Reading Questions Flashcards
What is the transporter defect in RTA type 2?
Proximal sodium bicarb transporter
What is RTA type 4 associated with and what patient population is it most commonly seen?
Volume expansion. Elderly or diabetic with CKD.
What are the 4 clinical conditions under the umbrella of UTI?
Cystitis, pyelonephritis, prostatitis and AB.
3 requirements for uncomplicated UTI?
Non pregnant, do indwelling instrument, no anatomical abnormality.
Why do men over 50 have such a high incidence of UTI?
Enlargement of the prostate
5 risk factors for cystitis?
Diaphragm with spermicide, DM, incontinence, history of UTI, lots of sex
What makes the pathogenesis of candida distinct and what does it usually indicate if the patient has a UTI caused by candida?
Blood route. genital contamination.
Clinical triad of cystitis?
Frequency, dysuria, and urgency
4 clinical signs of pyelonephritis?
Low back pain, fever, N, V.
What patient population are we seeing emphysematous pyelonephritis?
Diabetic patients.
Xanthogranulomatous pyelonephritis occurs with two things happening at the same time. What are those 2 things?
Chronic urinary obstruction and chronic infection.
What type of prostatitis is far more common?
Noninfectious.
2 things with 1 thing lacking is highly predictive of uncomplicated UTI?
Dysuria and frequency with vaginal discharge lacking
What can confirm the diagnosis of uncomplicated UTI on urine dipstick?
Nitrite or leukocyte esterase
What is the gold standard for diagnosis UTI?
Bacteria in urine culture.
What is the probably pathogen causing non gon urethritis?
M. Genitalium
2 clinical manifestations with urethritis and what is the 1 sign that is not present?
Dysuria and discharge. No frequency.
What kind of bacteria is n gon?
Gram negative diplococci
4 requirements for SIRS and how many of them do you need?
Need 2. Fever over 38 or less than 36. Tachypnea (over 24) Tachycardic (over 90) Leukocytosis, over 12k or luekopenia under 4K.
When do you say SIRS is sepsis?
Organ dysfunction with a known infection.
When do we say it is septic shock?
Sepsis with severe hypotension
What is the most common type of infection related to sepsis and what are the 4 top pathogens?
Respiratory infections.
PA, E. coli, staph aureus, candida.
What is the patho behind having multi-organ dysfunction?
Widespread vascular injury leading to severe vasodilation and compromising oxygen delivery.
How do we define oliguria, oligoanuira, and Anuria?
Urine output below 400, urine output below 100, and complete absence of urine output.
Oliguria most commonly presents in the setting of what?
Volume depletion and or hypoperfusion.
Why is oliguria never normal?
Because we need at least 400 ml of max concentrated urine to excrete our obligate amount.
How do we define polyuria?
Greater than 3 liters a day
What 3 things accompany polyuria?
Frequency, nocturia and hypernatremia
How do we define the presence of albumin in the urine?
ACR greater than 30
How do we define AKI/ARF?
Increase in serum creatinine.
Big picture, what is the most common cause of ARF?
Volume depletion/significant hypoperfusion
Most common cause of intrinsic renal failure?
ATN
FENA and BUN/CR of pre renal and intra renal?
Less than 1 and more than 20.
Greater than 1 and less than 15.
What is the FENA for post renal azotemia and what is the key diagnostic tool for post renal?
Fena greater than 1 eventually. Ultrasound to see the obstruction.
