Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Pharmacology > Q5 - Renal/STI/UTI > Flashcards

Q5 - Renal/STI/UTI Flashcards

(67 cards)

Start Studying
1
Q

Complicated vs uncomplicated

A

Complicated = structural/fxnl abnormalities and involve bladder and/or kidneys.
Fever >99.9, CVA tenderness, pelvic or perineal px in men.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

UTI in male patients and older adults are considered ________

A

Complicated.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

______ most common pathway for UTI
Hematogenous?

A

Ascending up urethra
Coming from outside the bladder (S. Aureus - immunocompromised)
Lymphatic - surrounding systems (bowel infx, retroperitoneal abcess).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Asymptomatic Bacteriuria (organism >=10^5) screening guidelines?

A

Screen pregnant females
Endourological procedures.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Majority of uncomplicated UTIs caused by _______.
___ Nitrites.
Complicated UTI organisms?_____

A

Enterobacterales.
E.coli = 75-95%
Klebsiela
Staph saprophyticus.

Positive. NitrATES usually exist in urine, but some Gram Neg bacteria convert nitrATES into NitrITES.

E.Coli, Klebsiela, Pseudomonas A., enterococcus, Staph aureus.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

How is estrogen used to treat UTIs?

A

Post-menopausal women have fewer UTIs than those who are not on therapy.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What factors would increase your risk for MDRO UTI?

A

Past 3 mo:
Any MDRO urinary isolate
Inpatient stay
Broad spectrum anti microbial
Travel to areas with high MDRO rates.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Male UTIs have a _______ treatment course than women

A

Longer.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Complicated UTI - start with 1 IV dose and then 7-10am PO dose.

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

If your patient has an MDRO complicated UTI and is unable to take a FQ, what is a consideration?

A

May need to admit for IV abx

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Critically ill complicated UTI therapy?

A

Meropenem, Imipenem AND Vanc.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Urinary Catheters should be exchanged in all patients who have had one in place for ________ and discontinuation is not an option.

A

14days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Acute vs chronic prostatitis

A

Acute 10-14 day course and BPH agents (tamulosin/Alfuzosin)

Chronic 4-12wks + BPH agents.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Nitrofurantoin - MOA, SE, Clinical considerations?

A

Protein synth inhibitors
N/v, brown urine, rash, liver Tox, neuropathy.
Not for CrCL<30ml/min
Can cause hemolytic anemia in pts with G6PD deficiency.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Fosfomycin - MOA, SE, Clinical considerations?

A

Cell wall inhibit.
GPos and GNeg
N/V/D, HypoK, dizziness
DI: Metoclopramide - low UOP
Works against ESBL-producing or carbepenem-resistant enterobactericeae.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

FQ Levoflox and Ciproflox - MOA, SE, Clinical considerations?

A

DNA gyrase inhibitors -
GI, long QT, Cdiff, CNS, AAA rupture, hypo/hyperglycemia, liver Tox, tendon rupture, neuropathies.
Renal dose adjust
DI: antacids, iron salts, zinc, other meds that prolong QT
Near 100% bioavailability. Exacerbate muscle weakness in MG (Aminoglycosides do too).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Beta-lactams - MOA, SE, Clinical considerations?

A

Cell wall synth inhibit
D, rash, HA, sz
Renal dose adjustment
DI - allopurinol =rash
Amox/Clav = most common drug-induced cholestatic liver injury (self-resolution)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Cephalosporins - MOA, SE, Clinical considerations?

A

Ceftriaxone = 3rd gen.
Cell-wall inhibit
N/v/d, rash, black tarry stools, sz
DI - PPIs, antacids and H2RA (abx failure)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Carbapenems MOA, SE, Clinical considerations?

A

Inhibit cell wall synth.
N./V/D, HA, rash, SEIZURES, Cdiff.
Renal adjust
DI: Valproic acid - decreased VA concentration.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Groups who are at highest risk for STI

A

15-24yo
Gay and bisexual men
Pregnant people
Racial and ethnic minorities

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is patient-delivered partner therapy?

A

Prescriptions provided for the partner to the patient evaluated.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

NAAT test picks up ______

A

Gonococcal and chlamydia - can be run on anal, vaginal, penile, throat swabs.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

T/F: Test of cure is never recommended for Gonorrhea or chlamydia.

A

False. Test of cure is recommended for pharyngeal gonorrhea on alternative tx. None for chlamydia
Retest for gonorrhea and chlamydia at 3 months after tx.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

T/F: Neonates born to mothers with gonococcal infections also get Ceftriaxone x1dose.

A

True.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Why is chlamydia so prevalent? Screening?
Asymptomatic in men and women. Annual screen women 25 and under.
26
What is a concern with treating infants with erythromycin base or Azithromycin for chlamydia infections?
IHPS - Infantile hypertrophic pyloric stenosis - projectile vomiting.
27
Doxycycline - MOA, SE, Clinical considerations?
Protein synthesis inhibitor N/v/d, photosensitivity, IHPS, tooth discoloration, not in pregnancy or breastfeeding. Administer with Food to increase absorption, don’t take with Ca containing foods and full glass of water and remain upright for 1-2hrs.
28
Macrolides - Azithromycin/erythromycin - MOA, SE, Clinical considerations?
Protein synth inhibit N/v/d, rash, HA, QTc prolongation
29
Primary syphilis - clinical presentation Secondary Latent
Solitary, painless chancre. 3 weeks after exposure. Heals and goes away and they forget. Secondary - fatigue, rash, sore throat, hepatitis, renal dysfxn, ocular neuritis or uveitis. W/in a few weeks of infx. Latent Tertiary is when neurological, cardiovascular and modular skin legions. Early and Late latent are asymptomatic.
30
If your syphilis patient has a PCN allergy, what is recommended?
PCN desensitization.
31
Benzathine (PCN) does/does not penetrate CNS spaces
DOES NOT
32
What is Jarisch-Herxheimer Reaction?
Initial tx of syphilis. Non-allergic - Fever/HA/myalgia - results of the lysis of spirochetes (syphilis organism). Treat with Tylenol/NSAIDS. Can cause premature labor in pregnant women.
33
2 Concerns with Trichomonas
Adverse pregnancy outcomes Risk of PID.
34
Trichomonas tx
Women: Metronidazole 500mg BID x7days Men: Metronidazole 2G PO x1 (pregnant women) Alternate for M/F: Tinidazole 2G PO x1.
35
Metronidazole - MOA, SE, Clinical considerations?
Loss of helical DNA structure and strand breakage. N/v/d, metallic tast, HA, dizziness. Safe in pregnancy.
36
HPV vaccination starts at ______.\ 2 dose series if prior to _____ 3 dose if after ____ Name of vaccine?
11/12yo 15 15 Gardasil9
37
HPV 6+11 = 90% genital warts. 16+18 = 99% of cervical cancers
38
T/F: HPV/HSV is curable.
False. Resolution of symptoms is possible.
39
Most genital wart tx for HPV causes the following SE:
Burning, scarring, bleeding, local irritation and pain. The goal of tx is to remove the superficial layer of the wart/virus.
40
Imiquimod, podofilox, sinecatechins,
HPV genital wart tx. Cryotherapy or surgical removal also possible.
41
HSV tx goal:
Reduce symptoms and viral loads.
42
Difference between HPV and HSV
HPV is more wort like HSV is fluid filled blister.
43
HSV-1 = oral to oral transmission and cold sores HSV-2 = sexually transmitted genital herpes.
44
Valacyclovir - what’s better about this?
Lasts longer, less doses/day and less SE than acyclovir.
45
Acyclovir, Valacyclovir and Famcyclovir are all safe in pregnancy (cat B)
46
Clindamycin — rec tx for PID in pregnancy. MOA, SE, Clinical considerations?
Protein synth inhibitor. Staph toxic type syndrome Anaerobic, strep and staph. N/V/D, Cdiff. Safe in pregnancy. IV and PO
47
What kind of AKI is caused by dehydration, HF, or liver failure?
Pre-renal.
48
What types causes intra renal AKI?
Hypertensive emergency, TTP/HUS, glomerular disease, ATN (Acute Tubular necrosis from sepsis, meds, contrast, rhabdo or prolonged prerenal AKI), AIN (acute interstitial nephritis)
49
What things cause post-renal AKI?
Ureteral obstruction (usually needs to be bilateral) Neurogenic bladder, UTI, meds, BPH
50
Drugs that are nephrotoxic? Acronym Ami ambles cautiously cycling looping near Polly and Radioing the Tack shop for Vacuums.
A aminoglycosides A Amphiterocin B C Cisplatin C Cyclosporine L Loop diuretic N NSAIDs P Polymyxins R Radiologic contrast/dye T Tacrolimus V Vanc
51
Management for AKI
Hydration, Diuresis and RRT.
52
Too much NS during AKI rectus situation could cause?
Hyperchloremic metabolic acidosis, further restricting renal blood flow
53
When are loop diuretics used for AKI? MOA? SE?
Tx of choice for Volume overload AKI Furosemide, bumetadine, torsemide, ethacrynic acid. Reduce reabsorption of NaCl in loop of Henle which draws more water to be excreted Ototoxicity, Sulfa cross sensitivity.
54
Preventing CKD through BP: Preventing CKD through DM management:
1st line is ACE or ARB - monitor SCr and K 2-4weeks post initiation SGLT2I (canagliflozin, dapagliflozin or empagliflozin) or/and GLP-1 receptor agonist.
55
ACE - end in -pril Block conversion of angioI to angioII decrease vasoconstriction and aldosterone secretion. SE =cough, hyper K and low BP
56
ARB - -sartan - block angioII from binding.
57
SGLT-2I MOA, SE, CI?
Inhibit Na-glucose co-transporter 2 in the kidney to reduce glucose reabsorption. TII DM only SE: UTIs, increase r/o bone fx, infection of genital area CI in severe renal impairment
58
GLP-1: MOA, SE, CI
Lower blood sugar by mimicking action of hormone called glucagon-like peptide 1 that stimulates the body to produce more insulin when blood sugars rise. SE N/v/d, hypoglycemia. CI in pancreatitis.
59
Finerenone: MOA, SE, CI
Blocks mineralocorticoid receptor overactivation in kidney, heart and blood vessels. Reduces r/o sustained eGFR decline, ESKD and CV death. SE: hyperK. CI in strong CYP3A4 inhib or adrenal insufficiency.
60
Stages of CKD
Stage 1 eGFR >=90 Stage 2 60-89 3A = 45-59 3B = 30–44 4 = 15-29 5 = <15. NEED Dialysis or transplant.
61
BAAM of CKD
Bone disorder Anemia Arrhythmias Metabolic acidosis.
62
Patho of hyperPh in CKD
HyperPH leads to decreased VitD activation -> hypoCa -> increased PTH stimulation ->Ca resorption from bone.
63
VitD supp in CKD 3+4, and Vit D analogs (increase intestinal absorption of Ca to provide negative feedback to stop PTH stimulation) for CKD5 or kidney failure
64
Calcimemetics MOA, SE, CI
Cinacalcet, Etelcalcetide Increse sensitivity of calcium-sensing receptor of parathyroid gland which decreases PTH, Ca and Phos. SE - hypoCa, n/v/d, muscle spasm, parenthesis, HA, fatigue, depression, bone fx, weakness, limb pain CI in hypoCa
65
Epoetin Alfa is only effective if _________.
Enough iron is present to make the Hgb (RBC). Assess Iron panel prior to starting.
66
Drugs that raise K
ACE, ARA, ARB, OCP, bactrim, transplant drugs.
67
3 mainstays of Tx of for HyperK
Stabilize the heart - CaGluconate (preferred) + CaCl Move K intracellular - insulin+ Dextrose, Sodium bicarb if acidosis is present Remove K - furosemide, Kayexalate, patiromer, Na Zirconium cyclosilicate(Lokelm - preferred in emergencies) all bind K in the GI tract and excrete through stool. Hemodialysis.

Pharmacology (20 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions