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GU69
UnitIII
| Question | Answer |
|---|---|
| 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
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