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Urinary > Session 10- Diuretics and UTI > Flashcards

Session 10- Diuretics and UTI Flashcards

1
Q

what are diuretics

A

act on kidney to increase the producton of urine and eliminate water from the body

  • reduce plasma volume and cardiac output
  • reduce blood pressure
  • reduce oedema
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2
Q

where do carbonic anhydrase inhibitors act

A

PCT

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3
Q

Where do osmotic diuretics act

A

pct

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4
Q

where do loop diuretics act

A

ascending loop of henle

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5
Q

where do thiazide and thiazide-like diuretics act

A

DCT

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6
Q

where do potassium sparing diuretics act

A

collecting duct

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7
Q

what is an example of an osmotic diuretic and hiw di they work

A

mannitol

increase water excretion with relatively less effect on Na+ (Water diuresis)

acts as an osmole draws water towards it. As it is filtered from glomerulus to the PCT draws water in so less is rebasorbed

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8
Q

what is the downside of mannitol

A

expand ECF, decrease blood viscosity and inhibit renin release and increase renal blood flow

  • headache
  • nausea
  • vomiting
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9
Q

when would you use mannitol

A

acute renal failure due to shock or trauma
acute drug poisoning
decrease intracranial and intraocular pressure

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10
Q

what transporter do loop diretics inhibit

A

Na/K/2Cl- co transporter

decreased sodium reabsorbed
less chlorine is reabsorbed also tubule is less positive leading to less Mg2+ and Ca2+ being reabsorbed

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11
Q

what is the most potent diretuc

A

loop

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12
Q

when would you use loop diretuc

A

emergency
hyperkalaemia
hypercalcaemia
pulmonary oedema

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13
Q

side effects of loop diuretics

A 
hypovolemia
hyponatraemia
hypokalemia
hypomagneisaemia
metabolic alkalosis
postural hypotension
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14
Q

what diuretics are most liley to prescribed long term

A

thiazixe and thiazide like diuretics

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15
Q

how to potassium sparing and aldosterone antagonists act

A

increase urinary Na+ excretion
decrease urinary K+ excretion
decrease H+ excretion - can develop metabolic acidosis

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16
Q

example of postassium sparing

A

amiloride act on collecting duct and distal DCT

16
Q

example of aldosterone antaginists

A

spironlactone

17
Q

when would you use a potassium sparing and aldosterone antagonist

A 
secondary hyperaldoteronism 
congestive heart failure
cirrhosis
nephrotic syndrome
hypertensioon
18
Q

pathophysiology of cystitis and pylenephritis

A

ascending colonisation of bacteria from urethra
bladder- cystitis
kidney- pyelonephritis

19
Q

risk factors of UTI

A 
female- short urethra
neurological conditions affecting bladder emptying 
pregnancy
abnormal renal tract
impaired host disease
20
Q

causative agent of UTI

A

escherichia coli most common

21
Q

what are the infective agents of e coli

A 
flagellar
pili
capsular polysaccharide
haemolysin
toxins
22
Q

how does cystitis present- lower UTI

A 
dysuria
cloudy urine
nocturia
frequency
urgency
suprapubic tenderness
pyrexia
23
Q

how does pyelonephritis present (upper UTI)

A 
high fever
loin pain
loin tenderness
nausea
vomiting
24
Q

What is an uncomolicated UTI

A

defined as infection by a usual organism in a patient with a normal urinary tract and normal urinary function

25
Q

what is an complicated UTI

A

> 1 factors that predispose to persistent infection, recurrent infection or treatment failure

  • abnormal urinary tract
  • virulent organism
  • impaired host defence
  • impaired renal function
  • suspected pyelonephritis
26
Q

how do you investigate uncomplicated UTI

A

if patient is non-pregnant and healthy no need for urine sample

27
Q

how do you investiagate complicated UTI

A

mid-stream urine
clean catch in children

culture within 4 hours of collection

28
Q

what does a urine sample positive for LE suggest

A

prescence of staph saprophyticus

29
Q

how do you treat UTI

A 
increase fluid intake 
regular analgesia
address underlying disorders 
antibiotics- trimethoprim 
-3 day course for uncomplicated UTI 
-5-7 day course for complicated lower UTI
30
Q

How can we treat cystitis

A

nitrofurantoin
trimethoprim
pivmecillinam
fosfomycin

31
Q

treatment of pyelonephritis/ septicemia

A

use agent with systemic activity

Co-amoxiclav

Gentamicin

32
Q

what are loop diuretics used to treat

A

severe oedema
hyperkalaemia
acute renal failure
hypercalcaemia

33
Q

what is the second most common cause of community acquired UTI

A

S. saprophyticus

Urinary (18 decks)

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