagen in mulitple organs. p/w htn, thickening of renal arteries--dec blood flow--activation of renin/angiotensin system--htn

what is the major cause of hypernatremia

unreplaced water loss (sweat, GI loos DI , osmotic diuresis)

what is the mech of nsaid inuded nephropathy?

nsaid -- dec PG ---dec vasodilation ---dec renal flow and gfr

ACE inhibitor; generally avoided in renal failure, this is an exception. nitroprusside can be added to reduce htn, single dose only. if bp falls too much, will further decrease renal perfusion, worsen renal failure

what is the tx of choice for scleroderma renal crisis?

when priapism is emergency?

if it lasts more than 3 hours. immediate step ice pack and local administration of vasoconstrictor (phenylephrine) every 5 min until resolution; no surgery, iv fluid in sickle cell

when to suspect obstructive uropathy?

hx of renal colic, pelvic or retroperitoneal malignancy, radiation; men- most common due to BPH

when to use shockwave lithotripsy in kidney stones?

uncomplicated proximal ureteral stones