Renal Outflow Disease

Question 1

What are the different urinary tract diseases

Answer 1

UTI
urinary tract obstruction
urinary tract malignancy

Question 2

What can be the causes of urinary tract obstruction

Answer 2

renal calculi
prostatic disease
urinary tract strictures
external compression

Question 3

Why do UTIs happen

Answer 3

Infection has got in through the exit of the urethra

Question 4

What do the ascending bacteria in a UTI do

Answer 4

They will irritate, colonies and destroy parts of the epithelium
They will attract invasion of inflammatory cells to get rid of the infection
There will be an increased blood flow

Question 5

If there are white blood cells, red blood cells and proteins in the urine what are these indicating

Answer 5

kidney disease, inflammatory changes or neoplastic changes

Question 6

Why is UTI commoner to women

Answer 6

due to anatomy

Question 7

What is the most common bacteria to cause a UTI

Answer 7

E.Coli

Question 8

What other organisms could cause a UTI

Answer 8

staph, fungi, virus and TB

Question 9

What is the effect of urine on perineal organisms

Answer 9

bacteriastatic

doesn’t kill them but stops them from reproducing

Question 10

What is cystitis

Answer 10

bladder inflammation

Question 11

What are predisposing factors to a UTI

Answer 11

poor bladder emptying

low urinary flow rates

Question 12

Does urine have bacteria in it

Answer 12

Urine should not

it is sterile

Question 13

What does detecting any bacteria in urine imply

Answer 13

infection

Question 14

What is skin contamination of urine

Answer 14

The first stream of urine to come out is often contaminated but the next bit of urine should be sterile

Question 15

What is indicative of an infection as well regarding urine

Answer 15

white cells

blood

Question 16

When should the urine sample be collected

Answer 16

mid stream

Question 17

What is supra pubic sampling

Answer 17

Suprapubic aspiration and catheterization is a procedure to obtain uncontaminated urine from the urinary bladder

Question 18

How is supra pubic sampling done

Answer 18

You can put a catheter through the bottom of the abdomen or go through the urethra

Question 19

If urine is infected what can it cause

Answer 19

cystitis
renal infection
prostate infection

Question 20

What can cause urethritis in isolation, without cystitis

Answer 20

Gonorrhea

Question 21

What are the symptoms of a UTI

Answer 21

dysuria 
urinary frequency
cloudy urine 
offensive smelling urine
supra-pubic pain

Question 22

How is a UTI diagnosed

Answer 22

MSSU only (less contamination)

Question 23

What is done to the urine in the lab

Answer 23

microscopy, culture and sensitivity

look for cells, try and culture the organism from that and see which antibiotics work

Question 24

How is a UTI treated

Answer 24

increased fluid intake
frequent micturition
occasionally antibiotics required

Question 25

What antibiotics are used to treat a UTI

Answer 25

trimethoprim | amoxycillin

Question 26

When do we give antibiotic

Answer 26

when we start to see systemic signs and symptoms

Question 27

Where does the prostate sit

Answer 27

underneath the bladder

Question 28

What is benign prostatic hypertrophy

Answer 28

gets bigger and so becomes smaller on the inside squeezing the urethra

Question 29

How can prostate disease lead to urinary tract obstruction

Answer 29

hypertrophy | prostatic malignancy

Question 30

What is prostatitis

Answer 30

inflammation of the prostate

Question 31

What is benign prostatic hypertrophy

Answer 31

hyperplasia of the prostate

Question 32

What is prostatic cancer

Answer 32

adenocarcinoma

Question 33

What does prostatitis result in

Answer 33

inflammation of bladder, narrowing of tube and inflammation and discomfort around the prostate itself

Question 34

What are symptoms of urine outflow obstruction

Answer 34

``` slow stream hesitancy frequency urgency nocturia incomplete voiding ```

Question 35

What is the treatment for BPH

Answer 35

initially drug based | may require surgery - prostatectomy

Question 36

What is the drug used for benign prostatic hypertrophy

Answer 36

alpha-adrenergic antagonist

Question 37

What are the two types of prostatectomy

Answer 37

transurethral prostatectomy | open prostatectomy

Question 38

What is transurethral prostatectomy

Answer 38

A transurethral resection of the prostate (TURP) is surgery to remove parts of the prostate gland through the penis

Question 39

What is an open prostatectomy

Answer 39

Open prostatectomy is a traditional “open” surgical procedure, which means the surgeon accesses the prostate gland through a standard surgical incision

Question 40

What are risks of prostatectomy

Answer 40

damage to sphincter of the bladder causing incompetence

Question 41

When does prostatic malignancy usually start

Answer 41

>45 YO

Question 42

Is prostatic malignancy symptomatic

Answer 42

Not usually - normally not the cause of death

Question 43

Why is PSA not used for screening

Answer 43

It is not always diagnostic | problems with specificity and sensitivity

Question 44

What is PSA useful for

Answer 44

monitoring disease activity in those known to have disease

Question 45

What is the treatment of prostatic malignancy

Answer 45

surgery radiotherapy hormone treatment

Question 46

What surgery is done for prostatic malignancy

Answer 46

radical prostatectomy

Question 47

What are issues with radical prostatectomy

Answer 47

can lead to incompetence problems

Question 48

What can radiotherapy do

Answer 48

it can help slow it down

Question 49

What is the hormone treatment for prostatic malignancy

Answer 49

anti-androgens and LHRH analogues

Question 50

Why are anti androgens used for prostatic malignancy

Answer 50

testosterone will make the cancer grow so we block testosterone and use Luteinizing hormone-releasing hormone instead

Question 51

What does Luteinizing hormone-releasing hormone do

Answer 51

Luteinizing hormone-releasing hormone (LHRH) analogs lower your body's ability to make testosterone to very low levels

Question 52

Where can you develop renal calculi

Answer 52

in the kidney | in the bladder

Question 53

What are the different stone types for renal calculi

Answer 53

``` calcium and oxalate (radiopaque) uric acid (not radiopaque( ```

Question 54

How do you treat renal calculi

Answer 54

lithotrypsy

Question 55

How does lithotripsy work

Answer 55

uses shock waves (pulses of energy) to break up the stones