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Pharmacology > Renal and Reproductive > Flashcards

Renal and Reproductive Flashcards

1
Q

What is urinary tract infection

A

It is an infection or inflammation of urinary epithelium usually caused by bacteria from gut flora

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2
Q

Where specifically do UTIs occur?

A 
Urthera (urethritis)
Prostate
Bladder (cystitis)
Ureter
Kidney (pyelonephritis)
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3
Q

What factors are combined to protect against UTIS?

A

Most are washed out of urethra during micturition
Low pH in our urine
Unide directional flow

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4
Q

Why are men less at risk for developing a UTI?

A

They have a long urethra and the presence of prostatic secretions decrease the risk of infection in men.

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5
Q

Who is at risk for UTI?

A 
Prepubertal children
Sexually active and pregnant women
Estrogen deficient postmenopausal women
Diabetics
Premature newborns
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6
Q

What is the most common infecting microorganisms in the uropathic way?

A

E.coli

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7
Q

What other microorganisms cause UTI

A 
Staphylococcus saprophyticus
Klebsiella
Proteus
Pseudomonas
STIs
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8
Q

What are the properties of urinary tract infections

A

They are more virulent
They have the ability to attach uroepethelial cells
They have the ability to attach to latex catheters
They express toxins and biofilms

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9
Q

What are the properties of urinary tract infections

A

They are more virulent and have the ability to attach uropethelial cells, latex catheters, express toxins and biofilms

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10
Q

What are the two types of clinical manifestations of urinary tract infections

A

Cystitis and Pyelonephritis

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11
Q

What is cystitis

A

inflammation of the bladder

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12
Q

What symptoms do we see with cystitis infections?

A 
Frequency
Urgency
Dysuria
Pain
Hematuria
Cloudy urine
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13
Q

What is pyelonephritis infection?

A

infection in the kidney

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14
Q

What symptoms do we see with pyelonephritis infections?

A 
Cystitis +
Fever
chills
nausea
vomiting
anorexia 
CVA tenderness
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15
Q

Name two types of atypical populations with UTIs

A

Pediatrics

Older adults

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16
Q

What are some of the symptoms pediatric patients present?

A 
Fever
Irritable (every time they wet a diaper they cry)
Poor feeder
ill appearing
Diaper rashes
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17
Q

What are some of the symptoms pediatric patients present?

A 
Mental status (they are confused, anxious, lethargic) 
They don’t have the capacity to have a fever
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18
Q

How do you diagnose patients with UTI?

A

History-physical
Urine-analysis and culture
Imaging (reflux and repetitive)

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19
Q

Describe what is means to have a uncomplicated UTI?

A

Patients who have UTIs that are mild and without complications are termed uncomplicated UTIs

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20
Q

Describe what is means to have a complicated UTI?

A

Patients who develop abnormality in urinary system or health problem that compromises their defenses

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21
Q

Give examples of complicated UTIs

A

HIV patients

renal transplant, spinal cord injury

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22
Q

What is pelvic inflammatory disease (PID)?

A

Infection of oviducts and ovaries and adjacent reproductive organs

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23
Q

What are examples of infections that occur in each of these organs?

A

Cervix (cervicitis)
Uterus (endometritis)
Oviducts (salpingitis)
Ovaries (oophoritis)

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24
Q

Name the two stages of pelvic inflammatory disease

A
  1. Vaginal/cervical infection

2. Migration of microorganisms to upper genital tract

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25
Q

What are the two primary causes of pelvic inflammation disease?

A

Gonorrhea and chlamydia

26
Q

What are two big risk factors associated with pelvic inflammation disease?

A
  1. Altered or destroyed normal cervical mucous

2. Bloodstream or drainage from another location

27
Q

what are the other risk factors?

A 
Douching
Antibiotics
Multiple sexual partners
Menstruation 
History of STD
28
Q

What are the clinical manifestations of PID

A 
Abdominal tenderness and pain
Regular bleeding that isn't normal menstrual cycle
Pain with intercourse
Dysuria
Pain on examination
Temperature, increase WBC
29
Q

What are the diagnosis for PID?

A

Land pelvic exam
Biopsy
MRI
Laparoscopy

30
Q

Name a few treatments for PID

A 
Antibiotics (longer)
Comfort measures (1-2weeks) 
Treat partners
Avoid intercourse
31
Q

What are the longer complications of PID?

A

Risk of chronic pelvic pain
Infertility issues
Ectopic pregnancy
Abscess

32
Q

What is the formula for blood pressure?

A

CO x SVR = bp

33
Q

What is the formula for cardiac output?

A

Heart rate x stroke volume

34
Q

Explain how blood pressures is regulated on short term bases

A

accommodates behavioral, emotional and physiologic changes

Mediated by sympathetic

Neurotransmitter includes Epi and Norepi

35
Q

Explain how blood pressures is regulated on long term bases

A

Neural, hormonal, renal

Connected with fluid volume homeostasis

36
Q

Describe the renin-angio aldosterone system?

A
  1. Stimuli: decrease blood pressure
  2. kidneys release “renin” into bloodstream
  3. Renin converts “angiotensinogen” into angiotensin 1 in the liver
  4. Lungs secrete ACE
  5. ACE converts Angiotensin 1 into “angiotensin 2” in lungs
  6. Causes vasoconstriction and aldosterone release
  7. Aldosterone causes “sodium” and “water” retention
  8. increases blood volume
  9. increases blood pressure
37
Q

What is hypertension?

A

increased in arterial blood pressure

38
Q

What are some facts regarding blood pressure?

A

The most primary diagnosis in the US and much of it is left undiagnosed

39
Q

What is primary hypertension

A

it is the result of complicated interaction of genetics and environment mediated

40
Q

What is secondary hypertension

A

caused by an underlying disorder such as renal disease

41
Q

Name risk factors associated with primary hypertension?

A 
Family history
Smoking
Obesity 
Lack of physical activity
Unhealthy diet
Increases in age 
Male
42
Q

Name risk factors in childhood and adolescent years that lead to hypertension?

A 
Maternal smoking
Pregnancy induced hypertension
low birth rate
low socioeconomic level of mother
less intake of calcium
43
Q

How do we diagnose hypertension

A

Take blood pressure
Labs can be draw
If you are diabetic, you are at risk

44
Q

Name treatments for hypertension?

A

Lifestyle modifications

45
Q

What is the most beneficial modification for hyperension

A

losing weight!!

Every 10kg a patient looses, blood pressure decreases 5 to 10mm hg

46
Q

Hypertension is known as what?

A

the “silent killer”

47
Q

What are the four levels of hypertension disorders in pregnancy

A

Preeclampsia-eclampsia
Chronic HTN
Chronic HTN w/superimposal preeclampsia
Gestational hypertension

48
Q

What are the risk factors associated with hypertensive disorders?

A 
Maternal age
First pregnancy
In vitro fertilization
Morbid obesity
Multifetal gestation
Diabetes
Rheumatoid arthritis
Lupus
49
Q

What maternal age group specifically is at a high risk?

A

`younger than 19 and older than 40

50
Q

For hypertension, it is important to monitor what organs?

A

eyes
brain
kidneys
heart and arteries

51
Q

What is meant by chronic HTN in pregnant women?

A

this means women who already had HTN before pregnancy

52
Q

What is meant by Gestational HTN in pregnant women?

A

A mother after 20 weeks of pregnancy and develops HTN and no other signs.

53
Q

What is meant by chronic HTN w/preeclampsia in pregnant women?

A

They have chronic HTN AND preeclampsia

54
Q

Name two big mechanisms behind? preeclampsia

A

Abnormal placental implantation

Endothelial function

55
Q

What is going on with abnormal placental implantation

A

the arteries stay constricted, not enough blood is getting into the placenta, therefore fetus will not grow

56
Q

What is going on with endothelial dysfunction

A

mom is producing pro inflammatory protein and circulating throughout body and causing vasoconstriction in several body systems

57
Q

Are the results of endothelial dysfunction

A

Reduces blood flow to kidneys, to liver, to fetus, eyes, brain

58
Q

What are the clinical manifestations of preeclampsia

A

Proteinuria
Thrombocytopenia
Impaired liver function
Renal insufficiency (elevated serum enzymes)
Pulmonary edema
New onset cerebral or visual disturbances

59
Q

What is the biggest complaint in impaired liver function?

A

Right upper quadrant or epigastric pain

60
Q

What is the treatment for preeclampsia?

A

If it is severe DELIVERY

if it is mild bed rest and fetal growth monitoring

Pharmacology (7 decks)

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