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Genitourinary
ClinMed3
| Question | Answer |
|---|---|
| What are the 3 mechanisms that all work together in concert to minimize any changes in blood ph? | 1.Ec and Ic buffering. 2. Adjustment in blood pCO2 by alteration in the ventilation rate of the lungs. 3.Adjustment in renal acid excretion. ...*also restoration of the blood pH to its normal value requires correction of the underlying process. |
| What is a buffer? | A buffer prevents any change in the PH when H is removed. |
| What is a major and minor extracellular buffer and its pK? | Bicarb is major pk-6.1 phoshphat is minor pk 6.8 |
| What are some intracellular buffers? | proteins like hgb, deoxyhgb, organic phosphates liek amp, adp, atp |
| What are 3 primary systems in the body that regulate the H in body fluids? | 1. Chemical acid/base buffer systems of body fluids by combining w/SA/B to convert to weak. 2. 2nd line is respiratory center acts in few minutes to eliminate CO2. 3. Kidneys acts in hours to days . this is the most powerful which includes bbs, pbs, abs |
| What are some ways to gain H? | generation of h ions from co2 in tissue capillaries. loss of bicarb in urine, diarrhea, production of non-volatile acids from metabolism of protein and organic sourcdes. |
| What is the Henderson Haseelbach equation? | To calculate pH in a solution of a WA/WB. Its used to determine which buffer can be used in a solution at a specific pH. |
| The phosphate buffer is a minor buffer but the most important ________ | urinary buffer |
| What are the 3 fundamental processes that regulate the H in ECF? | 1.Reabsorption of filtered HCO3. 2. Production of new HCO3 3. Secretion of H in tubular lumen. |
| What is the anion gap? | Refers to concentration of unmeasured anions in the body. ie. proteins. po4.so4.organic acids |
| Metabolic acidosis associated with increased AG and Normal Cl | MUDPILES methanol, uremia, diabetic ketoacidosis, paraldehyde,phenformin, iron tablets or inh, lactic acidosis, ethylene glycol, salicylates |
| metabolic acidosis associated with normal AG but Increased CL | CARD carbonic anhydrase,addisons disease, renal tubular acidosis, diarrhea |
| 80% of UTIs are caused by | E. Coli |
| UTI associated with renal calculi | Klebsiella, Proteus, Pseudomonas |
| UTI associated with young females | Staph. Saprophyticus |
| UTI associated with instrumentation | St. Aureus, enterococcus |
| cystitis | Sudden onset, suprapubic tenderness, urethral discharge think std ,treat uncomplicated w/bactrim x3days,cipro x3d, fluids-cranberry-water, sitz bath |
| why cant you give a quinolone to children. <18yrs old | Children less than 18 years of age have a higher chance of getting bone, joint, or tendon (musculoskeletal) problems such as pain or swelling while taking CIPRo |
| Urethritis | Hallmark is internal dysuria, caused by STD-hsv, gonorrhea, chlmaydia, |
| Pathogen for Acute Pyelonephritis | EPP-e coli, proteus, pseudo |
| Hallmark for Acute pyelonepritis | CVA tenderness |
| Pathognomonic for APN | WBC cast |
| Treatment for uncomoplicated APN | Oral quinolone 7-14days . Initial dose IV Cefrtrioxine followed by oral Bractrim for 14 days. |
| Treatment for complicated APN | Requires hospitalization. Parental quinolone, ceftriaoxne, ampicillin/gentamicin |
| Most common pathogen for acute bacterial prostatitis | e coli |
| prostate describition in abp | swollen tender boggy |
| clinical manifestations of abp | fever, chills, low back pain or perineal pain, dysuria |
| Most IMPORTANT THING TO REMEMBER WITH ACUTE BACTERIAL PROSTATITIS | DONT MASSAGE THE PROSTATE YOU CAN CAUSE THEM TO BE SEPTIC |
| Treatment for ABP | Admit to hospital, Initiate IV flouroquinolone, follow with oral ofloxacin 400mg bidx14 days ....if gonorrhea/chlymydia present give them ceftriaxone 250mg IM them doxycycline 100mg bids 14days |
| Chronic prostatitis | occurs in middle age men, history of bacteriuris, chronic pelvic pain, prostalgia |
| Common pathogens for chronic prostatitis | EPP e coli, proteus, psedomonas |
| Test for Diagnosing chronic prostatitis | 4 glass localization test |
| Treatment for chronic prostatits | urology referral/ciprofloxacin xweeks, ofloxacin for 6 weeks |
| prostate description for chronic prostatis | normal prostate, large and smooth |
| epididymitis pathogen for <35years and >35 | <35 years -chlamydia/gonorrhea >35 years-e coli |
| clinical manifestations of epididymitis | scrotal discomfort, fever, shills, warm scrotal mass, swollen tender epididymis |
| what 2 signs/reflex are positive with epididymitis | Phrens' sign -pain relieved with elevatin of scrotum or when supine. Cremasteric reflex is present on the ipsilateral side. |
| treatment for epididymitis | gon-ceftriaxone 250mg IM chlamydia-doxycycline 10mg bid x 10days e coli-ciprofloxacin 500mg bid for 10 days |
| Orchitis is a secondary manifestation of ____ | mumps from paramyxovirus |
| treatment for orchitis | mumps-symptomatic bacteria- same regimen as epididymitis |
| name the 3 major syndromes in glomerular disease | nephritic syndrome, nephrotic disease, asymptomatic renal disease |
| what are some clinical manifestations of nephritic syndrome | proteinuria, hematuria,, pyuria, hypertension, fluid retention, rise in serum creat |
| name all of the nephritic syndromes | RPGN, crescenteric gn, post strep, bergers, post strep, endocarditis related, lupus |
| whats special about the rpgn | creat rises quickly in few days |
| crescenteri gn characteristic | a characteristic glomerular lesion. |
| endocarditis associated glomerulonephritis | typically a complication of subacute bacterial endocarditis, in pts. who remain untreated for long time with neg. bloood cculture patients wwho have right sided endocarditis. |
| lupus nephritis | most severe in african american female adolescents, it results from deposition of circulating immune complexes--activate complement cascade--complement mediated damge--leukocye infiltration--release of cytokines. |
| most common symptom for lupus nephritis | proteinuria, hematuria, hypertension, varying degreee of rheumatic fever. |
| which nephritic syndrome has a depressed ch50, decreased c3, and normal c4 | post streptococcal glomerulonephritis |
| what is the most common form of glomerulonephritis worldwide with male predominance | iga nephropathy/berger disease |
| what are the 2 presentations of iga nephropathy | 1. recurrent episodes of macroscopic hematuria during or immediatedly following an upper respiratory infection in children. 2. asymptomatic microscopi hematuria often in adults. |
| What is used to treat alkalosis? | NH4CL is used to treat alkalosis. |
| Chronic kidney disease is marked by a GFR of what? | <60 |
| over 70% of cases of renal disease are do to ___and ___ | diabetes mellitus and hypertension |
Created by:
emorgan03
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