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Pathopharm I > Urologic Problems > Flashcards

Urologic Problems Flashcards

1
Q

UTI most common sites

A

Lower urinary tract & bladder

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2
Q

Reasons UTI common in women

A

Short urethra
Incomplete emptying
Urethral irritation

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3
Q

UTI risk factor

A

Protein in urine is a great risk for microorganism growth

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4
Q

UTI most common bacteria

A

E.coli

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5
Q

Bacteriuria

A

Bacteria in the urine NOT causing infection but places at risk for UTI

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6
Q

Urethritis

A

Infection in the urethra

Lower UTI

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7
Q

Cystitis

A

Infection in the bladder

Lower UTI

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8
Q

UTI Uncomplicated S/S

A

Asymptomatic, urgency, frequency, dysuria, hematuria, cloudy/foul urine, fever/chills/fatigue

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9
Q

UTI Uncomplicated diagnosis

A

H&P, UA, URINE CULTURE, CBC—leukocytosis

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10
Q

UTI Uncomplicated treatment

A

ANTIBIOTICS, ↑fluids, avoid irritants (i.e., caffeine), loose cotton clothes, frequent urination, probiotics

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11
Q

UTI: Protective Factors

A 
Acidic pH
Presence of urea
Men: prostatic secretions
Women: urethral gland secretions
Unidirectional urine flow
One-way valve at ureteral attachment to bladder
Immune system
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12
Q

UTI: Risk Factors

A

Catheters
Female sex (perineal irritation)
Older age (nursing home up to 50% have bacteriuria)
Pregnancy
Sexual activity (spermicide use with diaphragm or condom)
Urinary obstruction/reflux

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13
Q

UTI: Risk Factors

A

Immobility: urinary stasis
Bowel/urine incontinence
Decreased cognition
Bad personal hygiene

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14
Q

UTI in men

A

More likely to have recurrent UTI’s because bacteria can hide deep in the prostate/ BPH causing urinary retention

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15
Q

Urethritis/lower UTI s/s

A

Dysuria

Most common: ASYMPTOMATIC

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16
Q

Cystitis (bladder)/lower UTI s/s

A 
Frequency
Urgency
Suprapubic discomfort
Dysuria
Hematuria
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17
Q

UTI s/s in children

A 
Fever
Irritability
Poor feeding
Vomiting
Diarrhea
Ill appearance
Old enough to verbalize? 
Can be sign of sexual abuse
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18
Q

UTI s/s in elderly

A 
Anxiety
CONFUSION
Lethargy
Anorexia
Falls
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19
Q

Lower UTI pharm

A

trimethoprim-sulfamethoxazole (Bactrim)
ciprofloxacin
nitrofurantoin (Macrodantin/Macrobid)

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20
Q

trimethoprim-sulfamethoxazole (Bactrim) for lower UTI

A

First-line

Don’t give if sulfa allergies

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21
Q

ciprofloxacin for lower UTI

A

For patients with sulfa allergies

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22
Q

nitrofurantoin (Macrodantin/Macrobid) for lower UTI

A

For recurring lower UTIs

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23
Q

Urinary tract analgesic

A

phenazopyridine (Pyridium)

24
Q

phenazopyridine (Pyridium) indication

A

Relief of PAIN due to UTI

25
Q

phenazopyridine (Pyridium) MOA

A

Dye used in paint; local analgesic action

26
Q

phenazopyridine (Pyridium) SE

A

Well tolerated

REDDISH-ORANGE URINE

27
Q

Anatomy

A

Bladder is composed of smooth muscle (detrusor muscle); holds about 300-500 mL of urine; pelvic floor muscle help control bowel and bladder

28
Q

Overactive bladder

A

Occurs when bladder muscles involuntarily contract even when urine volume is low

29
Q

Overactive bladder causes

A 
Neurological conditions (CVA)
DM
UTIs
Hormonal changes during menopause
Badder tumors/stones
30
Q

Overactive bladder s/s

A

Sudden urge to urinate (may experience urgency incontinence)
Increased frequency (usually >8x in 24 hrs)
Nocturia (wake up >2x during the night)

31
Q

Overactive bladder causes

A 
Neurological disorders
Diabetes
UTI's
Hormonal changes
Tumors/stones
Obstructions
32
Q

mirabegron (Myrbetriq) class

A

Antispasmotic (urinary)

Beta-3 adrenergic agonists–me

33
Q

mirabegron (Myrbetriq) MOA

A

Selectively stimulates beta-3 adrenergic receptors, relaxing bladder smooth muscle

34
Q

mirabegron (Myrbetriq)/antispasmotic route

A

PO

35
Q

mirabegron (Myrbetriq)/antispasmotic SEs

A

HTN—must monitor BP
Urinary retention
UTI
Headache

36
Q

Incontinence

A

Involuntary urine loss

37
Q

Incontinence and older adults

A

NOT normal symptom of aging but may be related to functional changes associated with aging

38
Q

Urgency incontinence

A

Involves the involuntary leakage of urine immediately after a sudden sensation to urinate

39
Q

Urgency incontinence cause

A

Overactive detrusor muscle that suddenly contracts

40
Q

Urgency incontinence risk factors

A

Older age
Bladder infection that irritates the bladder lining
Bladder outlet obstruction (enlarged prostate)
CNS conditions (Parkinson’s, dementia, MS, CVA)
Drugs (diuretics, alcohol)

41
Q

Stress incontinence

A

Occurs when urine is involuntarily lost with increases in intraabdominal pressure
Precipitated by effort or exertion such as sneezing, coughing, or just bending down

42
Q

Stress incontinence causes

A

Loss of pelvic muscle and/or loss of fascial support of bladder and urethra; without support any increase in intraabdominal pressure changes normal angle between bladder and urethra and urethra cannot close all the way, causing leakage of urine

43
Q

Stress incontinence risk factors

A

Age (loss of pelvic floor muscle)
Obesity
Childbirth-related trauma
Pelvic surgery

44
Q

Mixed incontinence

A

Combination of urge and stress

Common in older women

45
Q

Overflow incontinence

A

Occurs when bladder is too full

Common in BPH-urinary retention

46
Q

Functional incontinence

A

Related to physical & environmental limitations

Inability to get to toilet in time

47
Q

Transient incontinence

A

Usually related to disease process
Sudden onset; reversible
Often related to UTI, constipation, or fecal impaction

48
Q

Incontinence complications

A

Skin irritation/inflammation
Redness, pain, and itching
Swelling, blisters, dryness
Damaged skin now vulnerable to infection
Damp/warm skin is breeding ground for bacteria and fungi
Areas at risk areas: genitals, between buttocks, inner thighs

49
Q

oxybutynin (Oxytrol) class

A

Anti-cholinergic

50
Q

oxybutynin (Oxytrol) MOA

A

Blocks the action of acetylcholine (rest/digest)

Acetylcholine activates bladder smooth muscle contractions

51
Q

oxybutynin (Oxytrol)/anti-cholinergic indications

A

Overactive bladder, incontinence

52
Q

oxybutynin (Oxytrol)/anti-cholinergic SEs

A

Dry mouth, constipation

53
Q

oxybutynin (Oxytrol)/anti-cholinergic form/route

A

Can be in extended- release forms

Only given PO

54
Q

Transient incontinence

A

Causes by medical conditions

Incontinence type most likely associated with a UTI

55
Q

Stress incontinence

A

Occurs due to weakness or injury to the urinary sphincter or pelvic floor muscles

56
Q

Overflow incontinence

A

Often caused by an overdistended bladder

Pathopharm I (10 decks)

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