Renal & GU Flashcards
Tx of BPH
Tamsulosin
Finasteride
Action of tamsulosin
& what class of drug is it?
Relax smooth muscle of bladder and prostate
∴ ↑ Urine flow rate
(selective alpha-1-adernergic receptor antagonists)
S/E of tamsulosin
Postural instability, retrograde ejaculation
Findings on DPE of BPH
Smooth, enlarged prostate
Findings of DPE of Prostate cancer
Hard and irregular
Ix for BPH
(incl values if measuring any antigens cough cough)
Digital Rectal Examination
Prostate-Specific antigen > 1.5ng/mL
GS (?) : Trans-rectal US
Ix for Prostate cancer
(no abbrv)
Digital Rectal Exam
Prostate Specific Antigen
Trans-rectal US
Prostate biopsy
What’s the grading thing called for prostate cancer?
Gleason grading score
Most common pathogens for UTIs
E.Coli
Proteus
Why is creatinine used as a marker of GFR?
Freely filterised
Not metabolised
Not secreted
Not reabsorbed
Mechanism of loop diuretics
Where do they act upon?
Act of ascending limb of loop of Henle
Inhibit Na+/K+/2Cl- co-transporter
(bc if it transports ions, water will follow)
Examples of loop diuretics
Furosemide
Bumetanide
S/E Loop diuretics
Dehydration
Hypotension
Hypokalaemia
& Metabolic alkalosis can occur !
If v high doses, can cause ototoxicity
Give an example of K+ sparing diuretic
Amiloride
Spironolactone
Mechanism of K+ sparing diuretics
Where do they act upon?
Act on the distal convoluted tubule
Inhibits reabsorption of sodium (and ∴ water) by epithelial sodium channels
∴ Na+ and H2O excretion
(and K+ retention)
S/E K+ sparing diuretics
GI upset
Hyperkalaemia
Metabolic acidosis
Gynecomastia
Example of a thiazide diuretic
Bendroflumethiazide
Mechanism of Thiazide diuretic
Where does it act upon?
Acts on sodium/chloride transporter
Prevents it from functioning properly
∴ Sodium is NOT retained
Compare thiazide and loop diuretics
(In terms of length and efficacy)
Thiazide diuretics are longer acting
But not as effective as loop
S/E Thiazide diuretics
Hypokalaemia
Metabolic alkalosis
Hypovolaemia
Hyponatraemia
Hyperglycaemia in DM
Where does Angiotensin II act on?
PCT
What does Angiotensin II do?
Causes thirst
↑ SNS activity
ADH release (by stimulating post. pituitary)
Aldosterone release (by stimulating adrenal glands)
↑Proximal tubule reabsorption which ↑Na+ reabsorption
Causes vasoconstriction to ↑BP
ESSENTIALLY, ↑BP
Where does Aldosterone act?
On DCT and collecting ducts
What does Aldosterone do?
↑Na+ reabsorption
↑K+ secretion
Binds to cytoplasmic receptors - transported to nucleus
↑Epithelial Na channels
↑Na+/K+ ATPase
↑Effective circulating vol