Genitourinary

Question 1

What is the most frequent cause of acute complicated UTI?

Answer 1

A. Escherichia coli

Other uropathogens include Enterobacterales (e.g., Klebsiella and Proteus species), Pseudomonas, enterococci, and staphylocci (both MSSA and MRSA).

Question 2

What is the antibacterial agent frequently used in combination with other agents for treatment of various infections?

Answer 2

Aminoglycoside

Aminoglycosides are used for septicemia, nosocomial respiratory tract infections, complicated UTIs, complicated intra-abdominal infections, and osteomyelitis.

Question 3

Aminoglycosides are considered nephrotoxic and can contribute to _______.

Answer 3

acute tubular necrosis

This toxicity can lead to significant kidney damage.

Question 4

Patients with acute kidney injury may present with symptoms of _______.

Answer 4

• Diminished kidney function
• Edema
• Hypertension
• Decreased urine output

These symptoms indicate a decline in kidney performance.

Question 5

What is often a consequence of volume depletion in the setting of hypovolemia?

Answer 5

Prerenal disease

Causes include dehydration, hemorrhage, or renal and gastrointestinal fluid loss.

Question 6

Define chronic kidney disease.

Answer 6

Presence of kidney damage or decreased kidney function for 3 or more months

This condition can arise from various causes.

Question 7

Postrenal acute kidney injury is often referred to as _______.

Answer 7

obstructive nephropathy

This condition can result from prostatic disease, renal calculi, clots, neurogenic bladder, or medications causing urinary retention.

Question 8

What is the preferred diagnostic test for nephrolithiasis?

Answer 8

CT of the abdomen and pelvis without contrast

This test reliably detects hydronephrosis.

Question 9

What is a reasonable alternative to a CT scan for detecting hydronephrosis, especially in pregnant patients?

Answer 9

Ultrasound of the kidneys and bladder

Ultrasound avoids ionizing radiation but is less accurate than CT.

Question 10

Which imaging techniques are used as adjunct or follow-up examinations for nephrolithiasis?

Answer 10

• Abdominal radiography
• Intravenous pyelography
• MRI

These are rarely used in the initial diagnosis.

Question 11

What does abdominal radiography fail to detect in the context of nephrolithiasis?

Answer 11

Hydronephrosis

It is also less accurate than CT for stone detection.

Question 12

What does intravenous pyelography detect, and how does it compare to CT?

Answer 12

Detects hydronephrosis but is less sensitive and specific compared with CT for stone detection

It is not preferred for initial diagnosis.

Question 13

What is prerenal disease often a consequence of?

Answer 13

• True volume depletion
• Hypovolemia
• Dehydration
• Hemorrhage
• Renal fluid loss (diuretics)
• Gastrointestinal fluid loss (vomiting, diarrhea)

Prerenal disease results from conditions that reduce blood flow to the kidneys.

Question 14

What are common causes of acute tubular necrosis?

Answer 14

• Nephrotoxins

Acute tubular necrosis is a form of intrarenal acute kidney injury.

Question 15

Postrenal acute kidney injury is often referred to as ________.

Answer 15

obstructive nephropathy

This condition can arise from various obstructions in the urinary tract.

Question 16

Name some causes of postrenal acute kidney injury.

Answer 16

• Prostatic disease (hyperplasia or cancer)
• Renal calculi
• Clots
• Neurogenic bladder
• Medications causing urinary retention

These factors can lead to obstruction and subsequent kidney injury.

Question 17

Most stones less than 5 mm pass spontaneously with supportive care, true or false

Answer 17

True 

Question 18

Is it true that Flomax may be considered for stones larger than 5 mm and less than 10 mm to aid passage, but is not a first-line intervention for a 5 mm stone in a stable, afebrile patient without obstructive symptoms?

Answer 18

True.

Question 19

Most common type of kidney stone

Answer 19

Calcium oxalate

Question 20

What is the diagnostic threshold for a urine culture and sensitivity (C&S) result indicating a urinary tract infection (UTI)?

Answer 20

A result of 10^5 CFU/mL of a single organism indicates a UTI.

This threshold is typically accompanied by symptoms such as dysuria, urgency, and frequency.

Question 21

What is dysuria in the context of a UTI?

Answer 21

A symptom involving painful urination

Dysuria is one of the symptoms associated with an acute uncomplicated UTI.

Question 22

Uncomplicated UTI

Answer 22

Is confined to the bladder and may involve dysuria, urinary frequency or nocturia 

Question 23

What is a complicated UTI?

Answer 23

An infection that extends beyond the bladder, often accompanied by symptoms such as fever, flank pain, and signs of systemic illness like chills and fatigue.

Complicated UTIs may involve pelvic organ pain in men and require more extensive treatment than uncomplicated cases.

Question 24

Acute kidney failure is a common complication of RHABDOMYOLYSIS secondary to myoglobin, damaging the kidneys, true or false.

Answer 24

True

Question 25

RHABDOMYOLYSIS

Answer 25

Patient taking statins and taking high dose NSAID for muscle pain, extreme exercise and having tea colored urine

Question 26

What are the **three major causes** of **acute tubular necrosis (ATN)**?

Answer 26

* Kidney ischemia * Sepsis * Nephrotoxins ## Footnote Nephrotoxins include substances like vancomycin, aminoglycosides, cisplatin, and radiocontrast media.

Question 27

Postrenal acute kidney injury is often referred to as __________.

Answer 27

Obstructive nephropathy ## Footnote This condition can result from prostatic disease, renal calculi, clots, urethral strictures, neurogenic bladder, or medications causing urinary retention.

Question 28

Name one cause of **postrenal acute kidney injury**.

Answer 28

* Prostatic disease * Renal calculi * Clots * Urethral strictures * Neurogenic bladder * Medications causing urinary retention ## Footnote These factors can obstruct urinary flow, leading to kidney injury.