Lower Urinary Tract Obstruction Facts

Question 1

lower urinary tract obstructions are related to

Answer 1

alterations of urine storage in the bladder or emptying of urine through the bladder outlet

Question 2

types of incontinence

Answer 2

urge (mostly older aldults) - abrupt and strong desire to void (urgency)
stress (mostly women < 60 yr old and men who have prostate surgery) - coughing, sneezing, etc.
overflow - overdistention of bladder
mixed (older women) - stress and urge combo
functional - dementia or immobility

Question 3

common causes of obstruction

Answer 3

urethral stricture, prostatic enlargement in men, pelvic prolapse (bladder and uterus) in women, tumor compression

Question 4

symptoms of obstruction

Answer 4

frequent daytime voiding (more than every 2 hours)
nocturia (more than once a night for 65+ yrs old and twice a night for older)
poor force of stream
intermittency of urinary stream
bothersome urinary urgency, often combined with hesitency
feelings of incomplete bladder emptying

Question 5

overactive bladder syndrome more common in

Answer 5

women and people over 65

Question 6

how many healthcare visits per yr for UTIs

Answer 6

10 million

Question 7

____% of women will have a lower UTI in their life

Answer 7

50

Question 8

factors that protect against UTI

Answer 8

most bacteria washed out during micturition (urination)
low pH and high osmolality of urea
presence of Tamm-Horsfall protein or uromodulin
secretion from uroepithelium
longer urethra and prostatic secretions in men

Question 9

____% of cases of septic shock are caused by urosepsis

Answer 9

30%

Question 10

most common infecting microorganism is
second most common is

Answer 10

e. coli
staph saprophyticus

Question 11

bladder infection most common in

Answer 11

women

Question 13

risk factors for bladder infection

Answer 13

sexual activity, pregnancy
vesicouretreral reflux
instrumentation, poor hygiene
neurogenic bladder
obstruction
diabetes

Question 14

common symptoms of bladder infection

Answer 14

can be asymptomatic - 10%
dysuria
urinary frequency
urinary urgency
suprapubic pain
hematuria

Question 15

treatment of bladder infection

Answer 15

1-3 days of antibiotics

Question 16

bladder infection can develop into

Answer 16

pyelonephritis (greater risk)

Question 17

most common route of infection for pyelonephritis

Answer 17

from bladder to kidneys
but can occur from blood stream

Question 18

most common bacteria for infection for pyelonephritis

Answer 18

e. coli, proteus, pseudomonas

Question 19

pathophysiology of pyelonephritis

Answer 19

infiltration of WBC with renal inflammation
renal edema
purulent urine
severe cases can have medullary or cortical abscess - necrosis
tubules primary affected

Question 20

symptoms of pyelonephritis

Answer 20

fever, chills, flank or groin pain

Question 21

glomerulus can be damaged by

Answer 21

immulnologic abnormalities (most common)
chemicals (drugs)
radiation
hypoxemia
vascular disorders
infection
unknown causes

Question 22

type of urine sediment from nephrotic damage

Answer 22

protein, lipids
little blood

Question 23

type of urine sediment from nephritic damage

Answer 23

blood with red cell casts
white cell casts
not high levels of protein

Question 24

glomerular damage decreases capillary membrane surface area which causes

Answer 24

fluid to move to interstitial spaces
decreased GFR

Question 25

symptoms of glomerulonephritis

Answer 25

hematuria with RBC casts * often smoky brown-tinged * indicates blood from glomerlulus proteinuria exceeding 3-5g/day (albumin major protein here) HTN decreased GFR - Na and water retention

Question 26

prognosis of progressive glomerulonephritis

Answer 26

acute may not progress if treated renal symptoms develop after 10-20 years nephrotic syndrome follows (loss of protein through glomerulus) progression to end stage renal failure ultimately require dialysis or transplantation

Question 27

hallmark signs of nephrotic syndrome

Answer 27

excretion of 3.5g or more protein in urine per day

Question 28

nephrotic syndrome usually seen in

Answer 28

glomerulonephritis diabetes systemic lupus erythematosus malignancies drugs

Question 29

nephrotic syndrome more common in

Answer 29

children

Question 30

nephrotic syndrome usually associated with

Answer 30

more serious prognosis

Question 32

hallmark signs of nephritic syndrome

Answer 32

hematuria and RBC casts in urine proteinuria seen but less severe than in nephrotic syndrome

Question 33

nephritic syndrome usually seen in

Answer 33

infection rapidly progressing glomerulonephritis