Chapter 23_2 flashcards
(20 cards)
Lower Urinary Tract Infection (UTI) / Cystitis: Common Cause & Symptoms
Most commonly caused by E. coli. Symptoms: Dysuria (pain/burning), frequency, and urgency. Hematuria may be present. A simple UTI does NOT typically cause fever.
UTI with Fever: Significance
A fever alongside UTI symptoms raises concern for pyelonephritis (a kidney infection), which is more serious and requires prompt medical attention.
UTI Risk Factors: Women vs. Men
Women are at higher risk due to shorter urethra and proximity to rectum. Men are rarely affected unless older; BPH is the most common cause of obstruction in men over 60.
Hospital-Acquired UTI (CAUTI)
Often associated with urinary catheterization and can involve multi-drug resistant bacteria.
UTI: Diagnosis & Treatment
Diagnosis: Urinalysis showing positive leukocyte esterase (WBCs) and nitrites (bacteria); urine culture confirms infection (>100,000 CFU/mL). Treatment: Antibiotics (e.g., nitrofurantoin, Bactrim), hydration. Phenazopyridine (Pyridium) for pain relief (turns urine red-orange).
Urosepsis: Definition & Risk Factors
A serious complication where a UTI spreads to the bloodstream, causing systemic infection. Symptoms include fever, chills, confusion, and hypotension. Elderly, catheterized, and immunocompromised individuals are most at risk.
Asymptomatic Bacteriuria (ASB)
The presence of bacteria in the urine (>100,000 CFU/mL on 2 cultures) without any symptoms of a UTI. Antibiotic treatment is generally NOT recommended unless the patient is pregnant.
Interstitial Cystitis (IC) / Painful Bladder Syndrome (PBS): Definition & Symptoms
A chronic bladder condition causing urgency, frequency (often >50 times/day), bladder fullness, and pain that is relieved by emptying the bladder.
Interstitial Cystitis (IC): Ulcerative vs. Nonulcerative
Ulcerative (Hunner’s Ulcer): A lesion is present on the bladder wall. Nonulcerative (more common): Bladder wall shows small tears and pinpoint hemorrhages (glomerulations) on bladder distention.
Interstitial Cystitis (IC): Treatment
No single treatment. Includes bladder training, Kegel exercises, avoiding irritating foods. Medications may include anticholinergics or amitriptyline. Intravesical therapy (meds into bladder) or Botox injections may be used.
Urolithiasis (Kidney Stones): Main Symptom
Renal colic: severe, intermittent (wave-like) pain in the flank and back that often radiates to the groin.
Urolithiasis: Main Types of Stones
- Calcium stones (most common, ~75%). 2. Struvite stones (associated with Proteus UTI). 3. Uric acid stones (associated with gout, high purine diet). 4. Cystine stones (rare genetic disorder).
Urolithiasis: Diagnosis & Treatment
Diagnosis: Urinalysis (hematuria, crystalluria), CT scan (gold standard), ultrasound. Stone analysis is key. Treatment: Pain medication, hydration (>3 L/day), lithotripsy (sound waves to break up stone), or cystoscopic surgery.
Bladder Cancer: Cardinal Feature
Painless, intermittent, gross hematuria (visible blood in urine).
Bladder Cancer: Risk Factors & Diagnosis
Cigarette smoking is the major risk factor. Also occupational exposure to organic chemicals. Diagnosis: Cystoscopy with transurethral biopsy is the gold standard.
Urinary Incontinence: Stress Incontinence
Most common type. Involuntary urine leakage during activities that increase abdominal pressure (coughing, sneezing, lifting). Caused by weakness of pelvic floor muscles.
Urinary Incontinence: Urge Incontinence / Overactive Bladder (OAB)
Caused by detrusor muscle overactivity, leading to a sudden, intense urge to urinate followed by involuntary loss of urine.
Urinary Incontinence: Overflow Incontinence
Involuntary release of urine from an overly full bladder, without the urge to urinate. Often due to bladder outlet obstruction (like BPH) or a weak detrusor muscle.
Urinary Incontinence: Functional & Neurogenic
Functional Incontinence: Inability to hold urine due to physical or cognitive issues (e.g., immobility, stroke, dementia). Neurogenic Bladder: Loss of bladder control due to a spinal cord or nerve condition.
Urinary Incontinence: Treatment
First-line, non-medication treatment is Kegel exercises to strengthen pelvic floor muscles. Other options include anticholinergic drugs (less ideal for elderly), incontinence pessaries, and surgery (e.g., transvaginal mesh).
