Genitourinary Disorders Flashcards
(127 cards)
1
Q
Describe the role of the renal system in the body.
A
The renal system reabsorbs, secretes, and regulates toxins and electrolytes, playing a crucial role in maintaining homeostasis.
2
Q
Explain how water movement is influenced by sodium in the body.
A
Water follows sodium through osmosis, which is the net movement of water to equalize solute concentrations on either side of a permeable membrane.
3
Q
Define urosepsis and its significance in elderly patients.
A
Urosepsis is a severe infection originating from the urinary system, particularly dangerous in elderly patients due to its high mortality rate.
4
Q
How do the kidneys contribute to blood pressure regulation?
A
The kidneys help regulate blood pressure by controlling blood volume and electrolyte balance, which affects vascular resistance.
5
Q
Explain the structure and function of the nephron.
A
The nephron is the main functional unit of the kidneys, consisting of the renal corpuscle, glomerulus, and various tubules that filter blood and form urine.
6
Q
Describe the process of renal blood flow.
A
Renal blood flow involves the left and right renal arteries feeding into interlobular arteries, which then lead to afferent arterioles, glomerular capillaries, and efferent arterioles, facilitating filtration and reabsorption.
7
Q
What is the glomerular filtration rate (GFR) and its clinical significance?
A
GFR measures the rate of filtration in the kidneys; a GFR below 60 indicates kidney disease, while normal ranges are 90-120 ml/min.
8
Q
How do diuretics affect fluid balance in the body?
A
Diuretics, such as frusemide, inhibit the reabsorption of fluid in the kidneys, leading to increased urine production and fluid elimination.
9
Q
Explain the role of ADH in renal function.
A
ADH (antidiuretic hormone) acts on the collecting ducts to promote water reabsorption, reducing urine output and helping to maintain fluid balance.
10
Q
Describe the mechanisms of renal reabsorption and secretion.
A
Renal reabsorption and secretion involve the movement of water and solutes along the nephron, with specific substances being reabsorbed or secreted at different segments.
11
Q
What factors regulate the glomerular filtration rate (GFR)?
A
GFR is regulated by renal autoregulation, sympathetic control, hormonal control (renin-angiotensin-aldosterone system), and medications.
12
Q
Explain the significance of juxtaglomerular cells in kidney function.
A
Juxtaglomerular cells monitor the filtration rate and release renin in response to changes, activating the renin-angiotensin-aldosterone system to regulate blood pressure.
13
Q
How does the body respond to fluid retention when GFR is less than 15?
A
When GFR is less than 15, the body experiences fluid retention, and creatinine levels may rise due to decreased kidney function.
14
Q
Describe the transport mechanisms involved in renal tubular reabsorption.
A
Transport mechanisms include simple diffusion, osmosis, active transport, and facilitated transport, allowing for the movement of solutes and water across tubular membranes.
15
Q
What is the impact of elevated creatinine levels on kidney function?
A
Elevated creatinine levels indicate impaired kidney function, as healthy kidneys excrete creatinine effectively.
16
Q
Explain the role of the renal corpuscle in the nephron.
A
The renal corpuscle, consisting of the glomerulus and Bowman’s capsule, is responsible for the initial filtration of blood in the nephron.
17
Q
Describe the composition of the nephron and its components.
A
The nephron is composed of approximately 1 million units per kidney, including the renal corpuscle, proximal convoluted tubule, loop of Henle, distal convoluted tubule, and collecting ducts.
18
Q
How does the body maintain fluid balance in relation to dehydration?
A
The body maintains fluid balance by regulating water reabsorption in the kidneys, adjusting urine output based on hydration status.
19
Q
Describe the role of blood pressure in regulating glomerular filtration rate (GFR).
A
Higher blood pressure increases renal perfusion, leading to a higher filtration rate in the kidneys, while lower blood pressure decreases GFR.
20
Q
Explain how osmosis contributes to water reabsorption in the kidneys.
A
Osmosis drives water reabsorption in the proximal convoluted tubule and loop of Henle, where water follows sodium as it is transported into the extracellular fluid, increasing osmotic pressure.
21
Q
Define the function of aldosterone in fluid balance.
A
Aldosterone reabsorbs sodium (Na+), which causes water to follow sodium, thus helping to maintain fluid balance.
22
Q
How does antidiuretic hormone (ADH) affect water reabsorption in the kidneys?
A
ADH increases the permeability of the collecting duct by inserting aquaporins, allowing more water to be reabsorbed through osmosis.
23
Q
Explain the role of atrial natriuretic peptide (ANP) in fluid regulation.
A
ANP increases GFR by dilating afferent arterioles and constricting efferent arterioles, promoting the excretion of sodium and water when blood volume is too high.
24
Q
Describe the impact of dehydration on the body.
A
Dehydration can lead to symptoms such as hypotension, tachycardia, confusion, uncoordination, and collapse due to inadequate fluid intake or excessive fluid loss.
25
Identify factors that can lead to inadequate fluid intake in the elderly.
Factors include a blunted thirst response, dementia, stroke, and incapacitation, which can contribute to dehydration.
26
How does excessive fluid loss occur during gastrointestinal issues?
Fluid loss can occur through gastrointestinal conditions like gastroenteritis or obstruction, where water is drawn from the blood, leading to dehydration.
27
Explain the significance of osmoreceptors in fluid balance.
Osmoreceptors detect imbalances in water levels, triggering responses to either conserve or excrete water based on blood osmolarity.
28
What is the relationship between alcohol consumption and fluid balance?
Alcohol inhibits the action of ADH, blocking aquaporins and leading to increased urine production, which can result in dehydration.
29
Describe the assessment methods for hydration status.
Hydration status can be assessed through history of fluid intake and output, vital signs, urine and serum specific gravity, and physical examination of skin turgor and mucous membranes.
30
How does heat affect fluid loss in the body?
In hot conditions, increased sweating leads to greater fluid loss, which can contribute to dehydration.
31
Define the term 'negative feedback loop' in the context of fluid balance.
A negative feedback loop in fluid balance refers to the body's mechanisms that counteract changes in fluid levels, such as the release of hormones to restore balance when dehydration occurs.
32
What are the symptoms of severe dehydration?
Symptoms include hypotension, tachycardia, confusion, uncoordination, and potential collapse.
33
Explain the role of juxtaglomerular cells in blood pressure regulation.
Juxtaglomerular cells detect changes in filtration rate and respond by decreasing renin secretion when blood pressure is high, helping to regulate blood pressure.
34
Describe how renal function contributes to fluid balance.
Renal function is crucial for fluid balance as the kidneys filter blood, reabsorb necessary water and electrolytes, and excrete excess fluid.
35
What is the effect of high osmolarity in the renal medulla on water movement?
High osmolarity in the renal medulla facilitates the movement of water out of the collecting duct, aiding in the concentration of urine.
36
Identify conditions that can lead to excessive fluid loss.
Conditions include gastrointestinal issues, febrile illnesses, burns, heat stroke, and endocrine disorders like diabetes insipidus.
37
How does the body respond to low blood pressure in terms of fluid retention?
In response to low blood pressure, the body releases ADH to increase water reabsorption and restore blood volume.
38
Explain the role of diuretics in fluid balance.
Diuretics promote the excretion of water and sodium, which can lead to decreased blood volume and affect fluid balance.
39
What is the significance of skin turgor in hydration assessment?
Skin turgor is an indicator of hydration status; decreased turgor suggests dehydration, while normal turgor indicates adequate hydration.
40
Describe the signs of dehydration.
Signs of dehydration include thirst, decreased fluid intake, reduced urine output, increased sweating, vomiting, diarrhea, dry tongue and membranes, increased skin turgor, tachycardia, and postural blood pressure drop.
41
Explain the management strategies for dehydration.
Management strategies for dehydration include assessing severity, considering underlying pathologies, providing oral fluid replacement, establishing IV access for IV fluids, restoring perfusion of vital organs, and rehydrating slowly while being cautious of electrolyte disturbances.
42
Define the causes of overhydration and edema.
Causes of overhydration and edema include idiopathic reasons, polydipsia, iatrogenic factors, renal failure, liver failure leading to hypoproteinuria, cardiac failure, and lymphoedema.
43
How does renal failure contribute to edema?
Renal failure contributes to edema by causing increased hydrostatic pressure, hypervolemia, venous congestion, decreased osmotic pressure, and abnormal distribution of fluid across compartments.
44
Explain the management of edema.
Management of edema involves assessing severity, evaluating breath sounds, checking for peripheral edema and JVP, managing pulmonary edema with oxygen, GTN, CPAP, restricting fluids, and using diuretics.
45
Describe the role of electrolytes in the body.
Electrolytes maintain a fine balance between reabsorption and secretion, allowing for waste elimination and retention of important electrolytes like sodium, potassium, calcium, magnesium, and chloride.
46
What are the consequences of hypernatremia?
Consequences of hypernatremia include cellular dehydration, stimulation of thirst, nausea, vomiting, fever, and confusion.
47
Explain the causes and effects of hyponatremia.
Hyponatremia can be caused by psychogenic polydipsia, 'salt wasting' kidney disease, aldosterone insufficiency, diuretic use, and dehydration. Effects may include edema, CNS effects like headache, confusion, restlessness, and myoclonic jerks.
48
Describe the implications of hyperkalemia on the body.
Hyperkalemia can lead to acidosis, decreased aldosterone, ECG changes, Kussmaul's respirations, muscle weakness, lethargy, confusion, and nausea/vomiting.
49
How is hyperkalemia treated?
Treatment for hyperkalemia includes administering calcium gluconate as a cardiac protector, using salbutamol to increase sodium-potassium pump activity, and addressing underlying causes.
50
Define the pathophysiology of edema.
The pathophysiology of edema involves increased hydrostatic pressure, hypervolemia, venous congestion, decreased osmotic pressure, hemodilution, and abnormal fluid distribution leading to peripheral and pulmonary edema.
51
What factors should be considered in dehydration management for vulnerable populations?
In dehydration management for vulnerable populations, consider age (elderly or very young), cardiac comorbidities, and the severity of dehydration.
52
Explain the importance of a good history in managing edema.
A good history is crucial in managing edema as it helps differentiate causes based on onset time, medication compliance, and recent medical events like myocardial infarction or missed dialysis.
53
Describe the role of sodium and potassium in cellular function.
Sodium and potassium are essential for depolarization and stimulation of various actions within the body, affecting the SA node, atrial muscle, AV node, and ventricular muscle.
54
What are the signs of hyperkalemia on an ECG?
Signs of hyperkalemia on an ECG include peaked T waves, sine wave patterns, ventricular tachycardia, ventricular fibrillation, and bradycardia leading to asystole.
55
How does dehydration affect urine concentration?
Dehydration leads to concentrated urine due to reduced fluid intake and increased reabsorption of water in the kidneys to conserve fluids.
56
Explain the relationship between fluid overload and cardiac failure.
In cardiac failure, the hydrostatic gradient increases due to the heart's reduced ability to pump effectively, leading to fluid overload and edema.
57
Describe the role of insulin in potassium regulation.
Insulin decreases potassium levels by promoting the uptake of potassium into cells through the use of the sodium-potassium pump.
58
Explain the function of sodium bicarbonate in acid-base balance.
Sodium bicarbonate acts as a buffer for hydrogen ions (H+) and helps to neutralize acid, particularly in cases of acidosis.
59
How does Resonium help in managing potassium levels?
Resonium binds with potassium in the gastrointestinal system, facilitating its excretion and thereby reducing potassium levels in the body.
60
Define hypokalaemia and its common causes.
Hypokalaemia is a condition characterized by low potassium levels in the blood, commonly caused by diuretics, excessive aldosterone, and excessive IV fluids.
61
List the signs of hypokalaemia.
Signs of hypokalaemia include muscle weakness, fatigue, headaches, and arrhythmias such as ectopic beats.
62
What is the normal potassium range in the blood?
The normal potassium range in the blood is 3.5 to 5 mmol/L.
63
Explain the equilibrium of water in relation to pH.
Water exists in equilibrium as H2O <-> H+ + OH-, and the pH of a solution is determined by the concentration of free hydrogen ions (H+), with lower pH indicating higher acidity.
64
Describe the role of kidneys in acid-base balance.
The kidneys help maintain acid-base balance by secreting or reabsorbing hydrogen ions (H+) and bicarbonate (HCO3-), thus altering their concentrations in the blood.
65
How do kidneys excrete hydrogen ions?
Kidneys excrete hydrogen ions through sodium/hydrogen (Na+/H+) transporters.
66
What are pre-renal disorders and their causes?
Pre-renal disorders are conditions affecting kidney function due to issues in the vasculature, such as dehydration, hypotension, and cardiac failure.
67
Identify intra-renal disorders and their implications.
Intra-renal disorders involve problems within the kidney or nephron, such as glomerular nephritis and tubular necrosis, leading to renal insufficiency.
68
What is glomerulonephritis and its effects on kidney function?
Glomerulonephritis is damage to the glomerulus that causes it to become leaky, leading to renal insufficiency, proteinuria, and haematuria.
69
Explain the long-term consequences of glomerulonephritis.
Long-term consequences of glomerulonephritis can include chronic kidney disease, hypertension, and edema.
70
What is rhabdomyolysis and its relation to acute kidney injury (AKI)?
Rhabdomyolysis is the breakdown of muscle tissue that releases substances like creatine kinase and myoglobin, which can lead to acute kidney injury (AKI) due to the overload of potassium and other electrolytes.
71
Describe the impact of excessive aldosterone on potassium levels.
Excessive aldosterone can lead to hypokalaemia by promoting the excretion of potassium in the kidneys.
72
How does increased respiratory rate affect acid-base balance?
Increasing respiratory rate helps to blow off carbon dioxide (CO2), which can reduce acidity and help maintain acid-base balance.
73
What are the signs of acute kidney injury (AKI)?
Signs of acute kidney injury can include decreased urine output, fluid retention, and electrolyte imbalances.
74
Explain the relationship between chronic hyperglycaemia and kidney disease.
Chronic hyperglycaemia is a leading cause of chronic kidney disease in developed countries, often resulting from diabetes mellitus.
75
What are the effects of kidney stones on renal function?
Kidney stones can cause post-renal disorders by obstructing urine flow, leading to increased pressure and potential kidney damage.
76
Describe the causes of muscle breakdown leading to acute renal failure.
Crush injuries, toxins from envenomation, prolonged muscle use, and severe dehydration can cause muscle breakdown, leading to acute renal failure.
77
Explain the role of myoglobin in acute renal failure.
Myoglobin is a large protein that enters the glomerulus, obstructs filtering, damages epithelial cells, and causes ischemia through vasoconstriction, leading to acute renal failure.
78
Define post-renal causes of acute renal failure.
Post-renal causes include problems with urinary outflow such as urinary tract infections, renal stones, ureteric obstructions, and prostatism, which can lead to hydronephrosis and impaired kidney function.
79
How does hydronephrosis affect kidney function?
Hydronephrosis causes backflow and congestion of fluid into the nephron, leading to swelling of the renal pelvis and impaired kidney function.
80
Explain the difference between lower and upper urinary tract infections.
Lower urinary tract infections include cystitis (bladder infection) and urethritis (urethra infection), while upper urinary tract infections refer to pyelonephritis (kidney infection).
81
Describe the risk factors for urinary tract infections in females.
Females are more prone to UTIs due to a shorter urethra and the proximity of the urethra to the anus, allowing bacteria to enter more easily.
82
What are common lab findings in urinary tract infections?
Common lab findings include a positive urine culture, often showing pathogens like Escherichia coli and other GUT flora or STIs.
83
List the signs and symptoms of a urinary tract infection.
Signs and symptoms include dysuria, frequency, urgency, hematuria, suprapubic pain, nausea/vomiting (in pyelonephritis), flank pain, cloudy or foul-smelling urine, fever, and altered mentation in the aged.
84
What is the management for urinary tract infections?
Management includes antibiotics, fluids, analgesia for pain, and recognition of potential underlying causes.
85
Describe the formation and implications of kidney stones.
Kidney stones are hard mineral/salt deposits that can obstruct collecting ducts or ureters, causing pain and complications only when they lead to obstruction.
86
Identify the risk factors for developing kidney stones.
Risk factors include family history, diet high in protein, sodium, and sugar, low fluid intake, weight, stress, dehydration, and certain medical conditions.
87
What are the symptoms associated with kidney stones?
Symptoms include severe pain from loin to groin, hematuria, general weakness, fever, and nausea.
88
Explain the paramedic management for kidney stones.
Paramedic management includes administering analgesia, antiemetics, and transporting the patient for further evaluation.
89
What imaging techniques are used in hospital management of kidney stones?
Imaging techniques include renal ultrasound and CT scans of the kidneys, ureters, and bladder (KUB) to assess the size and location of stones.
90
Describe gout and its relationship with uric acid levels.
Gout is characterized by elevated uric acid levels, leading to the formation of uric acid crystals in joints, causing inflammatory arthritis.
91
What dietary factors contribute to gout?
Foods high in purine, such as wine, red meat, and seafood, can increase uric acid levels and contribute to gout.
92
Identify the symptoms of acute renal failure.
Symptoms include mental status changes, seizures, anemia, fatigue, nausea, pruritus, fluid overload, shortness of breath, and peripheral edema.
93
What are the hospital management strategies for acute renal failure?
Management includes treating the underlying cause, managing fluid and electrolytes, and potentially initiating dialysis.
94
Explain the symptoms of chronic kidney disease (CKD).
CKD is often asymptomatic until 90% of kidney function is lost, leading to various symptoms as function declines.
95
Describe the symptoms associated with chronic kidney disease (CKD).
Symptoms of CKD include polyuria (increased urination), oliguria (pain on urination), anuria (not urinating at all), hypertension, fluid overload, pulmonary oedema, dyspnoea, electrolyte imbalances, anaemia, weakness, fatigue, nausea, vomiting, and appetite loss.
96
Explain the underlying causes of kidney disease.
Underlying causes of kidney disease include congenital factors, vascular issues, primary and secondary glomerular disease, tubular/interstitial disease, and urinary tract disease.
97
Define the risk factors for chronic kidney disease.
Risk factors for chronic kidney disease include diabetes mellitus (DM), hypertension, history of atherosclerotic disease, familial history, obesity, smoking, increasing age, being of Aboriginal or Torres Strait Islander origin, and previous acute kidney disease.
98
How is chronic kidney disease measured?
Chronic kidney disease is measured via glomerular filtration rate (GFR), proteinuria (albuminaemia), haematuria (presence of red blood cells), and elevated levels of creatinine and urea.
99
Do electrolyte imbalances affect kidney function?
Yes, electrolyte imbalances can lead to complications such as impaired erythropoietin production, which affects red blood cell formation and can result in anaemia.
100
Explain the community management strategies for chronic kidney disease.
Community management of CKD includes maintaining fluid and electrolyte balance, dietary restrictions (sodium, phosphate, calcium), supplementation with vitamins and iron, correcting acidosis, and controlling complications such as hypertension.
101
Describe the process of haemodialysis.
Haemodialysis occurs outside the body, where blood is cleaned and electrolytes are replaced as needed through a machine that filters the blood.
102
What is peritoneal dialysis and how does it work?
Peritoneal dialysis is performed inside the body using the peritoneal membrane. Dialysis fluids are introduced into the abdominal cavity, allowing for slow facilitated diffusion, simple diffusion, and osmosis to filter the blood.
103
When is renal replacement therapy indicated?
Renal replacement therapy is indicated in cases of acidosis, electrolyte abnormalities (such as hyperkalaemia), ingestion of nephrotoxic poisons, fluid overload, and uremic symptoms causing confusion.
104
How does renal failure affect drug metabolism?
Renal failure impairs the excretion of drugs and metabolites, prolonging their half-life, narrowing the therapeutic drug index, and increasing the risk of adverse drug reactions.
105
Describe the characteristics of benign prostatic hypertrophy (BPH).
Benign prostatic hypertrophy is characterized by urethral restriction, usually affects men over 50, and is related to androgens and testicular hormones.
106
What are the signs of kidney disease?
Signs of kidney disease include decreased GFR, proteinuria, haematuria, and increased levels of creatinine, urea, and potassium.
107
Explain the importance of an arteriovenous (AV) fistula in haemodialysis.
An AV fistula is crucial for haemodialysis as it provides the necessary blood flow of 250-450 mL/min. It is formed by joining an artery and a vein, and care must be taken to protect its integrity.
108
How should a paramedic manage a patient with renal failure?
Paramedic management of renal failure includes minimizing and managing shock, addressing presenting symptoms, recognizing and managing the cause of intra and post-renal failure, judicious fluid management if dehydrated, and administering analgesia/medications with caution.
109
What complications can arise from chronic kidney disease?
Complications of chronic kidney disease can include hypertension, nervous system involvement, fluid overload, and electrolyte imbalances.
110
Describe the symptoms of uraemia.
Symptoms of uraemia include a metallic taste in the mouth, insomnia, fatigue, depression, gastrointestinal disturbances such as nausea and vomiting, and changes in bowel habits.
111
How does chronic kidney disease lead to anaemia?
Chronic kidney disease leads to anaemia due to a deficiency in erythropoietin, which is necessary for red blood cell production.
112
What is the role of dietary management in chronic kidney disease?
Dietary management in chronic kidney disease may involve restricting sodium, phosphate, and calcium, supplementing with vitamins and iron, and ensuring adequate carbohydrate and fat intake to reduce protein breakdown.
113
Describe the common microorganisms associated with prostate issues.
E. coli is the most common microorganism carried to the prostate from the urethra.
114
Explain the signs and symptoms of prostatitis.
Signs and symptoms include perineal discomfort, burning, urgency, frequency, pain after ejaculation, dysuria, fever and chills, and rectal or low back pain.
115
How should paramedics manage a patient with suspected prostatitis?
Paramedic management includes recognition of symptoms, providing symptom relief, and referral to appropriate medical care.
116
Define testicular torsion and its significance.
Testicular torsion is the twisting of the spermatic cord, making it the most common acute scrotal disorder, requiring surgical intervention within 3 hours for a high chance of testicular salvage.
117
What are the common causes of testicular pain?
Common causes include torsion, hydrocele, trauma, and epididymitis/orchitis.
118
Describe the symptoms of epididymitis/orchitis.
Symptoms include inflammation of the epididymis or testis, red swollen shiny scrotum, scrotal and pelvic pain, often secondary to UTI or STI.
119
How should paramedics respond to a case of testicular torsion?
Paramedics should provide analgesia, assess the patient, and ensure rapid transport to a surgical facility.
120
Explain the importance of recognizing urethral bleeding in male anatomy injuries.
Urethral bleeding is a serious sign that may indicate significant injury and requires immediate medical attention.
121
What are the potential reasons for genitalia injury or mutilation?
Genitalia injury or mutilation can occur for cultural, medical, or non-medical reasons, including circumcision, removal of the clitoris, and other procedures.
122
Describe the paramedic management for genitalia injuries.
Management includes pain management, controlling bleeding, and ensuring transport to medical facilities.
123
How is testicular torsion typically diagnosed?
Testicular torsion is often assessed with ultrasound and a clinical diagnosis.
124
What is the typical age range for individuals affected by testicular torsion?
Testicular torsion typically occurs in individuals aged 8 to 18 years.
125
Explain the role of analgesia in the management of testicular pain.
Analgesia is important for pain relief in conditions such as testicular torsion, epididymitis, and other testicular injuries.
126
Describe the appearance of the scrotum in cases of epididymitis/orchitis.
The scrotum appears red, swollen, and shiny in cases of epididymitis/orchitis.
127
What is the recommended action for paramedics when encountering a young male with abdominal pain?
A young male with abdominal pain should be evaluated for possible testicular torsion.
