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Undeleted > Exam 2 Embryo/Anatomy/Pharm > Flashcards

Exam 2 Embryo/Anatomy/Pharm Flashcards

1
Q

What drains urine before kidneys form?

A

external glomerulus, connects to body cavity

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2
Q

What does mesonephric duct before?

A

males-vas deferens

females-regresses/Gardner’s cyst of broad ligament

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3
Q

What is the allantois?

A

precursor to bladder

becomes median umbilical ligament

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4
Q

Accessory renal artery problem

A

can compress renal pelvis, cause backup

no collateral circulation to kidney it supplies (cannot just ligate artery)

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5
Q

Cause of horseshoe kidney

A

IMA blocking ascent

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6
Q

Line of Broedel on kidneys

A

segments kidney blood supply

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7
Q

SMA compression of renal vein

A 
causes SMA syndrome
compresses duodenum (vomiting) or L renal vein (varicocele)
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8
Q

Differentiating pyelonephritis from cystitis

A

cystitis does not have a fever

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9
Q

Differentiating cystitis from urethritis

A

cystitis has hematuria and bacteriuria

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10
Q

Reasons to tx uncomplication UTI’s

A

pregnancy
GU procedure
within 48hrs of cath removal

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11
Q

Tx for acute uncomplication cystitis

A

TMP-SMX (also good for systemic)
nitrofurantoin (avoid in elderly)
fosfomycin

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12
Q

Nitrofurantoin characteristics

A

alters ribosomal proteins
is reduced by bacterial flavoproteins (to active)
no resistance
filtered by kidneys only (does not work systemically)

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13
Q

TMP-SMX characteristics

A

PABA analog (inhibits folate synthesis)
has resistance
can cause megaloblastic anemia/kernicterus
do not use in pregnancy

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14
Q

Fosfomycin characteristics

A 
blocks NAM synthesis via MurA
stops cell wall synthesis
analog of phosphoenolpyruvate
transported via G6P system
safe in pregnancy
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15
Q

Tx for acute pyelonephritis

A

TMP-SMX
cipro/levofloxacin if less than 10% resistance
IV ceftriaxone/aminoglycosides if more

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16
Q

Tx for asymptomatic bacteriuria in pregnancy

A

amoxicillin
cephalexin
fosfomycin
nitrofurantoin (can cause hemolytic anemia/birth defects)

17
Q

Drugs not to use with UTI in pregnancy

A

fluoroquinolones (cartilage damage)
aminoglycosides (ototoxicity)
tetracyclines (change in bone formation)

18
Q

Drugs only to use in 2nd trimester of pregnancy for UTI’s

A

nitrofurantoin-can cause cardiac defects

TMP-SMX (neural tube defects in 1st trimester/kernicterus in 3rd)

19
Q

Tx for acute pyelonephritis in pregnancy

A 
Beta lactams (3rd gen ie ceftriaxone)
carbapenems for resistant strains
20
Q

Prophylaxis tx for UTI’s by demographic

A

pregnancy-cephalexin/nitrofurantoin
sexually active-TMP-SMX/nitrofurantoin/cephalexin
post menopausal-estrogen replacement

21
Q

Cranberry juice benefit for UTI’s prevention

A

A proanthocyanidins attach to fimbriae

22
Q

When do you start meds for CKD?

A

GFR around 50-60ml/min

23
Q

Changes in volume distribution

A

more acidic-displaced from albumin in uremia
high protein binding-more free in liver problems
small vol of distribution-increased change in conc

24
Q

Metabolism by kidney for adjustment need

A

if over 30% excreted by kidney, needs adjustment in CKD

25
Q

Drug types poorly removed by dialysis

A

high protein binding

large volume distribution

26
Q

Causes of increased serum creatinine (not CKD)

A

more meat in diet
TMP/cimetidine/cephalosporings
ketoacidosis

27
Q

Cockcroft-Gault eqn use

A

for stable adults (no acute changes in GFR)
needs wt of pt
low serum conc overestimates GFR

28
Q

Modification of diet renal disease eqn

A

no need for wt
validate in subgroups
cannot use under 18 or over 70 y/o

29
Q

Aminoglycosides with CRF

A

can cause ototoxicity

30
Q

Vancomycin with CRF

A

can cause nephrotoxicity

31
Q

Imipenem with CRF

A

can cause seizures

32
Q

Gabapentin with CRF

A

can cause nystagmus/ataxia/dizziness

33
Q

Valacyclovir with CRF

A

can cause CNS/renal failure

34
Q

Lithium with CRF

A

can cause seizures/sedation

35
Q

Enoxaparin with CRF

A

can cause excess bleeding

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