RENAL 2 Flashcards
coliform of UTI
Coli, klebsiella, enterobactera, proteus
what is the commonest cause of UTI
E Coli
proteus leads to what
2 things
urease which converts urea to ammonia leading to stones
also foul smelling
enterococcus of UTI
faecalis
caecum - difficult to treat
staphyloccos saph sophiticus
coag neg staph
women of child bearing age
other causes of UTI - 2
SA
pseudomonas - catheter - ciprofloxacin
lab diagnosis of UTI
> 10^5 significant
10^4 - repeat
<10^3 - unsignificant
treatment of UTI
female lower UTI trim or nitro PO 3d
uncathaterised male UTI - trim/nitro PO 7days
pyloneph co-amox or cotramox 14d
pyloneph in hopistal amox (cotramox) and Gent IV 3d
asymp bacteria when should it be treated and why
in pregnant women
risk of pyelonephritis, IUGR, pre labour
abacterial cysts/uretheral syndrome is what
caused by what
rx
symp but no growth in culture
early phase of UTI, uretheral trauma, C/G
alkalising urine may help
AKI is what
abrupt <48 hour reduction in kidney function:
increased creatinine by 26.4/50%
decrease in urine output
staged of AKI 1-3
increased Cr >26 or >=1.5-1.9
UO <1.5 for 6 consecutive hours
increased >=2-2.9
<0.5 for over = 12 hours
increase >=3 or creatinine >=354 or need RRT
<0.3 for 24 hours or 12 hours of anuria
pre renal AKI
if left untreated
rx
hypovlaamie, hypotension, renal hypofucsion
ATN
fluid challenge for hypovlaamie saline over 2 mims and reasses
stop NSAIDs, ACEI/ARB, diuretics
renal AKI causes
cx
rx
vasculitis, GN, contrast, TB, sarcoid, ischaemia, Gent, rhabdo, acute tubular necrosis, acute interstitial necrosis, tumour lysis syndrome
renal parenchyma disease
good perfusion pressure, ABs if septic, stop nephrotoxins, dialysis if still anuric and anaemic
post renal AKI causes
ix
rx
stone, cancer, strictrures, BPH, extrinsic pressure
USS and CT
relieve instruction - catheter. percutaneous nephrostomy
