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