Lecture 16 Urinary System & Male tract Flashcards Preview

Pathology > Lecture 16 Urinary System & Male tract > Flashcards

Flashcards in Lecture 16 Urinary System & Male tract Deck (126):
1

Risk factors for UTI?

Urinary tract obstructions (stones/catheters), pregnancy, diabetes, sex, females.

2

Risk factors for UTI?

Urinary tract obstructions (stones/catheters), pregnancy, diabetes, sex, females.

3

Define UTI?

Presence of pure growth of >10^5 organisms in fresh urine

4

What is cystitis?

UTI in bladder

5

What is pyelonephritis?

UTI in kidney

6

What is the most common causative organisms?

E.coli (poo bacteria) 70% of community UTIs

7

What other organisms can cause UTIs?

Staphylococcus, proteus and klebsiella

8

What are the symptoms of pyelonephritis?

High fever, rigors, vomiting, loin pain and tenderness

9

What are the symptoms of prostatitis?

Few urinary symptoms, flu like, swollen tender prostate on PR

10

How are UTI managed?

Drink lots, urinate more, antibiotics (trimethoprim). US imaging in non-resolving UTIs, children, men and pyelonephritis.

11

What are the kidneys function?

maintenance of water, electrolyte and acid-base homeostasis. Excretes urea and creatinine

12

What hormones do the kidneys release?

Renin (BP control by controlling aldosterone), Erythropoietin - stimulates RBC and Vit D production

13

Define acute renal failure

deterioration in renal function, low urine volume (

14

Define Oliguria?

Abnormally small amounts of urine

15

What levels rise when someone has acute renal failure?

Plasma urea and creatinine levels

16

What causes "pre-renal" acute failure?

Hypoperfusion or sepsis

17

What causes "renal" caused acute failure

ATN (acute tubular necrosis) due to ischaemia or nephrotoxins

18

What causes "post-renal" acute failure?

Renal tract obstruction (stones/tumours)

19

Acute renal failure treatments?

Treat exacerbating factors (hypovolaemia/semsis). Stops nephrotoxic drugs (NSAIDs, ACE-1,...mycin). Haemofiltration/dialysis

20

GFR for chronic renal failure stage 1?

>90

21

GFR for chronic renal failure stage 2?

60-89

22

GFR for chronic renal failure stage 3?

30-59

23

GFR for chronic renal failure stage 4?

15-29 SYMPTOMS SHOW

24

GFR for chronic renal failure stage 5?

25

What is the GFR?

Volume of fluid flitered from glomerular capillaries into the Bowman's capsule/unit time

26

What can cause chronic renal failure?

Glomerulonephritis, diabetes, renovascular disease, hypertension, polycystic disease

27

What is glomerulonephritis?

disorders where there is damage to glomerular filtration apparatus

28

Signs of glomerulonephritis?

Protein or blood in urine. Immune complexes in one part of the nephron

29

What are stones?

Crystal aggregates (form in collecting ducts) that can be deposisted anywhere in renal tract

30

What is the % life time incidence of stones? Peak age and gender ratio?

15%, 20-40 years. Male:female 3:1

31

What are risk factors for stones?

Dehydration, dietary factors (^chocolates, tea and rhubard). Drugs (loop, antacids, steroids, aspirin), UTIs.

32

What pain do kidney stones cause?

loin

33

What do ureteric stones cause?

renal colic

34

Where do bladder and urethral stones cause pain?

Pain on micturition with interrupted flow.

35

When scanning for stones

80% visible on KUB-xray. 99% visible on CT scan

36

Stones

pass spontaneously within 48 hours, can take up to 30 days

37

Stones >5mm or causing obstruction

may need intervention

38

How common is renal cell carcinoma?

85% of all renal cancers

39

Who is renal cell carcinoma common to?

50-70 years old, 2:1 male predominance

40

What are the risk factors for renal cell carcinoma?

Smoking, obesity, hypertension, asbestos and hereditary conditions

41

Define polycythaemia

Abnormal ^ conc of haemoglobin in blood (^plasma volume or ^RBCs)

42

How to treat renal cell carcinoma?

Nephrectomy +/- chemo

43

What are the most common benign and malignant conditions in the bladder?

Cystitis and transitional cell carcinomas

44

What are the symptoms of transitional cell cancinoma (bladder)

Painless haematuria. Frequency urgency and dysuria.

45

What tests are done for bladder carcinomas?

Urine for cytology and cystoscopy and biopsy

46

How is early stage bladder carcinoma treated?

Diatheryl (high f electriacal currents -> stimulate circulation, reduce pain and destroy unhealthy cells. During cystoscopy

47

How are later stages of bladder carcinoma treated?

Radical cystectomy or palliative chemo/radio

48

What is the prostate?

Gland located at the base of bladder, (20gm). Helps in semen and spermatozoa secretion& maintenance

49

What are the age and incidence of benign prostatic hyperplasia given?

40s = 20%
60s = 70%
80s = 90%

50

What can the prostate weigh with benign prostatic hyperplasia?

60-100gm

51

Signs and symptoms of benign prostatic hyperplasia?

Same as lower urinary tract obstruction: ^frequency, hesitancy, nocturia, terminal dribbling. ^ infection risk. Enlarged prostate.

52

Treatments for benign prostatic hyperplasia?

Alpha-blockers. If small/non symptoms then conservative, reduce fluid (night), alcohol and caffeine.

53

What are the risk factors for prostate cancer?

Age, race(black men more common, Asian less common), family history, hormone levels, diet (^risk with ^fat consumption)

54

Signs and symptoms of prostate cancer?

May be asymptomatic. Nocturia, hesitancy, poor stream and terminal dribbling. Hard irregular prostate

55

How is prostate cancer diagnosed?

Raised PSA (prostate specific antigen), (normal in 30% of cases), biopsy.

56

Treatment for prostate cancer?

Depends on:age, stage and comorbidities. If many comorbidities watch and wait may be option. Hormone therapy and radiot in advanced changes.

57

Signs and symptoms for testicular torsion?

Sudden pair in 1 testis, pain in abdomen, N/V. Hot swollen and tender. May be high.

58

What age range is testicular torsion more common?

11-30 years old

59

How is testicular torsion tested for?

USS, doppler but may need exploratory surgery

60

Treatment for testicular torsion?

Urgent surgery, bilateral fixation (orchidopexy) if still poss, if abnormal then orchidectomy

61

What is the most common malignancy in males aged 15-44?

Testicular tumours

62

What are the risk factors for testicular tumours?

Undescended testis, infant hernia and infertility

63

Signs of testicular tumours?

Painless testicular lump noted after trauma or infection (doesn't cause it just found after this)

64

Can have germ cell tumours, most common is?

Seminoma

65

Define UTI?

Presence of pure growth of >10^5 organisms in fresh urine

66

What is cystitis?

UTI in bladder

67

What is pyelonephritis?

UTI in kidney

68

What is the most common causative organisms?

E.coli (poo bacteria) 70% of community UTIs

69

What other organisms can cause UTIs?

Staphylococcus, proteus and klebsiella

70

What are the symptoms of pyelonephritis?

High fever, rigors, vomiting, loin pain and tenderness

71

What are the symptoms of prostatitis?

Few urinary symptoms, flu like, swollen tender prostate on PR

72

How are UTI managed?

Drink lots, urinate more, antibiotics (trimethoprim). US imaging in non-resolving UTIs, children, men and pyelonephritis.

73

What are the kidneys function?

maintenance of water, electrolyte and acid-base homeostasis. Excretes urea and creatinine

74

What hormones do the kidneys release?

Renin (BP control by controlling aldosterone), Erythropoietin - stimulates RBC and Vit D production

75

Define acute renal failure

deterioration in renal function, low urine volume (

76

Define Oliguria?

Abnormally small amounts of urine

77

What levels rise when someone has acute renal failure?

Plasma urea and creatinine levels

78

What causes "pre-renal" acute failure?

Hypoperfusion or sepsis

79

What causes "renal" caused acute failure

ATN (acute tubular necrosis) due to ischaemia or nephrotoxins

80

What causes "post-renal" acute failure?

Renal tract obstruction (stones/tumours)

81

Acute renal failure treatments?

Treat exacerbating factors (hypovolaemia/semsis). Stops nephrotoxic drugs (NSAIDs, ACE-1,...mycin). Haemofiltration/dialysis

82

GFR for chronic renal failure stage 1?

>90

83

GFR for chronic renal failure stage 2?

60-89

84

GFR for chronic renal failure stage 3?

30-59

85

GFR for chronic renal failure stage 4?

15-29 SYMPTOMS SHOW

86

GFR for chronic renal failure stage 5?

Less than 15

87

What is the GFR?

Volume of fluid flitered from glomerular capillaries into the Bowman's capsule/unit time

88

What can cause chronic renal failure?

Glomerulonephritis, diabetes, renovascular disease, hypertension, polycystic disease

89

What is glomerulonephritis?

disorders where there is damage to glomerular filtration apparatus

90

Signs of glomerulonephritis?

Protein or blood in urine. Immune complexes in one part of the nephron

91

What are stones?

Crystal aggregates (form in collecting ducts) that can be deposisted anywhere in renal tract

92

What is the % life time incidence of stones? Peak age and gender ratio?

15%, 20-40 years. Male:female 3:1

93

What are risk factors for stones?

Dehydration, dietary factors (^chocolates, tea and rhubard). Drugs (loop, antacids, steroids, aspirin), UTIs.

94

What pain do kidney stones cause?

loin

95

What do ureteric stones cause?

renal colic

96

Where do bladder and urethral stones cause pain?

Pain on micturition with interrupted flow.

97

When scanning for stones

80% visible on KUB-xray. 99% visible on CT scan

98

Stones

pass spontaneously within 48 hours, can take up to 30 days

99

Stones >5mm or causing obstruction

may need intervention

100

How common is renal cell carcinoma?

85% of all renal cancers

101

Who is renal cell carcinoma common to?

50-70 years old, 2:1 male predominance

102

What are the risk factors for renal cell carcinoma?

Smoking, obesity, hypertension, asbestos and hereditary conditions

103

Define polycythaemia

Abnormal ^ conc of haemoglobin in blood (^plasma volume or ^RBCs)

104

How to treat renal cell carcinoma?

Nephrectomy +/- chemo

105

What are the most common benign and malignant conditions in the bladder?

Cystitis and transitional cell carcinomas

106

What are the symptoms of transitional cell cancinoma (bladder)

Painless haematuria. Frequency urgency and dysuria.

107

What tests are done for bladder carcinomas?

Urine for cytology and cystoscopy and biopsy

108

How is early stage bladder carcinoma treated?

Diatheryl (high f electriacal currents -> stimulate circulation, reduce pain and destroy unhealthy cells. During cystoscopy

109

How are later stages of bladder carcinoma treated?

Radical cystectomy or palliative chemo/radio

110

What is the prostate?

Gland located at the base of bladder, (20gm). Helps in semen and spermatozoa secretion& maintenance

111

What are the age and incidence of benign prostatic hyperplasia given?

40s = 20%
60s = 70%
80s = 90%

112

What can the prostate weigh with benign prostatic hyperplasia?

60-100gm

113

Signs and symptoms of benign prostatic hyperplasia?

Same as lower urinary tract obstruction: ^frequency, hesitancy, nocturia, terminal dribbling. ^ infection risk. Enlarged prostate.

114

Treatments for benign prostatic hyperplasia?

Alpha-blockers. If small/non symptoms then conservative, reduce fluid (night), alcohol and caffeine.

115

What are the risk factors for prostate cancer?

Age, race(black men more common, Asian less common), family history, hormone levels, diet (^risk with ^fat consumption)

116

Signs and symptoms of prostate cancer?

May be asymptomatic. Nocturia, hesitancy, poor stream and terminal dribbling. Hard irregular prostate

117

How is prostate cancer diagnosed?

Raised PSA (prostate specific antigen), (normal in 30% of cases), biopsy.

118

Treatment for prostate cancer?

Depends on:age, stage and comorbidities. If many comorbidities watch and wait may be option. Hormone therapy and radiot in advanced changes.

119

Signs and symptoms for testicular torsion?

Sudden pair in 1 testis, pain in abdomen, N/V. Hot swollen and tender. May be high.

120

What age range is testicular torsion more common?

11-30 years old

121

How is testicular torsion tested for?

USS, doppler but may need exploratory surgery

122

Treatment for testicular torsion?

Urgent surgery, bilateral fixation (orchidopexy) if still poss, if abnormal then orchidectomy

123

What is the most common malignancy in males aged 15-44?

Testicular tumours

124

What are the risk factors for testicular tumours?

Undescended testis, infant hernia and infertility

125

Signs of testicular tumours?

Painless testicular lump noted after trauma or infection (doesn't cause it just found after this)

126

Can have germ cell tumours, most common is?

Seminoma