CMN 577 - Unit 1
S/S of acute intermittent porphyria - CORRECT ANSWER-+ Abdominal pain of
varying severity
+ Absence of fever or leukocytosis
+ Peripheral neuropathy (symmetric OR asymmetric)
+ CNS sx (seizures, altered consciousness, psuychosis, abnormalities of basal
ganglia)
+ Hyponatremia
McPhee p 1690
Labs for acute intermittent porphyria - CORRECT ANSWER-+ Hyponatremia
+ Urine which turns dark when exposed to light or air (r/t porphobilonogen
excretion)
McPhee p 1690
Prevention of attacks in pts with acute intermittent porphyria - CORRECT
ANSWER-+ Sulfanoamides and barbituates
+ Starvation or prolonged fasting
+ Hormone changes during pregnancy
McPhee p 1690
Typical patient with AIP - CORRECT ANSWER-Young female
McPhee p 1690
Treatment for acute intermittent porphyria (AIP) - CORRECT ANSWER-+ High
carb diet
+ Analgesics and IV glucose in saline and hematin
McPhee p 1691
,Cause of acute intermittent porphyria (AIP) - CORRECT ANSWER-Genetic
condition, inherited as an autosomal dominant condition.
Pts have mutation in HMBS
McPHee p 1690
At what point in pregnancy can Down Syndrome be detected, and what tests are
used? - CORRECT ANSWER-+ Down syndrome can be detected in the 1st or
early 2nd trimester
+ Screen maternal serum for alpha-fetoprotein (should be LOW) and other
biomarkers (multiple marker screening)
+ Detecting nuchal thickness and underdevelopment of nasal bone on
ultrasonography.
McPhee p 1692
s/s of Down Syndrome - CORRECT ANSWER-+ Typical craniofacial features
(flat occiput, epicanthal folds, large tongue)
+ Hypotonia
+ Single palmar crease
+ Congenital heart defects (50% of pts)
McPhee p 1692
Hematuria --What do proteinuria and casts in urinalysis suggest? - CORRECT
ANSWER-Renal origin
McPhee p 962
What do irritative voiding sx, bacteruria and a positive urine culture suggest in the
female patient? - CORRECT ANSWER-Urinary tract infection
McPhee p 962
T/F - Urine cytology is recommended in the evaluation of asymptomatic
microscopic hematuria. - CORRECT ANSWER-FALSE
,McPhee p 962
In what type of patient is cystology indicated for evaluation of hematuria? -
CORRECT ANSWER-Pts with gross hematuria and those > 35 yrs with
asymptomatic microscopic hematuria
McPhee p 962
Common symtpoms of acute cystitis - CORRECT ANSWER-Irritative voiding sx
(frequency, urgency, dysuria)
Suprapubic discomfort
NOTE: ♀ may also have gross hematuria and sx follow sexual intercourse.
McPhee p 962
Urinalysis results in acute cystitis - CORRECT ANSWER-Pyuria
Bacteruria
Varying degrees of hematuria
McPhee p 963
When are ♀ candidates for prophyactic abx tx for prevention of recurrent UTI? -
CORRECT ANSWER-♀ who have > 3 episodes of cystitis per year
McPhee p 963
Microscopic hematuria in male patients is most often caused by what? -
CORRECT ANSWER-BPH
McPhee p 962
Most common cause of acute cystitis? - CORRECT ANSWER-Coliform bacteria
(especially E.Coli and occasionally gram positive bacteria).
McPhee p 962
, Tx of uncomplicated cystitis in women - CORRECT ANSWER-+ Short term
antimicrobial tx (either single dose, or 1-9 days)
+ 1st line therapies
-- Macrobid 100 mg BID x 5 -7 days
-- Bactrim 160/800 mg BID x 3 days
-- Fosfomycin trometamol (3 g single dose)
McPhee p 963-4
Most common causes of acute pyelonephritis - CORRECT ANSWER-Gram
negative bacteria (e.g. E coli, Proteus, Klebsiella, Enterobacter, Pseudomonas)
OCCASIONALLY, gram positive are seen (e.g enterococcus faecalis, staph
aureus)
McPHee p 965
s/s acute pyelonephritis - CORRECT ANSWER-+ Fever with shaking chills
+ Flank pain
+ Irritative voiding sx
+ Positive urine culture (pyuria, bacteriuria and some hematuria + occasional
white cell casts)
+ CBC shows leukocytosis and a left shift
McPhee p 965
Main differential dx for acute pyelonephritis in men? - CORRECT ANSWER-+
Acute epididymitis
+ Acute prostatitis
McPhee p 965
Tx of acute pyelonephritis - CORRECT ANSWER-+ Empiric tx OK while awaiting
cultures
-- Bactrim 160/800 mg BID x 10-14 days
-- Levofloxacin 750 mg daily x 5 days
-- Cipro 750 mg BID x 7 - 14 days
S/S of acute intermittent porphyria - CORRECT ANSWER-+ Abdominal pain of
varying severity
+ Absence of fever or leukocytosis
+ Peripheral neuropathy (symmetric OR asymmetric)
+ CNS sx (seizures, altered consciousness, psuychosis, abnormalities of basal
ganglia)
+ Hyponatremia
McPhee p 1690
Labs for acute intermittent porphyria - CORRECT ANSWER-+ Hyponatremia
+ Urine which turns dark when exposed to light or air (r/t porphobilonogen
excretion)
McPhee p 1690
Prevention of attacks in pts with acute intermittent porphyria - CORRECT
ANSWER-+ Sulfanoamides and barbituates
+ Starvation or prolonged fasting
+ Hormone changes during pregnancy
McPhee p 1690
Typical patient with AIP - CORRECT ANSWER-Young female
McPhee p 1690
Treatment for acute intermittent porphyria (AIP) - CORRECT ANSWER-+ High
carb diet
+ Analgesics and IV glucose in saline and hematin
McPhee p 1691
,Cause of acute intermittent porphyria (AIP) - CORRECT ANSWER-Genetic
condition, inherited as an autosomal dominant condition.
Pts have mutation in HMBS
McPHee p 1690
At what point in pregnancy can Down Syndrome be detected, and what tests are
used? - CORRECT ANSWER-+ Down syndrome can be detected in the 1st or
early 2nd trimester
+ Screen maternal serum for alpha-fetoprotein (should be LOW) and other
biomarkers (multiple marker screening)
+ Detecting nuchal thickness and underdevelopment of nasal bone on
ultrasonography.
McPhee p 1692
s/s of Down Syndrome - CORRECT ANSWER-+ Typical craniofacial features
(flat occiput, epicanthal folds, large tongue)
+ Hypotonia
+ Single palmar crease
+ Congenital heart defects (50% of pts)
McPhee p 1692
Hematuria --What do proteinuria and casts in urinalysis suggest? - CORRECT
ANSWER-Renal origin
McPhee p 962
What do irritative voiding sx, bacteruria and a positive urine culture suggest in the
female patient? - CORRECT ANSWER-Urinary tract infection
McPhee p 962
T/F - Urine cytology is recommended in the evaluation of asymptomatic
microscopic hematuria. - CORRECT ANSWER-FALSE
,McPhee p 962
In what type of patient is cystology indicated for evaluation of hematuria? -
CORRECT ANSWER-Pts with gross hematuria and those > 35 yrs with
asymptomatic microscopic hematuria
McPhee p 962
Common symtpoms of acute cystitis - CORRECT ANSWER-Irritative voiding sx
(frequency, urgency, dysuria)
Suprapubic discomfort
NOTE: ♀ may also have gross hematuria and sx follow sexual intercourse.
McPhee p 962
Urinalysis results in acute cystitis - CORRECT ANSWER-Pyuria
Bacteruria
Varying degrees of hematuria
McPhee p 963
When are ♀ candidates for prophyactic abx tx for prevention of recurrent UTI? -
CORRECT ANSWER-♀ who have > 3 episodes of cystitis per year
McPhee p 963
Microscopic hematuria in male patients is most often caused by what? -
CORRECT ANSWER-BPH
McPhee p 962
Most common cause of acute cystitis? - CORRECT ANSWER-Coliform bacteria
(especially E.Coli and occasionally gram positive bacteria).
McPhee p 962
, Tx of uncomplicated cystitis in women - CORRECT ANSWER-+ Short term
antimicrobial tx (either single dose, or 1-9 days)
+ 1st line therapies
-- Macrobid 100 mg BID x 5 -7 days
-- Bactrim 160/800 mg BID x 3 days
-- Fosfomycin trometamol (3 g single dose)
McPhee p 963-4
Most common causes of acute pyelonephritis - CORRECT ANSWER-Gram
negative bacteria (e.g. E coli, Proteus, Klebsiella, Enterobacter, Pseudomonas)
OCCASIONALLY, gram positive are seen (e.g enterococcus faecalis, staph
aureus)
McPHee p 965
s/s acute pyelonephritis - CORRECT ANSWER-+ Fever with shaking chills
+ Flank pain
+ Irritative voiding sx
+ Positive urine culture (pyuria, bacteriuria and some hematuria + occasional
white cell casts)
+ CBC shows leukocytosis and a left shift
McPhee p 965
Main differential dx for acute pyelonephritis in men? - CORRECT ANSWER-+
Acute epididymitis
+ Acute prostatitis
McPhee p 965
Tx of acute pyelonephritis - CORRECT ANSWER-+ Empiric tx OK while awaiting
cultures
-- Bactrim 160/800 mg BID x 10-14 days
-- Levofloxacin 750 mg daily x 5 days
-- Cipro 750 mg BID x 7 - 14 days
