Nephrology & Urology Exam Review: Renal and Urinary Disorders for Physician Assistants

Strengthen your exam readiness with this podcast-style summary of key nephrology and urology concepts from A Comprehensive Review for the Certification and Recertification Examinations for Physician Assistants by Claire Babcock O'Connell and Thea Cogan-Drew. This high-yield review covers the kidneys, urinary tract, and male reproductive system—diagnostics, management, and clinical pearls—tailored for physician assistants preparing for certification and clinical excellence.

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Renal Disorders

• Acute Kidney Injury (AKI): Rapid decline in renal function; classified by RIFLE and AKIN criteria. Causes include prerenal (dehydration), intrinsic renal (glomerulonephritis), and postrenal (obstruction). Management: treat the underlying cause and provide supportive care.
• Chronic Kidney Disease (CKD): GFR <60 mL/min/1.73 m² for more than three months. Common causes: diabetes, hypertension, glomerulonephritis. Managed by slowing progression, controlling complications, and preparing for dialysis or transplant.
• Glomerular Disorders:
  • Glomerulonephritis: Hematuria, proteinuria, edema.
  • Nephrotic Syndrome: Massive proteinuria, hypoalbuminemia, and edema.

Urinary Tract Disorders

• Urinary Tract Infection (UTI):
  • Cystitis: Dysuria, urgency, suprapubic pain.
  • Pyelonephritis: Fever, flank pain, systemic illness. Treat with antibiotics and supportive care.
• Incontinence: Types include stress, urge, overflow, and functional. Treatment ranges from behavioral therapy to medications and surgery.

Male Reproductive Disorders

• Prostatitis: Acute and chronic; pelvic pain, dysuria, fever. Diagnosis: clinical exam, urine studies. Management includes antibiotics and supportive care.
• Benign Prostatic Hyperplasia (BPH): Non-cancerous prostate enlargement causing urinary hesitancy, weak stream, nocturia. Treated with alpha-blockers, 5-alpha-reductase inhibitors, and sometimes surgery.

Neoplasms of the Urinary Tract

• Prostate Cancer: Common in older men, often asymptomatic early. Diagnosed with PSA testing and biopsy.
• Bladder Cancer: Presents with painless hematuria. Managed by surgical resection, chemotherapy, or radiation.

Glossary of Key Terms

• Azotemia: Elevated blood urea and creatinine, signaling kidney dysfunction.
• Proteinuria: Excessive protein in urine, a marker of renal damage.
• Lithotripsy: Shock wave procedure to break down kidney stones.
• BPH: Benign Prostatic Hyperplasia, frequent in aging men.
• PSA: Prostate-Specific Antigen, used in prostate cancer screening.

Conclusion: Exam Strategies for Nephrology & Urology

Success on the physician assistant exam requires mastery of renal and urinary disorders—from AKI and CKD to UTIs, prostate diseases, and urinary tract cancers. Focus on diagnostic criteria, first-line treatments, and distinguishing clinical features for rapid recall and safe practice.

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