Treatments Flashcards

1
Q

Renal colic/nephrolithiasis - Acute

A

Acute
NSAIDs for pain
Antiemetics for vomiting and nausea
Allow stones <5mm to pass spontaneously

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2
Q

Renal colic/nephrolithiasis - surgical interventions

A

Percutaneous nephrostomy

Extracorporeal shock wave lithotripsy

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3
Q

AKI

A

Treat hyperkalaemia risk for arrhythmia
Fluid rehydration - if pre-renal
Stop nephrotoxic medications
Relieve obstruction

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4
Q

CKD - Reduce risk of complications

A
Oral NaHO3 to treat metabolic acidosis 
Iron supplementation and erythropoietin to treat anaemia 
Vit D to treat renal bone disease 
Dialysis in the end stage renal failure 
Renal transplant in end stage failure
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5
Q

Prostate cancer

A
  • External beam radiotherapy directed at the prostate
  • Brachytherapy
  • Hormone therapy
  • Bilateral orchiectomy - to remove testicles (rarely used)
    Surgery
  • Removal of the prostate gland
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6
Q

Prostate procedure side affects

A

ED and urinary incontinence

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7
Q

Benign prostate hyperplasia - Mid/manageable

A

Behavioural management e.g. avoiding caffeine/alcohol

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8
Q

Medical options

A

1st - Alpha blockers e.g. tamsulosin

5-alpha reductase inhibitors e.g. finasteride

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9
Q

Mechanism of action Tamsulosin and Finasteride

A

Tamsulosin - relaxes smooth muscle

Finasteride - reduces size of the prostate

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10
Q

BPH - Most common surgical management

A

Transurethral resection

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11
Q

Urethritis - Gonorrhoea

A

Single IM dose of ceftriaxone if sensitivities unknown

Single does of oral ciprofloxacin if sensitivities are known

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12
Q

Urethritis - Chlamydia

A

Single 1g dose of azithromycin

Plus 7 days doxycycline

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13
Q

Varicocele

A

Uncomplicated can be managed conservatively - reassurance/observation
If testicular pain, atrophy or infertility risk then surgery may be indicated

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14
Q

Testicular Torsion

A

Surgical emergency
Orchiopexy - correcting the position of the tesicles by fixing them in place
Orchidectomy - removal if surgery is delayed or there is necrosis

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15
Q

SLE - mild disease

A

1st - Hydroxychloroquine - DMARD
Corticosteroids
NSAIDs
Sun cream and sun avoidance

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16
Q

SLE - severe disease

A

Rituximab - MCAB that targets CH20 protein on B cells

Belimumab - MCAB that targets B-cell activating factor

17
Q

Minimal change disease

A
1st line - High dose corticosteroids 
Plus 
Fluid restriction/low salt diet 
Albumin infusion may be required in severe hypoalbuminemia 
Furosemide - diuretic to treat oedema
18
Q

MCD - Steroid Resistance

A

ACE inhibitors and immunosuppressants e.g. cyclosporine, tacrolimus and rituximab

19
Q

Bladder cancer - Surgical options

A

Transurethral resection of bladder tumour (TURBT)
Intravesical chemotherapy
Intravesical Bacillus Calmette-Guerin (BCG)
Radical cystectomy - removal of entire bladder

20
Q

Pyelonephritis

A

Cefalexin 7-10 days

Trimethoprim (E.coli) or amoxicillin if sensitive

21
Q

Prostatitis - Acute

A

Oral ABs - trimethoprim (E.coli)
Analgesia
Laxatives

22
Q

Prostatitis - Chronic

A
Alpha blockers e.g. tamsulosin 
Analgesia NSAIDs or paracetamol 
Psychological treatment e.g. CBT or ADs 
ABs 
Laxatives
23
Q

Epididymitis

A
ABx- Ofloxacin 
Alternatively Levofloxacin, doxycycline or Co-amoxiclav 
Analgesia
Supportive underwear 
Reduce physical activity 
Abstain from intercourse
24
Q

IgA nephropathy (Berger’s disease)

A
Moderate: Observation 
Severe: 
- Supportive treatment for renal failure 
- ACE-I - benazepril/ramipril 
- Immunosuppressant medications
25
Q

Post-strep glomerulonephritis

A

Usually resolves spontaneously

26
Q

Focal segmental glomerulosclerosis -

Asymptomatic or proteinuria <3g/24h

A

ACE-i e.g. ramipril
Angiotensin-2 receptor antagonist e.g. irbesartan
Plus dietary modification
Adjunct: statin

27
Q

Focal segmental glomerulosclerosis -

Symptomatic or proteinuria 3g or more per 24h

A

Corticosteroid therapy

Plus ACE-I (ramipril) or A2RA (irbesartan)

28
Q

Membranous nephropathy

A

1st - Low-salt and low protein diet
Plus: ACE-I (ramipril) /A2RA (irbesartan) - for hypertension
Plus: Statin - For hyperlipidemia
Plus: Furosemide +/- hydrochlorothiazide - if risk of progression to end stage to renal failure

29
Q

Polycystic kidney disease - Dominant

A

Vasopressin receptor antagonist e.g. can slow the development of the cysts and the progression to renal failure
ACE-I/BB for hypertension e.g. ramipril/propranolol
ABxs for infection
Drainage of cysts
Dialysis/transplant
Genetic counselling
Avoid contact sports to avoid cyst rupture

30
Q

Cystitis

A

ABx 3 days of trimethoprim or nitrofurantoin

31
Q

UTI - uncomplicated

A

Trimethoprim or nitrofurantoin

32
Q

UTI - Pregnancy

A

1st Nitrofurantoin

2nd Cephalexin or amoxicillin

33
Q

Chlamydia

A

Single 1g dose of azithromycin

Plus 7 days doxycycline

34
Q

Gonorrhoea

A

Single dose Ceftriaxone IM dose

35
Q

Syphilis

A

IM benzathine benzylpenicillin (penicillin)