Genitourinaria dan Reproduksi
Core concepts
Cover renal medicine and reproductive medicine. Renal: acute kidney injury staging by creatinine and urine output, prerenal versus intrinsic versus postrenal causes, urinalysis interpretation (casts, protein, blood), nephrotic versus nephritic syndromes, and chronic kidney disease complications such as anaemia and hyperkalaemia. Urology: urinary tract infection and pyelonephritis, renal colic, benign prostatic hyperplasia, and haematuria evaluation. Reproductive: menstrual disorders, polycystic ovary syndrome, infertility basics, sexually transmitted infections, and prostate disease including cancer screening debates.
Traps
Examiners test fluid responsiveness in prerenal AKI versus the danger of fluid overload in intrinsic disease. Red cell casts indicate glomerulonephritis, not a simple urinary infection. Do not treat asymptomatic bacteriuria in most patients - but do in pregnancy. In nephrotic syndrome, complications include thrombosis and infection, not just oedema. Remember that a raised PSA is not diagnostic of cancer.
Worked example
A 30-year-old woman has fever, flank pain, and dysuria with nitrites and leukocytes on dipstick. Diagnosis: acute pyelonephritis. Rule of thumb: uncomplicated cystitis can be treated orally as an outpatient; pyelonephritis with vomiting or sepsis needs intravenous antibiotics and admission, and imaging if symptoms do not improve within 48–72 hours to exclude obstruction or abscess.