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GU69

UnitIII

QuestionAnswer
Most common pathogen that cause UTI? E. Coli
Causes fever, chills, flank pain; affects renal parenchyma, renal pelvis & Ureters? Upper UTI
NO systemic manifestations; cystitis & urethritis? Lower UTI
Purpose of dialysis? Control volume & Toxins
What do Creatinine labs monitor (0.6-1.3)? Kidney impairment
What do BUN labs monitor (12-20)? Hydration status
Uncomplicated UTI NO need to treat unless ________? Pregnant
Have a ↓ glycoproteins which ↑pH→↑risk for UTI? Menopause
Tx for ↓ glycoproteins 2° to Menopause? Low dose intravaginal Estrogen(↓pH)
Pt in renal failure will be in this pH balance? Metabolic Acidosis
Determines the type of organisms causing infection? Culture & Sensitivity
Used to Tx uncomplicated or initial UTI’s? Sulfamethoxazole(Bactrim); [8oz water/day & NO good for E.Coli infection]
Tx for complicated UTI’s; avoid sunlight, may cause brown urine; pulmonary fibrosis? Nitrofurantoin(Macrodantin) PO x4/day for 7days
Long acting Abx drug taken twice daily? Marcobid
Infection begins in the urethra or bladder & travels up into your kidney? Acute Pyelonephritis
Caused by ↑fluid volume in the kidneys? Hydronephritis
Medication used to buffer and prevent minimize nephrotoxic effects of IV contrast? Mucomyst
Analgesic; Relieves UTI pain; stains urine red-orange; soothes? Pyridium(Phenazopyridine) OTC
Inflammation of tiny filters(glomeruli) in kidneys? Glomerulonephritis
Causes Hematuria and Preteinuria? Glomerulonephritis
Causes edema to face, eyelids, and hands? Hypoalbuminemia
Collect in a bucket on ice to preserve elements of urine; discard first void? 24hr Urine Collection
Is positive with Glomerulonephritis 2° to Acute post streptococcal pyelonephritis? Antistreptolysin-O (ASO) Titer
Caused by a massive protein excretion via urine; clotting factors? Nephrotic Syndrome
Occurs in 40% of nephrotic pts with thrombosis? Pulmonary Emboli
Manifestations of Nephrotic Syndrome? Hypoalbuminemia, Hypocalcemia, Hyperlipidemia.
This causes Loss of clotting factors → Renal Vein Thrombosis? Hypoalbuminemia
What are the main functions of the kidney? Regulate ECF, Excrete waist, BP, Erythropoetin, Vit D, Acid-base.
What is normal GFR and how much filtrate is produced? 125ml/hr & only 1ml/min.
Reabsorption of 80% of electrolytes & water, glucose, AA; secretion of H⁺ & creatinine? Proximal Loop
Reabsorb Na⁺ & ↑ Cl⁻ concentration of filtrate? Loop of Henle
Makes the distal convoluted tubules and collecting ducts permeable to water→ water reabsorption? ADH (posterior Pituitary)
Acts on the distal tubule to cause reabsorption of Na⁺ & H₂O? Aldosterone
Narrow point of the Ureter (most likely to cause an obstruction by stone)? Ureterovesical Junction (UVJ)
What is normal urine output? 1500ml/day
What is maximum bladder capacity? 600-1000ml(Urge @200-250)
24hr urine collection required for this test? Creatinine Clearance
For these procedures check Iodine sensitivity & give cathartic or enema to empty colon? IVP and Renal Angiogram
Visualizes bladder and evaluates vesicoureteral reflux? Cystogram
What are some contraindications for a Renal Biopsy? Bleeding disorders, single kidney, & uncontrolled HTN
What is normal specific gravity of urine? 1.003-1.030 (↑=Dehydration)
Renal inability to concentrate urine; end-stage renal disease? Fixed SG @ 1.010
Are contraindicated for bowel prep because magnesium cannot be excreted by pts. ĉ renal failure? Fleet enemas & Mag Citrate
Waste product produced by muscle breakdown? Creatinine
Normal creatinine clearance values? 70-135 ml/min
A UTI that has spread into the systemic circulation (Medical Emergency)? Urosepsis
Tx based on a health care providers best judgement? Empiric Therapy
A long acting preparation of Nitrofurantoin that can be taken BID? Macrobid
Long term use of this Abx causes Pulmonary Fibrosis & Neuropathies? Nitrofurantoin
Recurrence of obstructive abnormalities that lead to scarring and poorly functioning kidneys? Chronic Pylonephritis
Pain during bladder filling that is relieved by voiding? IC/PBS
Alkalinized the urine and can provide relief from the irritating effects of certain foods? Calcium Phosphorus (Prelief)
The only oral agent approved for Tx of pts with s/s of IC? Pentosan(Elmiron)
Instilled through a sml catheter to desensitize pain receptors in the bladder wall? DMSO
Predisposing factors that can cause glomerulonephritis? SLE, Hep B,C, Systemic Sclerosis, Strep Infection.
Autoimmune disease; circulating antibodies against glomerular and alveolar basement membrane? Goodpasture Syndrome
Removes the circulating anti-GBM antibodies seen with Goodpasture Syndrome? Plamapherisis
Kidney stone disease? Nephrolithiasis
Stones larger than ___ are unlikely to pass through the ureter? 4mm
A procedure used to eliminate calculi from the urinary tract? Lithotripsy
Predisposition with UTI’s, common with Females? Struvite stones (Mag, Ammonium, Phosphate)
Most common types of renal calculi? Calcium Oxalate, Uric Acid, Calcium Phosphate
Is a waste product from purine foods (Protein)? Uric Acid
A narrowing of the lumen of the ureter or urethra? Stricture
Consists of sclerosis of the sml arteries and arterioles of the kidney; ↑ HTN? Nephrosclerosis
The most common life-threatening genetic disease in the world? Polycystic Kidney Disease (PKD)
Worst complication with of Polycystic Kidney Disease? Cerebral Aneurysm
Measures to prevent renal damage from IVP/MRA Angiogram? ↑Fluids, Bicarb, Mucomyst
These stones you Tx with Potassium Citrate to Alkalanize the urine? Ca²⁺ Oxalate, Uric Acid, & Cytine
Take measures to acidify urine with these types of stones? Struvite
Is the total inability to pass urine via micturition; Medical Emergency? Acute Urinary Retention
Dribbling of urine? Overflow Incontinence
Sudden ↑ in intraabdominal pressure causes involuntary passage of urine? Stress Incontinence
Caused by uncontrolled contraction or overactivity of detrusor muscle? Urge Incontinence
↓ overactive bladder contractions in urge incontinence? Oxybutynin(Ditropan)[Anticholinergic], Tolterodine(Detrol)
↓ urethral sphincter resistance to urinary outflow for overflow incontinence? Cardura, Flomax, Hytrin [a-Adrenergic Antagonist]
Is used to manage stress, urge or mixed UI? Pelvic floor muscle training (Kegel Exercises)
Ureters are implanted into part of ileum or colon that has been resected from intestinal tract? Ileal Conduit
Ureters are excised from bladder and brought through abd. Wall? Cutaneous Ureterostomy
Catheter is inserted into pelvis of kidney? Nephrostomy
What is normal PVR? 50-75mL
Gradual onset, caused mainly by DM neuropathy, GFR <60 for >3months, Dialysis, death by CVD? Chronic Kidney Disease
A rapid loss of kidney function demonstrated by a ↑ in serum creatinine and/or ↓ in urinary output? Acute Kidney Injury
An accumulation of nitrogenous waste products (uria nitrogen, creatinine) in the blood? Azotemia
The most common cause of intrarenal AKI? Acute Tubular Necrosis (ATN) from ischemia.
What does RIFLE stand for? Risk, Injury, Loss, ESDRF
Phases of progression of AKI? Oliguric, Diuretic, Recovery
A ↓ in urine output <400ml/day? Oliguria
In this the kidneys have recovered their ability to excrete wast, but no to concentrate the urine? Diuretic Phase
Is caused by a Hx of BPH, stones, CA of the bladder or prostate? Postrenal AKI
Rule for calculating fluid restriction with Renal pts? 600ml(insensible)+output of last 24hrs.
Therapies to ↓ K⁺ levels? Insulin, Bicarb, Kayexalate, Ca²⁺ Gluconate, Diet restriction(40mEq/day)
↑ the threshold at which dysrhythmias will occur, serving to temporarily stabalize the myocardium? Ca²⁺ Gluconate
1kg= to how much fluid? 1000ml
Severe ↓ GFR 15-29, preparation for KRT? Stage 4 CKD
Kidney failure GFR <15 (or dialysis), kidney replacement? Stage 5 CKD (ESRF)
Kidney damage with ↓ GFR <60 for longer than 3months? Chronic Kidney Disease
Often occurs with a GFR <10? Uremia
The leading cause of CKD? DM followed by HTN
These drugs bind phosphate in the bowel and are excreted in the stool? Ca²⁺ Acetate(PhosLo), and Ca²⁺ Carbonate(Caltrate)
During _______ protein intake must be ↑ enough to compensate for the losses so that nitrogen balance is maintained? Peritoneal Dialysis
One of the most important diet restrictions for pts on HD? Potassium Restriction
Weight gain greater than ______ should be reported? 4lbs(2kg)
Measures for conservative therapy of CKD? ↓ Fluid intake, ↓ Protein, ↑ Carbs
The 3 phases of PD cycle? Inflow, Dwell, Drain= 1 Exchange
The most frequent STD in the US? Chlamydial
Tx for Gonorrhea? Suprax and Rocephin
Avoid sunlight, antacids, iron products, or dairy products (Abx)? Doxycycline (Vibramycin)
Is caused by T. Pallidum? Syphilis
What are the 4 stages of Syphilis? Primary, Secondary, Latent, Late(Tertiary)
These tests are suitable for confirming the diagnosis of Syphilis? FTA-Abs and TP-PA
Tx of choice for all stages of Syphilis? Penicillin G (Bacillin)
Common diagnostic tests for Chlamydia? NAAT, EIA, DFA
Most frequent infects the genital tract and the perineum (i.e. Locations below the waist)? HSV-2
Three antiviral agents available for Tx of HSV? Acyclovir(Zovirax), Valacyclovir(Valtrex), Famciclovir(Famvir).
Created by: BOjangles1006