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