Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Urinary > 11- UTI and Diuretics > Flashcards

11- UTI and Diuretics Flashcards

1
Q

What are diuretics

A

Act on kidney to increase production of urine and eliminate water from body

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

What do diuretics do

A

Reduce plasma volume and CO
Reduce BP
Reduce edema and ascites
Act on tx on luminal membrane or renal tubular cells

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

Where do carbonic anhydrase inhibitors work

A

Inhibit carbonic anhydrase in PCT

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

Where do osmotic diuretics work

A

Whole tubule

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

Where do loop diuretics work

A

Loop of Henle

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

Where do K sparing diuretics work

A

DCT/CD

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

Where do thiazide and thiazide like diuretics work

A

DCT

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

How do CA inhibitors work

A

So HCO3 not produced in cell
So Na/HCO3 cotransporter can’t work
So high Na in cell
So less reabsorbed

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

How do osmotic Ds work

A 
Freely filtered
But no transporters so not reabsorbed
Stay in lumen and pull in water
Na spared
Expand ECF initially, decrease blood viscosity, inhibit renin release, increase renal blood flow
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

How do Loop Ds work

A

Work on Na/K/2Cl
So less reabsorbed
Stay in lumen so water stays too

Potent
Emergency situations

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

How do K sparing Ds work

A

With diuretics there is lots of Na in lumen
So when gets to CD the ENAC works and reabsorbs Na and ROMK kicks out K due to Na/K turning
With K sparing = ENAC/ROMK not upregulated

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

How do Thiazide Ds work

A

Block Na/Cl Co
So less Na
Can induce high Ca as less Na in cell so favours Na/Ca antiporter so more Ca absorbed

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

Why does low K cause alkalosis

A

Cell swaps intracellular K for H so less H in blood = higher Ph

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

What are the defences of the UT against colonisation

A

Emptying of bladder
Immunological factors
Mucosal barriers
Urine acidity

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

Why do you get false negatives with collection bag

A

Peritoneal contamination

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

How long can you take to get samples to culture

A

4 Hours or refrigerate or boric acid

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

When does a dipstick indicate UTI

A 
Leucocyte esterase
Nitrates
Blood
Higher pH 
Protein- WBC
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

When is a dipstick useful

A

Under 65

Children to help rule out

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

When is a dipstick not useful

A

Over 65

Catheter

20
Q

When is a dipstick not necessary

A

2-3 of dysuria, new nocturia, cloudy urine

21
Q

When is a dipstick not necessary

A

2-3 of dysuria, new nocturia, cloudy urine

22
Q

What is the role of culture

A

Investigate complicated infections
Epidemiology
Antibiotic susceptibility data

23
Q

When do you do image urinary tract

A

Children with UTI
Septic patients to see renal involvement
Males: urethral valves
Females and children: vesico-ureteric reflux

24
Q

When would you get sterile pyuria (WBC but not growth)

A 
Prior abx
Urethritis- STI
Vaginal infections- postmenopausal vaginitis
TB
Appendicitis
25
Q

Asymptomatic bacteriuria

A

High prevalence in elderly

Screen and treat in pregnancy

26
Q

Risk of asymptomatic bacteriuria in pregnancy

A

Premature birth

Pyelonephritis

27
Q

Treat UTI

A

Increased fluid
Analgesia
Treat underlying disorders

28
Q

How to treat uncomplicated UTIs

A

3 day nitrofurantoin

Catheter - treat only if unwell

29
Q

How to treat complicated

A

5-7 days nitrofurantoin, pivmecillinam, trimethoprim

Cefelexin in pregnancy

30
Q

How to treat pyelonephritis/ septicaemia

A

7-10 days
Need systemic activity
IV Co-amoxiclav, Gen, cipro (7 days)

31
Q

When to give prophylaxis

A

More than 3 episodes in a year
Good hygiene and behavioural measures taken
No treatable underlying condition
Abx chosen according to recent culture and susceptibility results
Breakthrough infections documents

32
Q

Side effects of osmotic Ds

A

Headache, nausea, vomitting due to high Na
Extracellular volume expansion = oedema, HF
Do not use in chronic HF
Dehydration and high Na

33
Q

Side effect of Loop D

A

Low electrolytes

Metabolic alkalosis

34
Q

Side effect of Thiazide Ds

A

Hypercalcaemia low intracellular Na so more Na/Ca antiporter

35
Q

When not to use K sparing Ds

A

Hyperkalemia

Liver disease

36
Q

When to use K sparing Ds

A

Secondary hyperaldosteronism
CHF, hepatic cirrhosis, nephrotic syndrome
Hypertension in combination with others

37
Q

When to use K sparing Ds

A

Secondary hyperaldosteronism
CHF, hepatic cirrhosis, nephrotic syndrome
Hypertension in combination with others

38
Q

When to use osmotic Ds

A

Acute renal failure
Acute drug poisoning
Before surgery to reduce intracranial pressure

39
Q

When to use loop Ds

A

Severe oedema
Hypercalcemia
Acute pulmonary oedema
Acute hyperkalaemia

40
Q

When to use thiazide Ds

A

Essential hypertension
Mild heart failure
Osteoporosis

41
Q

What is main complaint of UTI

A

Dysuria

42
Q

What is a gram pos cocci that is coagulase neg

A

Staphylococcus epidermidis

43
Q

What is Staphylococcus saprophyticus

A

Found in normal flora of female genital tract and perineum
Coagulase positive coccus
If nitrites negative

44
Q

What is the first immunoglobulin to respond

A

IgM

45
Q

What D normally added to loop to create potency

A

Thiazide when low GFR

46
Q

What is a side effect of spironalactone

A

Gynecomastia as work on other steroid receptors

47
Q

What drug reduces mortality by 30% in those with HF and LV dysfuntion

A

Spironolactone

Urinary (11 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions