Term
| What is the diagnostic criteria for acute renal failure? |
|
Definition
| 50% increase in baseline value of creatinine or an increase of at least. 5 mg/dL/ also can pertain to a 50% decrease in the GFR |
|
|
Term
| What is the definition of oliguria? anuria? |
|
Definition
| urine output <500 ml in 24; anuria is an urine output < 100 ml in 24 hr |
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|
Term
| Name two medicines that interfere with creatinine secretion? |
|
Definition
| trimethoprim and cimetidine |
|
|
Term
| Name three medications that interfere with creatinine assay? |
|
Definition
| cefoxitin/ flucytosine/ acetoacetate |
|
|
Term
| How do changes in the GFR relate to changes in creatinine? |
|
Definition
| changes in the GFR precede changes in creatinine level by at least 24 hours |
|
|
Term
| What type of acute renal failure is most common in hospital settings? |
|
Definition
| intra-renal acute failure |
|
|
Term
| The majority of cases of acute renal failure cases in the hospital feature what specific pathology? |
|
Definition
|
|
Term
| In prerenal failure, what is the FENa value? |
|
Definition
|
|
Term
| What is the BUN-Cr ratio in prerenal failure? intrarenal failure? |
|
Definition
|
|
Term
| A larged distended abdomen to due to bowel obstruction sounds like what during auscultation? |
|
Definition
| high-pitched/tinkling sounds |
|
|
Term
| A sigmoid volvulus looks like what on a X-ray film? |
|
Definition
|
|
Term
| What enzyme marker is a good indicator of a gallstone in the bile duct? |
|
Definition
|
|
Term
| A person who is supine with his hips flexed and very still probably has what? |
|
Definition
|
|
Term
| What are two ways a person with peritonitis can present as? |
|
Definition
| an immobile board-like structure or in the fetal position |
|
|
Term
| How can NSAID use lead to pre-renal ARF? |
|
Definition
| NSAID's inhibit prostaglandin synthesis, which means the afferent arteriole is constricted by AT II. |
|
|
Term
| In which people is calculating FeNa ineffective? |
|
Definition
| In normal peeing patients (test designed for oliguric and anuric patients) |
|
|
Term
| In patients with metabolic acidosis, instead of sodium what serves as a more accurate marker of urine output? |
|
Definition
|
|
Term
| How do diuretics affect the FeNa value? |
|
Definition
|
|
Term
| What are the three types of ATN (acute tubular necrosis)? |
|
Definition
| ischemic, sepsis, and nephrotoxic |
|
|
Term
| How does someone with ischemic ATN usually end up that way in the hospital |
|
Definition
| were pre-renal for a long time and not taken care of |
|
|
Term
| What are the four classes of compounds that commonly cause nephrotoxic ATN? |
|
Definition
| radiocontrast agents, aminoglycosides, amphotericin B, and chemotherapeutics |
|
|
Term
| What percentage of patients on aminoglycosides are likely to get renal failure? How long were they on it? |
|
Definition
| 30%/ at least 5 days of treatment |
|
|
Term
| For different aminoglycosides, what factor lessens one's nephrotoxicity relative another? |
|
Definition
| the number of amino groups |
|
|
Term
| How does alkalinizing the urine decrease aminoglycoside nephrotoxicity? |
|
Definition
| It raises the pH and decreases aminoglycoside uptake by the proximal tubule |
|
|
Term
| What is the most common reason of hospital-acquired acute kidney failure? |
|
Definition
| radiocontrast (usually happens 2-3 days later) |
|
|
Term
| For people with rhabdomyolysis, how does myoglobin in the urine present? |
|
Definition
| Brownish color/ granular casts/ myoglobin present in both the urine and the serum |
|
|
Term
| What is the main treatment for rhabdomyolysis? |
|
Definition
|
|
Term
| For people with atheroembolic disease, what do you want to avoid? |
|
Definition
| anticoagulants (can make the plaques more unstable) |
|
|
Term
| How does a person with abdominal compartment syndrome typically present? |
|
Definition
| distended abdomen and oliguria |
|
|
Term
| What is the diagnostic criteria for abdominal compartment syndrome as it pertains to the bladder? |
|
Definition
| exclude if pressure < 10 mmHg/ diagnostic if pressure > 25 mmHg |
|
|
Term
| What are the five main indications for dialysis? |
|
Definition
| acidosis, electrolyte abnormaliteis, ingestions, overload (fluid), and uremic symptoms |
|
|
Term
| Granular casts are 100% diagnostic of what? |
|
Definition
|
|
Term
| In chronic kidney disease, how long does the creatinine level have to be elevated? |
|
Definition
|
|
Term
| With chronic kidney disease, does there need to be decline in kidney function? |
|
Definition
|
|
Term
| What is the leading cause of CKD? |
|
Definition
|
|
Term
| What is the gold standard for measuring GFR? |
|
Definition
|
|
Term
| What is the con of using the Cockgroft-Gault formula? |
|
Definition
| Needs lean-body people (difficult in fatties) |
|
|
Term
| For people older than 65 years, what formula is best for GFR calculation? |
|
Definition
| MDRD (CG formula for those 65 years) |
|
|
Term
| For patients who are anemic, what is their GFR typically? |
|
Definition
|
|
Term
| For patients with renal failure, what is the hypoglycemic drug of choice? |
|
Definition
|
|
Term
| When the hydroxyvitamin D is low, what is the next step? |
|
Definition
|
|
Term
| What CCB do you want to avoid in people with CKD? |
|
Definition
|
|
Term
| How does the GFR rate influence what kind of diuretic we want to give? |
|
Definition
| If GFR > 30, give the thiazide; if GFR <30 give the lasix |
|
|
Term
| What is the source in initial hematuria/ terminal hematuria? |
|
Definition
|
|
Term
| What lower urinary tract symptoms are considered irritative symptoms? |
|
Definition
| frequency, urgency, dysuria, and nocturia |
|
|
Term
| What sort of symptoms present with BPH? |
|
Definition
| irritative and/or obstructive symptoms |
|
|
Term
| What is the definition of premature ejaculation? |
|
Definition
| orgasm within 1 minute of intercourse w/ inability to delay |
|
|
Term
| For a patient with hematospermia, what do we normally do? |
|
Definition
| Prostate exam and check the PSA |
|
|
Term
| How much volume of fluid inside the bladder does there need to be in order for it to be palpable? |
|
Definition
|
|
Term
| Along with a penile carcinoma, what other feature is typically palpable? |
|
Definition
|
|
Term
| How does the urine collection vary for men and women? |
|
Definition
| for accuracy sake, we want mid-stream collection in men and catheter collection in women |
|
|
Term
| What drug is associated with orange urine? |
|
Definition
|
|
Term
| What are the four common reasons of increased SG? |
|
Definition
| proteinuria, decreased fluid intake, contrast, and SIADH |
|
|
Term
| With renal tubular acidosis, what is type II due to? |
|
Definition
| failure to reabsorb bicarbonate |
|
|
Term
| What is the normal excretion range of protein in the urine for adults? |
|
Definition
|
|
Term
| For testing proteinuria, what are some ways that can generate a false negative test? |
|
Definition
| if the urine is alkaline or if it is too dilute |
|
|
Term
| For doing ketone urinalysis, what are some scenarios that generate a false positive? |
|
Definition
| urine with high SG, abnormally colored urine, or very acidic urine |
|
|
Term
| What possible cancer risk exists with COCP use? |
|
Definition
| sligh increase in adenocarcinoma of the cervix with prolonged COCP use (> 12 years) |
|
|
Term
| What two drugs increase the failure rate of OC's? |
|
Definition
| rifampin and cyclophosphamide |
|
|
Term
| Which progestin shows the greatest increase in SHBG? |
|
Definition
| Desogestrel (may switch to norethindrone or levonorgestrel if libido drop is too much) |
|
|
Term
| Typically any sort of gynecological malignancy is contraindication to OC use. Which one is the exception? |
|
Definition
|
|
Term
| What is the dosage regimen of mini-pills? |
|
Definition
|
|
Term
| After depo-provera therapy is withdrawn, what is the typical period of return to fertility? |
|
Definition
|
|
Term
| What black box warning does depo-provera carry? |
|
Definition
| osteopenia (recommendation to take exogenous calcium supplements with depo-provera) |
|
|
Term
| What physical limitation is there to implanon? |
|
Definition
| effective only for women up to 130% of their IBW. |
|
|
Term
| What is the main mechanism of action for post-coitus contraception pills (morning after pills)? |
|
Definition
| increase tubal motility so that the conceptus arrives in the uterine cavity before there is adequate glycogen to support therapy |
|
|
Term
| Why do most women discontinue IUD therapy? |
|
Definition
| increased or irregular bleeding |
|
|
Term
| Which IUD can decrease menstrual flow by up to 60%? |
|
Definition
|
|
Term
| What is the most effective mode of contraception to prevent STD transmission? |
|
Definition
|
|
Term
| How is spermicide applied to the diaphragm or cervical cap? |
|
Definition
| spermicide applied after diaphragm or cervical cap is inserted |
|
|
Term
| What spermicide is commonly used in many chemical barriers and when must it be used? |
|
Definition
| nonoxynol-9/ 20-60 minutes prior to intercourse |
|
|
Term
| How long can the sperm remain viable after coitus? |
|
Definition
| up to 48 hours (ovary viable up to 24 hours) |
|
|
Term
| When is a tubal ligation typically? |
|
Definition
| in the immediate post-partum period or anytime after the 6 week postpartum exam |
|
|
Term
| What is the success rate of tubal ligation? |
|
Definition
|
|
Term
| At what degree of prolapse is the uterus at the introitus? |
|
Definition
|
|
Term
| Where is the pilonidal cyst usually located? |
|
Definition
| in the midline superficial to the coccyx or the lower sacrum |
|
|
Term
| What are external hemorrhoids? |
|
Definition
| dilated hemorrhoidal veins that originate below the pectinate line and are covered with skin |
|
|
Term
| If the rectum prolapses through the anus, how does it typically look? |
|
Definition
| as a doughnut or rosette of red tissue |
|
|
Term
| What is the origin of the rectal shefl? |
|
Definition
| widespread peritoneal metases from any source that may develop in the area of the peritoneal reflection anterior to the rectum |
|
|
Term
| What percentage of women experience menorrhagia? |
|
Definition
|
|
Term
| How is menorrhagia defined? |
|
Definition
| Prolonged (more than 7 days) or excessive (greater than 80 ml) uterine bleeding occurring at regular intervals |
|
|
Term
| What is the definition of amenorrhea? |
|
Definition
| No menses for at least 6 months |
|
|
Term
| What is the treatment for hyperprolactinemia? |
|
Definition
|
|
Term
| What is the benefit of oral contraceptives with regard to coagulation/ |
|
Definition
| Increase Factor VIII and suppress ovulation and decrease endometrial thickness so less blood loss |
|
|
Term
| What is the most common cause of reproductive age abnormal uterine bleeding? |
|
Definition
|
|
Term
| Prolonged use of low OC's can lead to what? |
|
Definition
|
|
Term
| What two elements are key to defining PCOS? |
|
Definition
| ovulatory dysfunction and androgenic hyperfunction |
|
|
Term
| Describe the normal course of the BBT? |
|
Definition
| Lower during the follicular phase/ rises 0.4-0.8 F at ovulation, drops slightly and remains slightly higher than the follicular phase for the remainder of the cycle |
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