CMN 577 - Unit 1
S/S of acute intermittent porphyria - ANS-+ 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 - ANS-+ 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 - ANS-+ Sulfanoamides
and barbituates
+ Starvation or prolonged fasting
+ Hormone changes during pregnancy
McPhee p 1690
Typical patient with AIP - ANS-Young female
McPhee p 1690
Treatment for acute intermittent porphyria (AIP) - ANS-+ High carb diet
+ Analgesics and IV glucose in saline and hematin
McPhee p 1691
Cause of acute intermittent porphyria (AIP) - ANS-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?
- ANS-+ 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 - ANS-+ 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? - ANS-Renal origin
McPhee p 962
What do irritative voiding sx, bacteruria and a positive urine culture suggest in the
female patient? - ANS-Urinary tract infection
McPhee p 962
T/F - Urine cytology is recommended in the evaluation of asymptomatic microscopic
hematuria. - ANS-FALSE
McPhee p 962
In what type of patient is cystology indicated for evaluation of hematuria? - ANS-Pts with
gross hematuria and those > 35 yrs with asymptomatic microscopic hematuria
McPhee p 962
Common symtpoms of acute cystitis - ANS-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 - ANS-Pyuria
Bacteruria
Varying degrees of hematuria
McPhee p 963
When are ♀ candidates for prophyactic abx tx for prevention of recurrent UTI? - ANS-♀
who have > 3 episodes of cystitis per year
McPhee p 963
Microscopic hematuria in male patients is most often caused by what? - ANS-BPH
McPhee p 962
Most common cause of acute cystitis? - ANS-Coliform bacteria (especially E.Coli and
occasionally gram positive bacteria).
McPhee p 962
Tx of uncomplicated cystitis in women - ANS-+ 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 - ANS-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 - ANS-+ Fever with shaking chills
S/S of acute intermittent porphyria - ANS-+ 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 - ANS-+ 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 - ANS-+ Sulfanoamides
and barbituates
+ Starvation or prolonged fasting
+ Hormone changes during pregnancy
McPhee p 1690
Typical patient with AIP - ANS-Young female
McPhee p 1690
Treatment for acute intermittent porphyria (AIP) - ANS-+ High carb diet
+ Analgesics and IV glucose in saline and hematin
McPhee p 1691
Cause of acute intermittent porphyria (AIP) - ANS-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?
- ANS-+ 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 - ANS-+ 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? - ANS-Renal origin
McPhee p 962
What do irritative voiding sx, bacteruria and a positive urine culture suggest in the
female patient? - ANS-Urinary tract infection
McPhee p 962
T/F - Urine cytology is recommended in the evaluation of asymptomatic microscopic
hematuria. - ANS-FALSE
McPhee p 962
In what type of patient is cystology indicated for evaluation of hematuria? - ANS-Pts with
gross hematuria and those > 35 yrs with asymptomatic microscopic hematuria
McPhee p 962
Common symtpoms of acute cystitis - ANS-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 - ANS-Pyuria
Bacteruria
Varying degrees of hematuria
McPhee p 963
When are ♀ candidates for prophyactic abx tx for prevention of recurrent UTI? - ANS-♀
who have > 3 episodes of cystitis per year
McPhee p 963
Microscopic hematuria in male patients is most often caused by what? - ANS-BPH
McPhee p 962
Most common cause of acute cystitis? - ANS-Coliform bacteria (especially E.Coli and
occasionally gram positive bacteria).
McPhee p 962
Tx of uncomplicated cystitis in women - ANS-+ 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 - ANS-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 - ANS-+ Fever with shaking chills
