Renal and Reproductive Disorders Flashcards
(33 cards)
Acute Kidney Injury: Aetiology and Pathophysiology
sudden reduction in glomerular filtration rate
categorised into 3 types:
Prerenal: reduced blood flow to kidneys; decreased glomerular filtration rate.
Intrarenal: kidney tissue damage due to disease.
Postrenal: urine flow blocked after leaving kidneys.
Acute Kidney Injury: clinical manifestations
Kidney function decline: decreased glomerular filtration rate, increased serum creatinine and blood urea nitrogen.
Sudden reduction in urine output; possible cessation of urine production.
Prerenal: hypotension, tachycardia
Intrarenal and postrenal: hypertension.
Side pain, potassium retention, swelling due to reduced glomerular filtration rate.
Acute Kidney Injury: Diagnosis
Essential tests: blood count, electrolyte levels, renal function, urinalysis.
Helps distinguish acute from chronic kidney disease.
Acute Kidney Injury: Management
Tailor treatment to type and cause.
Address underlying cause for recovery.
Renal function recovery may take months; not always complete.
Treatment must match type: Diuretics for intrarenal, but may worsen prerenal.
Chronic Kidney Disease: Aetiology and Pathophysiology
Chronic kidney disease develops gradually due to long-standing conditions like diabetes mellitus and hypertension.
Characterized by gradual loss of nephron function, measured by reduced glomerular filtration rate.
Kidneys can adapt; clinical signs of impairment appear only after 70–75% loss of function.
Chronic Kidney Disease: Clinical Manifestations
Nitrogenous wastes build up in the blood, leading to uraemia (urine components in the bloodstream).
Early symptoms: hypertension, nocturia, restless legs, hematuria, shortness of breath, fatigue, anorexia, weight loss.
Progression: itchy, dry skin, increased infection risk from scratching.
End-stage kidney disease: fluid and electrolyte imbalances, cardiovascular dysfunction, anemia, platelet dysfunction, gastrointestinal/endocrine issues, skeletal and neurological problems.
Other issues: immune suppression, reduced sex hormone levels, decreased libido, infertility.
Chronic Kidney Disease: Diagnosis
Blood tests for full blood count, electrolyte levels, renal and liver function are essential for monitoring disease progression.
Urinalysis may show blood, white blood cells (if infection), and increased protein levels.
Chronic Kidney Disease: Management
End-stage kidney disease is incurable; focus on slowing or halting disease progression.
Dialysis is the primary treatment for end-stage kidney disease.
Urinary Tract Infections (UTI): Aetiology and Pathophysiology
Kidneys, ureters, bladder, and proximal urethra are sterile, maintained by urine flushing.
Distal urethra has resident microbes; urine becomes contaminated during passage.
Compromised urinary tract defences increase infection risk.
Most urinary tract infections originate from the patient’s bowel flora.
Bacteria enter the urinary tract at the urethral opening and ascend to the bladder.
Hospital-acquired infections often result from urological procedures, especially catheterization.
Females are 30 times more likely to develop urinary tract infections due to shorter urethra and proximity to the anus.
Higher infection rates in older adults due to bladder dysfunction, incontinence, and hormonal changes.
Risk factors include urinary tract obstruction, incomplete voiding, and diabetes mellitus.
Urinary Tract Infections (UTI): clinical manifestations
Symptoms of urethritis or cystitis (inflammation of the bladder): pain during urination (dysuria), increased frequency and urgency of urination.
Urinary Tract Infections (UTI): Diagnosis
Urine may have an offensive smell, abnormal colour, and cloudy appearance.
Urinary dipstick test may show positive results for blood and nitrite.
Midstream urine sample analysis may reveal leucocytes, high bacteria concentration, nitrite, and blood.
Urinary Tract Infections (UTI): Management
Removing or replacing an indwelling catheter often resolves the infection.
Broad-spectrum antimicrobial therapy initiated while awaiting culture results.
Encourage fluid intake to help flush bacteria from the urinary tract.
Urinary alkalisers and warm baths may reduce dysuria.
Cranberry derivatives are gaining acceptance to prevent bacterial adhesion in the urinary tract.
Sexually Transmitted Infections (STI): Aetiology and Pathophysiology
acquired through vaginal, anal, and/or oral sex with an infected individual.
Common STIs include herpes, genital warts, hepatitis, HIV/AIDS, chlamydia, gonorrhoea, and syphilis.
These infections cause local tissue damage and inflammation at the entry point.
If untreated, they can lead to chronic inflammation, affecting pelvic organs and potentially causing systemic lesions.
Sexually Transmitted Infections (STI): clinical manifestations
STIs can be asymptomatic.
Symptoms usually appear 5–14 days after infection.
Symptoms include cramps, lower abdominal pain, painful urination, painful menstruation, and abnormal vaginal discharge.
Infections may occasionally spread to systemic structures, particularly the joints.
Sexually Transmitted Infections (STI): Diagnosis
Diagnosis involves clinical history, physical examination, swabs, urinary polymerase chain reaction tests, syphilis serology, and Pap smear.
Sexually Transmitted Infections (STI): Management
Treatment depends on the causative organism.
Antibiotics are effective for bacterial infections.
Antiviral agents reduce genital herpes symptoms but do not cure the infection.
Genital warts can be removed surgically or treated with cryotherapy (cold or freeze therapy), laser ablation, or electrocautery (using heat from an electrical current)
Care plan should be non-judgmental, reduce anxiety, and maintain privacy.
Polycystic Ovary Syndrome: Aetiology and Pathophysiology
Caused by endocrine imbalance with elevated estrogen, testosterone, luteinizing hormone, and reduced follicle-stimulating hormone.
Exact cause unclear; likely a combination of genetic and environmental factors.
Leads to numerous ovarian follicles, excess estrogen, ovarian enlargement, and irregular egg release.
Polycystic Ovary Syndrome: clinical manifestations
Symptoms: Infrequent or prolonged menstrual periods, elevated male hormone levels.
Typically diagnosed during adolescence when symptoms appear.
Other symptoms: amenorrhea (absence of menstruation), acne, obesity, excessive hair growth in male-pattern areas (face, chest, back)
Polycystic Ovary Syndrome: Diagnosis
Diagnosis includes clinical history, physical examination, pelvic ultrasound, and laparoscopy.
Blood tests to assess gonadotropin and ovarian hormone levels.
Metabolic profiles (glucose tolerance, insulin resistance, lipid levels) may be evaluated.
Polycystic Ovary Syndrome: Management
Treatment individualized based on symptoms, fertility goals, and complication prevention.
Options: lifestyle changes for weight reduction, hormonal therapy to regulate menstruation and reduce androgen production.
Ovulation-promoting medications may be prescribed for women who wish to conceive.
Breast Cancer: Aetiology and Pathophysiology
Most breast cancers originate from epithelial cells lining milk ducts and lobules
.
Cancers in milk ducts can become invasive, spreading to surrounding breast tissue, lymphatic and blood vessels.
Locally advanced breast disease occurs when cancer invades skin, chest wall, or lymph nodes, potentially causing lymphoedema.
Metastatic breast cancer refers to the spread of cancer cells to distant tissues via bloodstream and lymphatic system.
Specific gene mutations are strongly linked to increased breast cancer risk
Breast Cancer: Risk Factors
Age, female gender, long reproductive life, few children, late first pregnancy, high saturated fat diet, obesity, alcohol consumption, urban living, ethnicity, genetics, family history, radiation exposure, hormone therapy.
Breast Cancer: clinical manifestations
Common symptoms: Lump in the breast (can be painful), changes in nipple position/orientation, alterations in breast skin colour/texture, abnormal nipple discharge (clear or blood-stained)
Breast Cancer: Diagnosis
Involves health history, physical examination, mammography, and possibly ultrasound.
Biopsy (fine-needle aspiration or open procedure) is performed for histological and cytological examination
