GU & Renal Disorders

Question 1

• Affects younger men; painless mass
• Cryptorchidism- Undescended testicles
• High cure rates (Caugh early)
  What is this cancer?

Answer 1

Testicular Cancer

Question 2

• Proliferation of prostate tissue (Men over >50)
• Compresses urethra
• Urine backs up -> hydronephrosis, postrenal AFR
  “Enlarged prostate”

Answer 2

Benign Prostatic Hyperplasia

Question 3

(S/s): Urgency, weak flow, slow to-start flow, urinary retention
- Elevated PSA

Answer 3

Benign Prostatic Hyperplasia

Question 4

• Diet high in saturated fat
• High testosterone
• Family history (African Americans)
  Causes what type of cancer?

Answer 4

Prostate Cancer

Question 5

• High Prostate-specific antigen (PSA)
• Enlarged prostate on rectal exam
  Dx for what two prostate problems?

Answer 5

• Benign Prostatic Hyperplasia
• Prostate cancer

Question 6

• Inflammation
• Discomfort in penis
• Dysuria (occasionally a discharge)

Answer 6

Urethritis

Question 7

• Inflammation/ infection of prostate
  (S/s): urgency, delay in urine flow, decrease in flow of urine, urine retention

Answer 7

Prostatitis

Question 8

Urethritis & Prostatitis are most caused by what?

Answer 8

(STIs)
- Chlamydia
- Gonorrhea

Question 9

• Menstruation more painful, frequent, larger in bleeding volume than normal
  (Caused by): Hormonal disturbance

Answer 9

Dysmenorrhea

Question 10

No periods (Menses)
(Causes): Anorexia, over-exercising
- Associated with hormonal disturbances
- Hallmark of menopause

Answer 10

Amernorrhea

Question 11

• Ectopic
• Endometrium in the pelvis ( Proliferating & bleeding where it implants itself)
  (Cause): Retrograde menstruation
  (S/s): dyspareunia (pain during intercourse), dysmenorrhea

Answer 11

Endometriosis

Question 12

Tx for Endometriosis

Answer 12

Hormonal therapy &/or Surgery

Question 13

Vague
(S/s): Bloat, abdominal discomfort, constipation (Not dx until it has metastasized to areas such as the liver)
(Metastasizes intra-abdominally S/s): Pain ascites, dyspepsia, vomiting, alteration in bowel movements

Answer 13

Ovarian Cancer

Question 14

Infection of uterus, fallopian tubes (Salpingitis) or ovaries (Oopheritis)
(Causes): STI (Chlamydia infecting & inflaming cervix)

Answer 14

Pelvic inflammatory disease

Question 15

(S/s): Vaginal discharge, pelvic pain worsens with movement

Answer 15

Pelvic Inflammatory disease

Question 16

Tx for PID

Answer 16

• Antibx
• Pain killers

Question 17

(S/s):
- Dysuria (Pain on urination)
- Frequency & urgency of urination
- Hematuria
- Pyuria
- Abdominal & back pain t costovertebral angle (Pyelonephritis)

Answer 17

Urinary Tract infection

Question 18

Dx by S/s of UTI

Answer 18

• Urine analysis
• Urine C&S

Question 19

• Chlamydia, Gonorrhea, Syphilis, Herpes

Answer 19

Sexually Transmitted Infections (STI)

Question 20

(S/s):
- (Men): Inflammation, discomfort in the penis, Dysuria, occasionally a discharge
- (Women): PID

Answer 20

Chlamydia

Question 21

• Bacterial infection of genital tract of men & Women
• (Women): Asymptomatic or vaginal discharge, or bleeding, or pull PID
• (Men): Purulent discharge from penis & Dysuria

Answer 21

Gonorrhea

Question 22

Chancres in primary stages (Lesions of skin)
- If not treated can lead to (Neurosyphilis, syphilitic aortitis)

Answer 22

Syphilis

Question 23

Invades lips & surrounding areas (Cold sores)
- Not considered an STI
- Passed by kissing

Answer 23

HSV-1

Question 24

Invades genital areas & spread to perineum & anus
- Considered an STI
(S/s): Fever, malaise during break-out episodes

Answer 24

HSV-2

Question 25

Serious sequela of any Urinary Obstructive Disorder is?

Answer 25

Hydronephrosis

Question 26

"Water on kidneys" - Enlargement of & pressure in renal pelvis & calyces dye to patho accumulation of fluid - Leads to malfunction of nephrons & subsequent renal failure

Answer 26

Hydronephrosis

Question 27

Caused by - Kidney stones (Renal calculi or lithiasis); dehydration, problems with hyperuricemia (Gout), hypercalcemia disorders (Multiple myeloma) - Male are 4x at risk

Answer 27

Hydronephrosis

Question 28

(S/s): Sudden onset colicky pain, hematuria

Answer 28

Hydronephrosis

Question 29

Tx for Hydronephrosis

Answer 29

Lithotripsy if stones is too large to pass

Question 30

Function of kidneys

Answer 30

- Maintain fluid balance - Maintain metabolic functions

Question 31

(Causes) - Congenital issues (PKD) - Acquired nonrenal Dz (HTN, Diabetes, Atherosclerosis - Autoimmune renal Dz (Glomerulnoephritis)

Answer 31

Chronic Kidney Disease

Question 32

What happens if the GFR decreases?

Answer 32

increase risk of accumulation of wastes & water in body

Question 33

Caused by - Post infections GN (Post-strep autoimmune disorder) autoantibodies attach to glomerular membrane -> inflammation, leaky membrane (Proteins & RBCs) in urine (S/s): Hematuria, hyperproteinuria, oliguria (Less GFR)

Answer 33

Glomerulonephritis

Question 34

Abrupt (Occurs over <48hrs) decrease in UO (GFR) or Serum Creatinine (S/s): Acute oliguria &/or Acute jump in serum creatinine (Causes): Infection, sepsis, trauma

Answer 34

Acute Kidney injury (AKI)

Question 35

Problem of blood flow to kidneys (Vessel problem - renal artery blockage or decreased cardiac output from a volume deficit due to bleeding, HF, sepsis) (S/s): Oliguria, elevated serum creatinine (sCr)

Answer 35

Prerenal AKI

Question 36

Caused by Acute tubular necrosis (ATN) ischemia to nephron blood supple -> cells (casts) slough off into tubular canal & blocks urine flow -> retrograde pressure -> hydronephrosis -> ischemia, necrosis, malfunction (S/s): Oliguria, elevated serum creatinine (sCr) + blood, protein, cast in urine

Answer 36

Intrarenal AKI

Question 37

Direct trauma to nephrons (Nephrotoxic drugs, toxic microbes, toxins, poisons) - Tubular cells die they slough off into lumen of tubules -> cast formation -> tubular blockage & sluggish urine flow -> increase pressure on bowman's capsule & glomerular capillaries -> reduced GFR (S/s): Oliguria, decrease ability to excrete creatinine

Answer 37

Acute tubular necrosis

Question 38

Obstruction (Urethral obstruction: BPH in man or uterine prolapse in women) causes backup of urine into kidney (Hydronephrosis) that interferes w/ tubular function -> Intrarenal AKI &/or CKD (S/s): Oliguria, elevated serum creatinine (sCr), obstruction

Answer 38

Postrenal AKI

Question 39

Tx for Prerenal AKI

Answer 39

- IV fluids/ blood given

Question 40

If a patient has a low urine creatinine clearance what will the serum creatinine be?

Answer 40

Higher

Question 41

What do you measure to see if the kidneys are concentrating urine appropriately?

Answer 41

Specific Gravity