Seminar Topics Week 8, 10, 12 Flashcards
What are the most common bacterial infections in women?
UTIs.
How are UTIs classified?
Can be classified into upper and lower UTIs, depending on which part of the system the affect.
What is pyelonephritis?
Implies inflammation in the renal parenchyma and the collecting system.
What is cystitis?
Indicates inflammatory condition in the urinary bladder,. Characterized by pain, urgency, and hematuria.
What is urethritis?
Inflammation in the urethra.
What are normal defence mechanisms that prevent UTIs?
Normal voiding w/ complete emptying, antibacterial capability of the bladder mucosa and urine, uretero-vesicle junction competence, peristaltic activity.
How do bacteria cause UTIs?
usually introduced via the urethra from intercourse, improper hygiene. May come from the blood or lymphatic system, or instrumentation.
What are some CM of LUTIs?
Dysuria, hesitancy, intermittency, pain on urination, urinary retention, weak urinary stream, incontinence, nocturia, nocturnal enuresis, urgency, urinary frequency.
What are some CM of UUTIs?
Flank pain, chills, fever as well as symptoms of lower utis.
What symptoms of UTIs may older adults experience?
Nonlocalized abdo pain, cognitive impairement, delerium, falls.
How are UTIs diagnosed?
Dipstick urinalysis- look for presence of nitrites, WBCs and leukocyte esterase.
Urine culture, imaging studies of urinary tract.
What are some treatments for an uncomplicated UTI?
Adequate fluid intake, antibiotic, counselling for risk.
What are some treatments for recurrent, uncomplicated UTIs?
Repeated urinalysis, antibiotic, adequate fluid intake, imaging study.
What is polynephritis?
Inflammation of the renal parenchyma and collecting system. Commonly caused by bacterial, infection.
What is urosepsis?
Systemic infection arising from a urological source. Can lead to septic shock.
Where does polynephritis begin?
The lower urinary tract, usually caused by visco-ureteral reflux (upflushing of the urine from the lower tract to the upper tract). Starts in the renal medula and spreads to the cortex.
What are the CM of polynephritis?
Mild fatigue, chills, fever, vomiting, malaise, flank pain, annoying LUTIs. CM subside within a few days.
What diagnostic studies are done to detect polynephritis?
Urinalysis (will show pyuria, bacteruria, and hematuria)
CBC shows leukocytosis, w/ shift to the left.
Imaging studies- IVP or CT scan, ultrasound.
How are mild symptoms of polynephritis treated?
Adequate fluid intake, NSAIDs, outpatient management, IV antibiotics.
How are severe symptoms of polynephritis treated?
Adequate fluid intake, hospitalization, NSAIDs, parenteral antibiotics, urinary analgesics.
What is actue poststreptococcal glomerulo-nephritis APSGN?
Complication of strep throat/impetigo. Pt produces antibodies to streptococcal antigen. Antigen antibodies end up in glomeruli and activate compliment system, causing inflammation. This causes a decrease in filtration of metabolic waste, and increases the nephron permeability to big proteins.
What are the CM of APSGN?
Body edema, hypertension, oliguria, hematuria, rusty looking urine, and proteinuria.
Why does fluid retention occur with APSGN?
Result of decreased glomular filtration, edema starts in low pressure tissues, then worsens to other parts of the body.
How is APSGN diagnosed?
Pt Hx, BUN serum creatinine, albumin CBC Complement levels and ASO titre Renal biopsy Urinalysis
What are some treatments for APSGN?
Adjustment of dietary protein Antihypertensive Diuretics Rest Na and Fluid restriction
What is hepatitis?
Hep refers to inflammation of the liver, caused by viral infection (most of the time).
What is hepatitis caused by?
- Viral Infections
- Chemicals
- Alcohol
- Autoimmune diseases
- Metabolic disorders
- Genetic abnormalities
What happens during acute viral hepatitis (patho)?
Liver damage is mediated by cytotoxic cytokines and NKCs. This causes the lysis of infected hepatocytes.
What happens when bile flow is interrupted by the inflammation?
Causes cholestasis (impaired bile flow).
What are the system effects of viral hepatitis?
Antigen-antibody complexes form b/w the virus and the antibody, which circulates and activates the complement system.
What are the CM of the antigen-antibody complexes that form from the virus/antibody?
Rash, angioedema, arthritis, edema, fever and malaise.
What are the CM of viral hep in the acute phase?
Incubation phase: anorexia, nausea, vomiting, RUQ discomfort, malaise, fatigue, headache, low-grade fever, arthralgaias, rahses.
What may physical examination reveal in the acute phase of viral hep?
Hepatomegaly, lymphadenopathy, and maybe splenommegaly.
What does it mean if the acute phase is icteric?
The person has jaundice.
What does it mean if the acute phase is anicteric?
Person has no jaundice.
When does the convalescent phase begin?
Begins as jaundice dissapears, and may last weeks to. months. Major CM is malaise, and easy fatiguability.
Which viral infections may have a chronic phase?
Hep B and C.
What are the potential complications of viral hepatitis?
Fulminant hepatitis. Occurs with v little cases. Clinical syndrome that results in necrosis of liver cells and potential liver failure.
What are the diagnostic tests used to detect viral hep?
Viral serological tests, serum liver enzymes, liver function tests.
What is Hep A?
RNA virus, found in feces 2 weeks before onset of symptoms, or 1 week after onset of jaundice.
What is the mode of transmission for Hep A?
Fecal oral, or foodborne.
What are the CM of Hep A?
Anorexia, nausea, fatigue, fever, jaundice. Symptoms common in adults, not kids.
What is Hep B?
DNA virus, causes inflammation of the liver. Preventable by vaccine
How is Hep B transmitted?
Perinatally, percutaneously, sexually, horizontally. Body fluids.
What is dementia?
Abnormal aging that is a gradual degenerative collection of symptoms affecting brain, cognition and mental state
What causes dementia?
Abnormal aging, loss of communication between nerve cells, amyloid plaques or protein deposits in the brain.
What are some risk factors for dementia?
Race, gender, age, lower education/less mental stimulation, strokes, diabetes, hypertension, chronic inflammatory conditions, depression etc.
CM of dementia
mild-severe cognitive impairment inability or difficulty in completing ADLs/apraxia anosognosia exit seeking abnormal behaviours (cursing, screaming, socially inappropriate) apathy amnesia aphasia altered perceptions reflexive grabbing reversion to mother tongue
Diagnostic Tests of dementia
Rule out all other cognitive impairment, imaging techniques for the brain to see lewy bodies, cognitive testing, mental status assessment, physical and history exam
Treatment for dementia
there is no cure, so only trying to slow the progression of the illness and treating symptoms. Drug therapy (anti-anxiety, slow protein buildups), and may have caregivers/moving to retirement homes for ADL assistance
What is multiple sclerosis
degenerative autoimmune disease of the CNS. Characterized by scarring, inflammation, and demyelination of nerve fibers in the brain
What are some complications of multiple sclerosis
UTI, resp. infections, incontinence, and blindness.
What is the pathology of multiple sclerosis?
Disruption of the blood-brain barrier and compromised immune system causes a loss of myelin, plaque formation, lowered oligodendrocytes, and proliferation of astrocytes
Diagnostic tests of multiple sclerosis
physical exam, history, cerebrospinal fluid testing for inflammatory markers, and imaging techniques for seeing scarring and plaque buildups.
CM of Multiple Sclerosis
impaired functioning diminished cough reflex dysphasia retention of urine hesitant and frequent urination eye pain with blind spots memory impairment painful tremors difficulty walking and speaking fatigue weakness of limbs ataxic movements muscular atrophy irritability nausea vertigo numbness pallor impaired judgement loss of perception infertility and loss of sensation in genitals
Treatment goals of Multiple Sclerosis
reducing plaque formation and addressing symptoms as treatment is not available
Drugs for MS
CNS depressors, corticosteroids, immuno-modulators, cholingenerics, anticholinergics, muscle relaxants, acetylcholinertase inhibitor, nerve conduction enhancer, and sphingosine-1-phosphate receptor modulators
Collab Care for MS
Drug and nutritional therapies. May consider alternative therapies for muscles and reducing systems, like acupuncture.
Complications with Hep A, B, and C
may develop fundamental hepatitis, liver failure, morbidity and fatality
Treatment of Hep A, B, and C
Vaccination prevention. Drugs for specific symptoms (anti-viral, immuno-modulatory) and liver transplant may be required, based on severity
What is Acute Pancreatitis?
Short-term inflammation of the pancreas due to injury.
