Not a country western guy
Incompatibility of blood groups causes this type of hypersensitivity reaction
Bonus: What type of hypersensitivity reaction is chronic transplant rejection?
Bonus Bonus: Acute transplant rejection?
What is a type II reaction?
Slide 10
Bonus: Type 3 (ish)
Bonus Bonus: Type 4
Remember that Ab against blood Ag are more frequent in patients who have received multiple blood transfusions
NSAIDs indirectly cause this glomerular arteriole to constrict
Bonus: What arteriole do ACEIs and ARBs effect?
What is the afferent arteriole?
Bonus: Dilate efferent arteriole
This is the only time in life which UTIs affect men more than women
What is a newborn?
Slide 7
50 and above, UTIs affect men and women equally
This phosphate binder combines with dietary phosphate into insoluble calcium phosphate
What is calcium acetate (PhosLo)?
Slide 19
Patients with hypercalcemia should not take PhosLo and no other calcium supplements should be taken with PhosLo
Remember that phosphate binders are taken with meals
This drug requires bacterial nitroreductases to convert it to reactive metabolites
What is Nitrofurantoin?
Particularly effective against E. coli and Enterococci
Systemic toxicity can arise in patients with decrease renal function
This test is the HLA equivalent of ABO cross-matching
What is Mixed Lymphocyte Reaction (MLR)?
Slide 22
This is the MOA of oxybutynin
Bonus: If a patient can't handle the side effects of oxybutynin, this other drug can be used instead to achieve the same desired effect
Bonus Bonus: What is the MOA of this alternative drug?
What is a competitive muscarinic antagonist (anticholinergic)?
Bonus: Mirabegron
Bonus Bonus: B3 agonist
Recurrence of a UTI within this timeframe is usually regarded as a relapse rather than a reinfection
Bonus: In asymptomatic patients, this is the standard threshold for bacterial growth in CFUs that is reflective of bladder bacteriuria
Bonus Bonus: What is the treatment for ASB?
What is 2 weeks?
Slide 19
Bonus: 105 CFUs/mL
Bonus Bonus: Don't treat; unless patient is pregnant, undergoing urologic intervention, or is a renal transplant recipient
In symptomatic females with pyuria, lower midstream urine counts (≥102 CFUs/mL) have been associated with the presence of bladder bacteriuria
This is the MOA of cinacalcet
What is binding to CaSR in the parathyroid gland?
Slide 21
This is the MOA of fosfomycin
What is inhibition of MurA?
Block the first step in cell wall synthesis
A recipient's serum reacts with donor B cells but not donor T cells. This class of HLA antibody is the most likely explanation.
What are anti-HLA-II antibodies?
Slide 12
- anti-HLA-I Abs react with both B and T cells
- anti-HLA-II Abs react only with B cells
Cisplatin and aminoglycosides cause toxicity in this region of the nephron
Bonus: What is the major electrolyte disturbance associated with desmopressin?
What is the PCT?
Bonus: Hyponatremia
These are the 3 main first-line treatments (and timeframe) for simple cystitis
Bonus: Which one of these treatments should be reserved for MDR infections only or if the others cannot be used?
What are nitrofurantoin (5 days), TMP-SMX (3 days), and fosfomycin (1 dose)?
Slide 34
Bonus: Fosfomycin
The monitoring of these 2 serum levels are required in calcitriol and vitamin D analog therapy
What are calcium and phosphate?
Slide 18
TMP-SMX should be avoided in patients with this allergy
Bonus: This bactericidal antibiotic class kills urinary pathogens by preventing peptidoglycan cross-linking
What is a sulfa allergy?
Bonus: Beta-Lactams
When transplanting tissues, matching of at least these 3 HLA isotypes shows good outcomes in the context of immunosuppressive drugs
What are HLA-A (I), HLA-B (I), and HLA-DR (II)?
Slide 15
Best outcome: HLA-A, HLA-B, HLA-C, HLA-DP, HLA-DQ, and HLA-DR
Still good: HLA-A, HLA-B, HLA-C, and HLA-DR
REMEMBER: There is codominant expression of MHC alleles, so you need to match 2 alleles per HLA isotype!!!!!
This class of drug may be used to treat urinary problems due to BPH
Bonus: What drug can be used to treat an underactive bladder?
What are alpha-1 blockers?
Bonus: Bethanechol (muscarinics)
These 2 pathogens are tied for the most common causative agents for catheter-associated UTIs
Bonus: In men with acute complicated cystitis, this class of drugs should be used due to concern for prostate involvement
What are E. coli and Candida species?
Slide 45
Bonus: Fluoroquinolones
While a patient is on epoetin alfa, it is important to monitor the level of this, in order to reduce the risk of thromboembolic events
Bonus: This therapy is only effective if this mineral is also available
What is hemoglobin?
Slide 27 and 28
Bonus: Iron
Hb goal: 10-11 g/dL
This antibiotic class is often avoided as first-line therapy for uncomplicated cystitis because of toxicity concerns rather than lack of efficacy.
Bonus: What is the MOA of this drug class
What are fluoroquinolones?
Bonus: Inhibits DNA gyrase/Topoisomerase IV
Sharing this specific HLA allotype between a prior blood transfusion and a transplanted organ is associated with the transfusion effect
What is HLA-DR?
Slide 26
Development of Treg cells that suppress alloreactive CD4 and CD8 effector T cells, via the indirect pathway of allorecognition
This is a rare but potentially severe disease associated with exposure to certain gadolinium-based contrast agents, mainly in people with severe kidney dysfunction
Bonus: Amphotericin B can cause renal tubular injury, leading to urinary wasting of these two electrolytes
What is nephrogenic systemic fibrosis?
Bonus: Potassium and Magnesium
Hematogenous spread accounts for <2% of documented UTIs and usually results from bacteremia caused by these 2 organisms
What are salmonella and S. aureus?
Slide 16
Remember that candiduria usually comes from hematogenous spread
Diabetes by itself is not enough, but the additional presence of either of these two findings warrants therapy with an ACE inhibitor or ARB
Bonus: What side effect of ACEIs is the usual cause of patients switching to an ARB?
What are hypertension and/or albuminuria?
Slide 32
Bonus: Persistent dry cough
Remember that there is a transient rise in creatinine at the beginning of the use of these drugs, and to also monitor potassium levels
This drug is used more for UTI prophylaxis rather than an active infection
What is Methenamine?
Requires acidic urine (pH <5 for optimal activity); converted to formaldehyde and ammonia