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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.
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*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.
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π *IMPORTANT 523* π
*Commonest causes of AKI :*
Sepsis.
Major surgery.
Cardiogenic shock.
Other hypovolaemia.
Drugs.
Hepatorenal syndrome.
Obstruction.
Good Luck
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π *IMPORTANT 522* π
The Kidney Diseases: Improving Global Outcomes (KDIGO) guidelines define AKI as:
β’ rise in creatinine >26ΞΌmol/L within 48h.
β’ rise in creatinine >1.5 β baseline (ie before the AKI) within 7 days.
β’ urine output <0.5mL/kg/h for >6 consecutive hours.
Good Luck
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π *IMPORTANT 521* π
*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
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π *IMPORTANT 520* π
Avoid using ciprofloxacin, trimethoprim in 1st trimester and nitrofurantoin in 3rd trimester while managing UTI in pregnancy
Good Luck
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π *IMPORTANT 519* π
Please
Do not use antibiotics for the treatment of asymptomatic bacteriuria in non-pregnant women, men, and adults with catheters.
Good Luck
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π *IMPORTANT 518* π
*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
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π *IMPORTANT 517* π
*Causes of sterile pyuria*
*Infection related*
TB
Recently treated UTI
Inadequately treated UTI
Fastidious culture requirement
Appendicitis
Prostatitis
Chlamydia
Good Luck
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π *IMPORTANT 515* π
*Sterile pyuria*
Increased numbers of white cells in urine but sterile on standard culture
Good Luck
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π *IMPORTANT 514* π
*Common organisms in UTI*
Usually anaerobes and Gram-negative bacteria from bowel and vaginal flora.
E. coli is the main organism (75β95% in community ).
Staphylococcus saprophyticus (a skin commensal) in 5β10%.
Other enterobacteriaceae such as Proteus mirabilis and Klebsiella pneumonia.
Good Luck
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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.
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π *IMPORTANT 513* π
Please
Do not rely on classical symptoms and signs of UTI in a catheterized patient.
Good Luck
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π *IMPORTANT 512* π
*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
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π *IMPORTANT 511* π
*Few symptoms of urinary tract infection :*
β’ *Cystitis:* Frequency, dysuria, urgency, supra pubic pain, polyuria, haematuria.
β’ *Acute pyelonephritis:* Fever, rigor, vomiting, loin pain/tenderness, costovertebral pain, associated cystitis symptoms, septic shock.
β’ *Prostatitis:* Pain: perineum, rectum, scrotum, penis, bladder, lower back. Fever, malaise, nausea, urinary symptoms, swollen or tender prostate on PR
Good Luck
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π *IMPORTANT 510* π
*Few risk factors for UTI*
β’ increased Bacterial inoculation: Sexual activity, urinary incontinence, faecal incontinence,
constipation.
β’ Reduced binding of uropathogenic bacteria: Spermicide use, decreased oestrogen, menopause.
β’ Decreased Urine flow: Dehydration, obstructed urinary tract.
β’ Increased bacterial growth: DM, immunosuppression, obstruction, stones, catheter, renal tract malformation, pregnancy.
Good Luck
