Medical Issues Genitourinary and Gynecological Pathology Flashcards Preview

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Flashcards in Medical Issues Genitourinary and Gynecological Pathology Deck (37):
1

S/S with renal/reproductive pathology

hematuria
changes in urinary habits
nipple discharge
hypertension
anemia
sexual dysfunction
menstrual irregularities
pain

2

heamturia

blood in the urine
pseudohematuria
-change in urine color as a result of something you ingest
exertional hematuria
-increase in RBCs that show up in the urine after heavy exertion
-ex. marathon, swimmers
if it occurs after trauma it's a medical emergency

3

changes in urinary habits

dysuria
nocturia
unusual urgency
ncontinence
oliguria
anuria

4

nipple discharge

serous
sanguineous
serosanguineous
can indicate breast cancer or benign breast conditions (gland infection or hormonal imbalances)

5

kidneys and BP

dual control of BP
resistance exercise vs. endurance exercise
-resistance
--increase in both systolic and diastolic
-endurance
--slight increase in systolic

6

anemia

kidney pathology may affect the production of erythropoietin (hormone that regulates RBC production)
decrease in erythropoietin leads to decrease in

7

sexual dysfunction

impotence
painful intercouse
hemospermia
bleeding during intercourse or loss of libido

8

menstrual irregularities

amenorrhea
-primary: don't begin menstruating (16 y/o)
-secondary: stops menstruating (3 or less times a year or 3 consecutive months
oligomenorrhea
-3-6 cycles per year
dysmenorrhea
-disabling pain with menstruation

9

pain referral patterns

kidney
-lower back or abdomen
-typically due to infection or trauma
bladder
-over bladder
-refer to lower back or thighs possibly
ureter
-groin

10

male-specific pain referral patterns

prostate gland
-refers to lower back, scrotum, or perineum
-diffuse but centralized area
testicular disease
-focal
-testicles or lower abdomen

11

female-specific pain referral patterns

uterus
-lower back
ovaries and fallopian tubes
-lower abdomen and sacrum
breast
-chest and ipsilateral shoulder

12

medical history and physical examination

family and personal history
inspection - edema in extremities (advanced kidney pathology)
palpation
other things to consider
-age of first period
-cycle length
-sexually active

13

urinalysis

purpose
-general evaluation of health
-metabolic disorders or systemic disease
-endocrine disorders
-diabetes
-pregnancy
-drug screening
-specific gravity
-pH
-protein
-ketones
-nitrates
-trauma to kidneys

14

urinalysis methods

best method
-clean catch mid stream urine
-needs to be tested within the hour
-catheter can be used - comes with risks
testing
-dipstick method
-microscopic

15

urinalysis abnormal results

cloudy
foul smelling
fruity - diabetes, starvation, and dehydration

16

urinalysis abnormalities cont.

blood
casts
-small fibrous pieces
-protein buildup
crystals
protein
sugars

17

renal pathology and pathogenesis

S/S
-kidney trauma
--direct blow to middle/lower back
--tenderness ribs 10-12
--blood in urine (emergency referral)
--treated with meds. not surgery
-bladder and urethral trauma
--more common in crashes than sports (bladder)
--pain in lower abdomen
--traumatic impact to the urethra

18

renal pathology and pathogenesis treatment and referral

gross observable blood in urine after a blow to the back or abdomen requires immediate referral
changes in urine or frequency requires referral

19

UTI's

bacterial infection
more common in sexually active females
S/S
-dysuria
-increased frequency
-scanty flow
-back pain
red flags
-gross hematuria
-abnormal vaginal bleeding
-fever

20

UTI Tx and referral

urinalysis and referral is often needed
need to determine cause before treatment
-bacterial
-fungal
-parasite
-yeast
medications also include analgesics and antipruretics (anti-itching)
cranberry juice

21

urolithiasis (kidney stones)

forms due to excess salt, calcium or uric acid in the kidney filtrate
when stones get big enough to block urine flow pain begins
not usually any trauma
pain in abdomen, lower back radiating to anterior thigh
vomiting, pallor, tachycardia and signs of shock
small stones treated with medication and good hydration to pass
large stones-fragmented with light sound or shock
proper diet/hydration decreases chances

22

prostate disorders

produce symptoms due to chronic or acute inflammation (prostatitis)
likelihood increases with age
most commonly due to infection, but cancer and urogenital disease as well
symptoms - dysuria, increased volume or frequency or urination and nocturia
dull ache in low back/scrotum

23

prostate cancer

S/S
-no reliable S/S in early prostate cancer
fatigue
weight loss
hematuria
urinary retention
urinary incontinence
back pain
Tx and RTP guidelines
-radiaton and hormone therapy
-radiation to metastasized areas as needed
-RTP during treatment is okay if they feel well enough and no significant side effects

24

testicular torsion

spermatic cord twists, compressing veins and arteries to the testicles
S/S
-nausea and vomiting
-abdominal pain
-scrotal swelling
-tender testicle
-elevated bilaterally
Tx
-manual detorsion is successful 30-70% of the time
-6 hours from the onset of pain treatment will result in 80-100% salvage
12+ hours 0% salvage

25

hydrocele

fluid collection along the scrotal sac or along spermatic cord
6% of adult men
asymptomatic
possible aching/fullness
RTP is not limited if asymptomatic

26

varicoceles

valves in the veins fail
veins stretch, get bigger or become swollen
feels like a "bag of worms"
dull ache and heaviness in scrotum
no participation risks

27

testicular cancer

S/S
-nodule in testicle is palpable
-unilateral testicular swelling
-pain in testicle
-rare occasions - breast tenderness and heaviness and aching in the scrotum
Tx
-removal of testicle and spermatic cord (orchiectomy)
-chemo and/or radiation therapy
-RTP si based on symptoms during treatment and physician orders
-wearing a cup is mandatory to protect remaining testicle

28

athlete recommendation

get a yearly exam

29

endometriosis

when endometrial tissue grows outside of the uterus
between ages of 30-40
S/S
-dysmenorrhea
-increased discharge volume with menstruation
-dysparenunia
-dysuria
-pain with bowel movements
-back pain
-leading cause of infertility
Tx
-hormone and pain therapy (progesterone)
-occasionally surgical intevention

30

pregnancy

S/S
-unceplained weight gain
-recurring vomiting and nausea
-abdominal pain
-frequent urination
-hypertension
-breast enlargement

31

pregnancy facts

25-30 pounds are added during pregnancy
heart rate increases up to 15 bpm
hormone relaxin is secreted throughout pregnancy and makes patient more susceptible to injury

32

NCAA recommendations for the pregnant athlete

avoid supine positions
no heavy weight lifting
discourage valsalva maneuver
no activities that involve risk of falling
avoid contact sports after the 14th week
no hot tubs/whirlpools
no scuba diving
if previous medical condition (diabetes, hypertension, cervical defects)

33

ruptured ectopic pregnancy

when ovum attaches outside uterus, usually in fallopian tube
normal signs of pregnancy
once large enough, tube ruptures causing severe hemorrhaging
low back pain, low quadrant tenderness, vaginal bleeding, syncope, and shock
baby will due no matter what
surgery is to save the mother

34

female athlete triad

amenorrhea (any menstrual irregularity), disordered eating (overall energy availability), and osteoporosis

35

pelvic inflammatory disarders

infection of the cervix, uterus, or fallopian tubes
chlamydia and gonorrhea are the most common culprits
S/S
-abdominal pain
-high-grade fever
-nausea
-abnormal vaginal discharge
complications
-infertility
-ectopic pregnancy
-chronic pelvic pain
treatment
-antibiotics

36

ovarian cysts

fibrous cysts or fluid filled sacs can form within urogenital system
may cause unusual bleeding or interference with menstrual cycle and estrogen production
if rupture cause internal hemorrhaging, abdominal pain, peritenosis, shock, and sometimes death

37

pediatric concerns

primary amenorrhea
kidney trauma
-more frequent than spleen or liver injuries because they are more highly exposed
-trauma should be screened for S/S of renal damage
cryptorchidism - "undescended testes"
-most common congenital abnormality
-associated risk with inguinal hernia