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without, lack of
ie: anuria |
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little, scanty
ie: oliguria |
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little ball
ie: glomerulonephritis |
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renal pelvis
ie: pyelonephritis, pyelogram |
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narrowing
ie: renal stenosis |
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crushing
ie: lithotripsy, lithotriptor |
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| Intake and Output (ins and outs) |
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| What Pharmacists need to know about Pessaries? |
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Definition
1. Selection depends on diagnosis
2. Pessaries are fit by trial and error
3. The largest pessary that can be worn comfortably is the most effective
4. The patient should report any discomfort during urination or defecation to the physician immediately
5. Cost ranges from $30-50 for a pessary |
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| What are urinary catheters indicated for? |
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Definition
1. Urinary incontinence
2. Urinary retention
3. Measurement of urinary output or residual volume (PVR) |
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T/F
Catheters decrease the patients risk of UTIs? |
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Definition
False.
Catheter-associated UTIs account for >40% of all nosocomial infections. |
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| What is the size range of catheters and how do you come up with that measurement? |
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Catheters are sized from 10Fr-30Fr.
The French (Fr) number divided by 3 is the outer diameter of the catheter in millimeters. |
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| When would you refer a catheterized patient to see their physician? |
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Definition
1. urine has a strong smell or becomes thick and/or cloudy
2. fever, chills
3. burning sensation
4. back pain
5. urethral swelling around the catheter
6. bleeding into or around the catheter
7. catheter draining little or no urine despite adequate fluid intake
8. leakage of large amounts of urine around the catheter |
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| What does Saw Palmetto do? Active ingredient, interactions, side effects... |
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| Saw Palmetto (dwarf palm/Serenoa repens/ Sabal serrulata)- active ingredient is unknown. Indicated for BPH. There is conflicting evidence to its efficacy. SIDE EFFECTS: mild GI effeects. No interactions. |
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| What does Cranberry do? interactions, active ingredient, side effects... |
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| Cranberry- it was once thought that cranberries increased the amount of hippuric acid in the urine. Another claims cranberrys cause urinary acidification. Both theories, however, have been disproven. Active ingredient is unknown. Cranberries contain a substance that prevents bacterial adhesion to the bladder wall. Indications: UTI prophylaxis & tx and urinary deodorant. No evidence as to whether or not cranberries can cure UTIs, but they can prevent UTIs in women with recurrent UTIs. No interactions and no side effects. |
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| Name two herbal products that claim to treat urinary tract problems. |
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Definition
1. Saw Palmetto
2. Cranberry |
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| What are the three places that are the best to look for unbiased herbal information? |
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Definition
1. Facts and Comparisons Review of Natural Products [rxweb/idapharm]
2. Natural Medicines Comprehensive Database, by the Pharmacists Letter [Computer Resources->Pharm Letter->Natural Medicines]
3. Cochrane Database [http://www.isu.edu/library/ihsl then click on Cochrane Library] |
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| A good source to determine the quality of a nutritional supplement is_______________. |
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Definition
| www.consumerlab.com You need a subscription, but it doesn't cost much. |
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| What is cystography and how is it performed? |
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| it's for diagnosing vesiculoureteral reflux. It is performed by instilling a pertechnetate into the bladder then having the patient void into a bedpan while infront of the camera. (You can see if the urine is flowing back up the ureter. |
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| What is a renogram and how does it work? |
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| It assesses kidney function (perfusion and urine formation) and evaluates renal obstructions, renal artery stenosis, acute tubular necrosis, transplant rejection, and renovascular HTN.99m Tc-MAG3 is injected via IV, activity in the kidney is seen 30-60 sec later. |
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| What are the six possibilities of a renogram showing a delayed normal peak activity? (typically seen after 3-5mins) |
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| Peak activity is delayed with dehydration, renal artery stenosis, actue tubular necrosis, nephritis, urinary tract obstructions, or kidney transplant rejection. |
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| What is a diuretic renogram? |
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Definition
| administer 99mTc-MAG via IV, wait 20 mins, give furosemide 40mg IV (to increase urine flow). Prompt washout of kidney activity is normal. Lack of washout indicates urinary obstruction. |
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| What does it mean when there is a lack of washout when performing a diuretic renogram? |
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Definition
| urinary obstructions cause a lack of washout. |
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| What is a captopril renogram and how does it work? |
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Definition
It's used to DIAGNOSE renovascular HTN (elevated BP secondary to renal artery stenosis, the stenosis causes a reduction in renal artery pressure, and the body responds by stimulating the renin-angiotensin system, which constricts the efferent areteriole to resport the pressure)
ACEI (Captopril) relaxes the efferent arteriole causing a drop in the stenotic kidney's filtration pressure and a reduced extraction of 99mTc-MAG3. |
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| What are five indications for use of pessaries? |
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Definition
Indications include nonsurgical management of pelvic support defects,such as:
1. uterine prolapse
2. vaginal prolapse
3. stress incontinence
4. cystocele
5. rectocele |
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| What are the symptoms of BPH? |
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Definition
1. urgency
2. frequency
3. nocturia
4. hesitancy
5. weak stream
6. dribbling
7. increased PVR (postvoid residual) |
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