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*Announcement for Online Session No 66* *11 Sep 2022* DEAR DOCTORS : MAY I HAVE YOUR ATTENTION PLEASE : *Today we will have an online session on Zoom discussing 1 station 2 ( History Taking )* regarding our preparation for MRCP PACES ( UK ) TIMINGS : Saudia Arabia: 4 pm Pakistan : 6 pm Bangladesh : 7 pm India : 6 30 pm Singapore : 9 pm Hong Kong : 9 pm Malaysia : 9 pm Egypt : 3 pm Libya : 3 pm Bahrain : 4 pm Burma ( Myanmar ) :7 30 pm Sudan : 3 pm UAE : 5 pm UK : 2 00 pm Ireland ( Dublin ) : 2 00 pm Afghanistan : 5 30 pm Kenya : 4 00 pm Germany ( Berlin ) : 3 00 pm Nigeria : 2 00 pm Japan ( Tokyo ) : 10 00 pm Denmark : 3 00 pm Qatar : 4 00 pm Oman : 5 00 pm Italy : 3 00 pm Indonesia : 8 00 pm ( please Google for your local time zones to avoid any inconvenience ) Zoom meeting link will be shared 5 minutes before start time. The candidate for today,s session has been selected GOOD LUCK.

*Announcement for Online Session No 66* *11 Sep 2022* DEAR DOCTORS : MAY I HAVE YOUR ATTENTION PLEASE : *Tomorrow we will have an online session on Zoom discussing 1 station 2 ( History Taking )* regarding our preparation for MRCP PACES ( UK ) TIMINGS : Saudia Arabia: 4 pm Pakistan : 6 pm Bangladesh : 7 pm India : 6 30 pm Singapore : 9 pm Hong Kong : 9 pm Malaysia : 9 pm Egypt : 3 pm Libya : 3 pm Bahrain : 4 pm Burma ( Myanmar ) :7 30 pm Sudan : 3 pm UAE : 5 pm UK : 2 00 pm Ireland ( Dublin ) : 2 00 pm Afghanistan : 5 30 pm Kenya : 4 00 pm Germany ( Berlin ) : 3 00 pm Nigeria : 2 00 pm Japan ( Tokyo ) : 10 00 pm Denmark : 3 00 pm Qatar : 4 00 pm Oman : 5 00 pm Italy : 3 00 pm Indonesia : 8 00 pm ( please Google for your local time zones to avoid any inconvenience ) Zoom meeting link will be shared 5 minutes before start time. The candidate for tomorrow,s session has been selected GOOD LUCK.

👉 *IMPORTANT 523* 👈 *Commonest causes of AKI :* Sepsis. Major surgery. Cardiogenic shock. Other hypovolaemia. Drugs. Hepatorenal syndrome. Obstruction. Good Luck

👉 *IMPORTANT 522* 👈 The Kidney Diseases: Improving Global Outcomes (KDIGO) guidelines define AKI as: • rise in creatinine >26μmol/L within 48h. • rise in creatinine >1.5 ≈ baseline (ie before the AKI) within 7 days. • urine output <0.5mL/kg/h for >6 consecutive hours. Good Luck

👉 *IMPORTANT 521* 👈 *Catheterized patients and UTI* All catheterized patients are bacteriuric. Send MSU only if symptomatic. Symptoms of UTI may be non-specific/atypical. Possible symptoms include fever, flank suprapubic pain, change in voiding pattern, vomiting, confusion, sepsis. Change long-term catheter before starting an antibiotic. Refer to local guidelines for initial antibiotic choice. Where possible use a narrow-spectrum antibiotic according to culture sensitivity. Good Luck

👉 *IMPORTANT 520* 👈 Avoid using ciprofloxacin, trimethoprim in 1st trimester and nitrofurantoin in 3rd trimester while managing UTI in pregnancy Good Luck

👉 *IMPORTANT 519* 👈 Please Do not use antibiotics for the treatment of asymptomatic bacteriuria in non-pregnant women, men, and adults with catheters. Good Luck

👉 *IMPORTANT 518* 👈 *Causes of sterile pyuria* *Non infection related* Calculi Renal tract tumour Papillary necrosis Tubulointerstitial nephritis Chemical cystitis Polycystic kidney Recent catheter Pregnancy SLE Drugs, eg steroids Good Luck

👉 *IMPORTANT 517* 👈 *Causes of sterile pyuria* *Infection related* TB Recently treated UTI Inadequately treated UTI Fastidious culture requirement Appendicitis Prostatitis Chlamydia Good Luck

👉 *IMPORTANT 515* 👈 *Sterile pyuria* Increased numbers of white cells in urine but sterile on standard culture Good Luck

👉 *IMPORTANT 514* 👈 *Common organisms in UTI* Usually anaerobes and Gram-negative bacteria from bowel and vaginal flora. E. coli is the main organism (75–95% in community ). Staphylococcus saprophyticus (a skin commensal) in 5–10%. Other enterobacteriaceae such as Proteus mirabilis and Klebsiella pneumonia. Good Luck

ANNOUNCEMENT Hello n salam everyone Regarding our *Sep 2022 online course for PACES MRCP (UK) ( duration 15 days ).* starting from *12 Sep* till *28 Sep* All slots for active participants are fully occupied however *you can still join as Listeners* Interested candidates may send a personal message for details. WhatsApp No: 00923346036496. Email: drtanzeelbukhari@gmail.com GOOD LUCK.

👉 *IMPORTANT 513* 👈 Please Do not rely on classical symptoms and signs of UTI in a catheterized patient. Good Luck

👉 *IMPORTANT 512* 👈 *Few signs in urinary tract infections* Fever Abdominal or loin tenderness Check for a distended bladder Enlarged prostate. If vaginal discharge, consider PID Good Luck

👉 *IMPORTANT 511* 👈 *Few symptoms of urinary tract infection :* • *Cystitis:* Frequency, dysuria, urgency, supra pubic pain, polyuria, haematuria. • *Acute pyelonephritis:* Fever, rigor, vomiting, loin pain/tenderness, costovertebral pain, associated cystitis symptoms, septic shock. • *Prostatitis:* Pain: perineum, rectum, scrotum, penis, bladder, lower back. Fever, malaise, nausea, urinary symptoms, swollen or tender prostate on PR Good Luck

👉 *IMPORTANT 510* 👈 *Few risk factors for UTI* • increased Bacterial inoculation: Sexual activity, urinary incontinence, faecal incontinence, constipation. • Reduced binding of uropathogenic bacteria: Spermicide use, decreased oestrogen, menopause. • Decreased Urine flow: Dehydration, obstructed urinary tract. • Increased bacterial growth: DM, immunosuppression, obstruction, stones, catheter, renal tract malformation, pregnancy. Good Luck