GU/ Renal Step Up

Pylenonephritis

-def

-Most commonly occurs as

-DX

-TX

Fluroquinolonlones have comparable bioavailablity

for the oral and IV formulations

Most common site of renal stone impaction

uretero-vesical junction

Nephrolithasis

-def

-RF

-Types of stones

• Calcium oxolate, Struvite, Calcium phosphate, Uric acid, cystine

• Cause

• Radiology

• Notes

Nephrolithasis

-SXS

-DX

-TX

-Complications

Patients with kidney stones should be hospitilized if

intractable pain and/or vomitting, infected stones, a solitary kidney, or renal failure/insufficiency

Hydronephrosis

-def

-caused by

-can lead to

-SXS

-DX

-TXT

-Complications

Next Step: anuric patient

r/o bladder or uretheral obstruction via attempting bladder cath

10-15% of pts with polycstic kidney disease develop

subarachnoid hemmorahage

Polycystic kidney dease

-type

-SXS

-Dx

-TX

-Complications

Malignancies that cause increased EPO

hepatocellular carcinoma

pheochromocytoma

hemangioblastoma

RCC

-RF

-SXS

-DX

-TX

-Complications

Interstitial Nephropathy (Acute interstitial Nephritis)

-Def

-Most common causes are

-SXS

-Labs

-Tx

-Complications

Nephritic syndromes

-def

-SXS

-Labs

-Tx

Nephrotic Syndromes

-def

-frequently subsequent to

-SXS
-Labs

-Tx

Postinfectious glomerulnephritis

IgA nephropathy

-pathology

-SXS

-Labs

-Tx

Goodpasture syndrome

Alport syndrome

-pathology

-SXS

-Labs

-Tx

RPGN

Lupus nephritis

Gramulotomotis with polyangitis (Wegener)

-pathology

-SXS

-Labs

-Tx

Minimal Change Disease

FSGS

Membranous Nephropathy

-Pathology

-SXS

-Labs

-TX

MPGN

DM nephropathy

Amyloidosis

-Pathology

-SXS

-Labs

-TX

AKI:

• Prerenal 4 points

• Lab values prerenal, renal, post renal failre for FeNA, Urine Na, BUN: Cr

AKI:

• Cast locations and causes

  • RBC casts

  • WBC casts

  • Eosinophils

  • Granular casts

  • hyaline casts

-Intrinisc 3 points

-post renal point

-SXS general

-Labs

-Radiology

-Tx

Next step: BUN:CR ratio is

quick way to help determine the cause of AKI

ratio>20 if prerenal cause

CKD does not occur until

>90% of renal parenchyma is sclerosed or necrotic

CKD

-def

-causes

-SXS

-Labs

-Radiology

-Tx

-Complications

Dialysis

-def

-Types 2

-indications

-complications

Renal Tubular Acidosis (RTA)

-abnormalities in

-leads to

-Characteristics of RTA

• Distal Type 1, Proximal Type 2, Low Renin/Aldo

  • defect, cause, urine pH, Serum electrolytes, Radiology, Tx

Acid-Base Physiology

-in healthy person, serum pH is regulated by

-in healthy person pH=, Pco2=, Po2=, HCO3=

-Pco2 and Ph can be measured with

-pH for acidosis vs alkalosis

-High AG metabolic acidosis mnemonic

Acid-Base disturbances

-Anion gap

• def

• calculation

• normal is

• increased AG suggests

-Mixed disorder

• def

  • detected when

Acid base pathway

Hypernatremia

-level

-classified by x3

-SXS

-Tx

• tx

• correction forumla

• hald of deficit is given

• euvolemic hypernatremia

• hypervolemic hypernatremia

-complications

Pseudohyponatremia is

artifact of HLD in which serum Na falsely appears to be low

TO calculate Na that will result from correction of hyperglycemia

add 1.6 meQ/L Na for every 100 mg/dl glucose >100

Hyponatremia

-level

-SXS

-Tx

-Complications

Pseudohyperkalemia occurs from ___

next step____

Hyponatremia pathway

Hyperkalemia

-level

-caused by

-SXS

Hyper K

-ECG

-Tx

HypoK pathway

Hyper calcemia sxs pneumonic

Hypercalcemia

-level

-caused by

-SXS

-Labs

Hypercalcemia

-ECG

-Tx

Next step: differentiate familial hypocalciuric hypercalcemia adn other causes of hypercalcemia

Hypocalcemia

-level

-caused by

-SXS

-Labs

-ECG

-Tx

Thiazide diurrects are “-sparing” and can cause

Ca-sparing

hypercalcemia

UTI

-def

-microbes

-RF

-SXS
-Labs

-Treatment

• uncomplicated

• complicated

• Asymptomatic bacteriuria

• pregnancy

-Complications

Next Step: man with suspected UTI

workup for STI urethritis because sxs same as UTI

Urinary incontenence

-def

-first step in eval

-Urge incontenence

• def

• SXS

• Tx

-Stress incontienence

• def

• RF

• SXS

• Tx

Overflow

• def

• common in

• causes

• SXS

• Testing

• Tx

Bladder Cancer

-Types

-RF

-SXS

-Labs

-Radiology

-Tx

-Complications

Urethritis

-def

-SXS
-Labs

-Tx

-Complications

Prostatitis

-def

-SXS

-Labs

-Tx

BPH develops in

central zone of the prostate adjacent to the urethra and does not predispose patients to prostate cancer

BPH

-def

-SXS

-Labs

-Radiology

-TX

Prostate cancer is most common _____ in ___

_____ is the greatest cause of cancer related death in ____

______ is the second highest

Prostate Cancer

-def

-RF

-SXS

-Labs

-Radiology

-Tx

-Complications

Supporting the scrotum

testicular pain vs epididmyitis

Epididymitis

-def

-caused by

-SXS

-Labs

-Tx

Testicular Torsion

-def

-SXS
-Radiology

-Tx

-Complications

Testicular Cancer

-Def

-RF

-SXS
-Labs

-Tx

-Complications

95% of testicular malignanices are a

germ cell origin

Testicular cancer common in ages

15-35 year old males

ED

-def

-caused by

-SXS

-Labs

-Tx