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Phase 3a > General > Flashcards

General Flashcards

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1
Q

How many days should uncomplicated UTI be treated for ?

A

3

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2
Q

How many days should a complicated UTi be treated for

A

7

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3
Q

What medication is used to tx pyleonephritis

A

-IV coamoxiclav +/- gent

+ fluid resus +/- drainage of obstructed kidney

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4
Q

List which Pt are considered to have complicated UTIs

A 
Male 
Pregnant
Children
Catheterised 
Recurrent / persistent 
Urosepsis
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5
Q

What two factors are contraindications to nitrofuratoin in uti tx

A

Third trimester

Poor renal function

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6
Q

What are the causes of pyleonephritis

A

Ascending - catheter / intercourse
Heamatogenous
Lymphatic

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7
Q

What microorganisms can be responsible for UTIs

A

Ecoli (common - coliform , gram -ve bacillus , pink on McConkey agar)

Klebsiella - catheter aq

Proteus - associated with renal stones

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8
Q

Signs and symps of pyleonephritis

A

Lion pain
Pyuria
Pyrexic
RA tenderness

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9
Q

Would you treat assymptomatic 65+

A

No

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10
Q

Complications of catheters

A

Chronic inflam
UTIs
Renal stones

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11
Q

Investigations for pyleonephritis

A

Bloods + culture
MSU
Abdo exam -RA tenderness , exclude tubular, ovarian, appendix
USS

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12
Q

When should urolithesis be surgically removed?

A

Coexisting obstruction

Sepsis

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13
Q

What is the management of urolithesis confirmed by CT

A

Nsaids
Antiemetics
Hydration

(Alpha blocker ie, tamsulosin)

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14
Q

Differentials for renal colic

A 
Bilary colic
Chloecystitis
Peritonitis
Appendicitis 
Endometriosis
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15
Q

Investigations for renal colic

A

CT
Urinalysis

Bloods- FBC, U&E, Cr
Pregnancy test

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16
Q

Surgical treatment for urolithesis

A

Retrograde stent
Percutaneous nephrostomy

Shockwave lithrotripsy

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17
Q

Causes of heamaturea

A 
UTI
Acute pyleonephritis
Bladder cancer
Prostate cancer
BPH
Renal colic 
Mensuration
Recent instrumentation of the urinary tract
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18
Q

Two factors that progression of CKD to ESRF relies on

A

Bp control

Underlying nephropathy

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19
Q

Causes of CKD

A 
Primary Glomerulonephritis
Atherosclerotic vascular disease
PKD
Progression from AKI
SLE
20% idiopathic
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20
Q

RFs for CKD

A 
Female
Age
Hypertension 
Diabetes 
Smoking 
AKI
Chronic use of NSAIDs
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21
Q

What does GFR have to be below for CKD

A

<60ml/min (G3)

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22
Q

Complications of CKD and why

A

Anaemia (herceptin is not excreted so Fe cannot be absorbed from duo)

Heart failure due to fluid overload

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23
Q

5 kidney functions

Study These Flashcards
A 
Nitrogenous waste excretion 
Fluid electrolytes balance
Vitamin D metabolism 
RBC production (erythropoietin synth)
Acid base balance (metabolic compensation)
24
Q

4 nephrotixic drugs

Study These Flashcards
A

Metformin
NSAIDs
Acei
Diuretics

25
Treatment for stress incontinence
Pelvic floor exercises Colposuspension/ sling surgery
26
Treatment for overflow incontinence
Tamsulosin | Intermittent catheterisation
27
Tx for OAB/ urge incontinence
Bladder training No caffeine or alcohol Distraction techniques Antimuscarinics - oxybutanin / tolterodine Botox injections
28
Tx of nocturia
Desmopressin
29
Two components of urodynamics
Flow rate+ residual volume | freq volume chart
30
2 causes of low flow rate
Detrusor under-activity | Obstruction
31
Parasympathetic innervation of voiding - nerve roots - function
S2-s4 | Detrusor contraction.
32
Sympathetic innervation of voiding - nerve roots - function
T10-L2 | Contraction of sphincter, inhibits detrusor contraction
33
Complications of BPE
``` Stones Infections Incontinence Retention Symptomatic voiding ```
34
Two components of BPH
Static - glandular and Stromal hyperplasia and-hypertrophy Dynamic - sm contraction of prostrate
35
Incontinence investigations
Bloods- PSA, renal func PR, abdo, genital exam Urodynamics MSU BLADDER SCAN TRUSS / flexible cystoscopy
36
What is the scoring system used for BPH
IPSS | International prostate scoring system
37
What is the normal post void residual volume
<12mls
38
What might you see on USS with a post mic residual volume of >250mls?
Hydronephresis- dilated ureters
39
What are the treatments for BPH and their SE/ complications
Finesteride tackles the static component - 5alpha reductase inhibitor - SE ED Tamsulosin tackles the dynamic part - alpha adrenergic antagonist -SE postural hypotension, retrograde ejac TURP- infection, haemorrhage, clots, ED
40
What is the surgical criteria forTURP?
RUSHES ``` Retention UTI Stones Heamaturia Elevated Cr Symptoms worsening ```
41
What is chronic retention+ low pressure a sign of
Detrusor failure
42
Pharma Treatment for HfrEF
Class 1- ACEI +Beta blocker Class 2- above / ARB+ aldosterone antagonist Class 3 - above + isosorbide dinitrate Class 4- diuretic
43
None pharma tx of HFrEF
Refer to advanced HF programs | Refer for possible pacemaker
44
Tx of HFpEF
Blood pressure control | Symptom management I.e. diuretics for breathlessness
45
Treatment algorithm for hypertension
``` ACD <55: A A+Cor D A+C+D A+C+D+ MCRA(spirolactone) >55: C or D A2 / A+ C A+C+D ```
46
Secondary causes of hypertension
Coarctation of the aorta OCP Low K+ (underlying Cohns) Vascular / congenital abnormalities Renal artery stenosis - increased serum Cr Thyroid disorder Aldosteronism (sign= hypocalemia) Iatrogenic drugs- sertoids, immunoSs, TCAs,
47
Lifestyle changes in hypertension
``` Low Na diet Reduce alcohol Stop smoking. Exercise Wt reduction ```
48
What is considered stage 2 hypertension
160-179/ 100-109
49
What stages of Hypertension do you treat
Stage 2+ or stage 1 if diabetic/ CVA / Hf/ renal probs
50
What symptom+sign in addition to Hx of hypertension requires admission
Headache | Papillodema
51
Hypertension investigations
``` ABPM ECG Urine Dip - ACR , protein/ blood fundoscopy Bloods= hba1c, LFTs , Cr U&E (end organ damage) ```
52
Name two thiazide diuretics
Bendroflumethiazide. | I dap Amie’s
53
SE of ACEi
Dry cough | Detrimental on Renal function, check this before starting in elderly
54
SE of amlodipine
ankle swelling
55
SE of diuretics
ED! Thiazide diuretics can cause hyponatremia in the elderly

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