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Clin med A 2 > Trigger - bladder and urethral disorders > Flashcards

Trigger - bladder and urethral disorders Flashcards

1
Q

which bladder cancer type is assocaited with chronic inflammation d/t stones, catheters, UTIs, and more

A

squamous cell carcinomas

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2
Q

hepatomegaly, lymphadenopathy +/- lymphedema suggests what

A

metastatic spread of bladder cancer

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3
Q

MC presenting symptom in bladder CA

A

hematuria

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4
Q

what is the gold standard for dx bladder cancer

A

cystoscopy with biopsy

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5
Q

what will urine cytology show in bladder cancer

A

abnormal shed epithelial cells

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6
Q

transurethral tumor resection +/- intravesical chemo is used when

A

for superficial bladder cancer (TIS, Ta, T1)

also see:
BCG and anti-TB

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7
Q

BCG and anti-TB treatment is used when?

A

treatment for superficial bladder cancer (TIS, Ta, T1)

Also see:
transurethral tumor resection +/- chemo

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8
Q

radical cystectomy and urinary diversion is used when?

A

treatment for invasive bladder cancer

also used:
+/- chemo, immunotherapy, radiation

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9
Q

a 4 year old girl with a 3 month hx of achieving urinary continence is now wetting her bed every night. what is the term used to describe this

A

primary nocturnal enuresis

secondary would be in patients who were previously continent for 6+ months.

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10
Q

a patient has a tumor that is extending into, but not past, the fatty layer of the bladder. What stage of bladder cancer is he in?

A

stage T3

TIS - on superficial bladder lining
Ta - extending into bladder lining
T1 - extends into connective tissue
T2 - extends into muscle
T3 - extends into fat
T4 - extends past fat and beyond bladder tissue

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11
Q

confusion and anemia can be assocaited with which condition

A

nocturnal enuresis

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12
Q

first line med tx for nocturnal enuresis

A

desmopressin

2nd line includes: imipramine, oxybutinin

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13
Q

what is more common in men

A
  • Bladder cancer
  • nocturnal enuresis
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14
Q

what is more common in women

A
  • interstitial cystitis
  • urethral prolapse
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15
Q

assocaited with chronic pain syndromes as well as certain foods/drinks (spicy, caffiene, alcohol)

A

interstitial cystitis

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16
Q

hunner’s ulcers/lesions on cystoscopy

A

interstitial cystitis

also see:
increased mast cells on biopsy
glomerulations

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17
Q

cystscopy shows glomerulations and increased mast cells on biopsy

A

interstitial cystitis

also see:
hunners ulcers/lesions

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18
Q

1st line med is amitriptyline

A

interstitial cystitis

followed by:
- hydroxyzine
- nifedipine
- pentosan polysulfate sodium

note: this is NOT the first line TREATMENT, only the first line med. first line tx is lifestyle mod and self care

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19
Q

what is the only FDA approved tx of interstitial cystitis

A

pentosan polysulfate sodium (elmiron)

20
Q

SE includes elevated LFTs, GI upset and hair loss

A

pentosan polysulfate sodium (elmiron)

21
Q

CI with anticoagulants/antiplatelets (LMWH, heparin)

A

pentosan polysulfate sodium (elmiron)

22
Q

hydrodistention, electrocauterization and intravesical lidocaine is used when

A

3rd line treatment for interstitial cystitis

23
Q

when do you use botulinum injections to the detrusor muscle and sacral neuromodulation

A

refractory interstitial cystitis

24
Q

when are phenazopyridine and methenamine used in this lecture?

A

interstitial cystitis as adjunct tx

25
Q

this condition is usually iatrogenic in etiology and is MC in men

A

urethral strictures

26
Q

spraying of the urinary stream with obstructive voiding s/s are seen in which condition?

A

urethral stricture

27
Q

when are cystourethrograms and cystourethroscopy used?

A

to evaluate and visualize urethral strictures

cystourethroscopy can also help confirm dx of mass in urethral meatus or urethral prolapse

28
Q

when is a post void residual ultrasound used?

A

in urethral srictures to r/o urinary retention

29
Q

this condition is d/t malformation of the urethral malformation or weakness of the pelvic floor

A

urethral prolapse

30
Q

what is the difference between prepubescent and postmenopausal urethral prolapse

A

prepubescent is usually asymptomatic with spotty vaginal bleeding

post menopausal is symptomatic with vaginal bleeding, dysuria, urgency, frequency and nocturia. presents with hematuria. can have venous thrombosis, obstruction and necrosis

31
Q

what is the difference in treatment for prepubescent and postmenopausal urethral prolapse

A

both recieve sitz baths, topical abx and estrogen

perpubescent - manage comorbid dz
post menopausal - do not use estrogen or abx of necrosis, thrombosis or bleeding

32
Q

exam showing donut shaped protrusion of tissue obscuring urethral meatus

A

urethral prolapse

33
Q

what is MC method of surgical treatment in urethral prolapse

A

excision of mucosa with short term cath (may need long term estrogen cream if post menopausal)

34
Q

this is associated with parkinsons, bladder stones, tumors and prostate disease

A

urge incontinence d/t overactive detrusor muslce

35
Q

urethral incompetence with intrinsic sphincter deficiency is the cause of what type of urinary incompetence

A

stress incontinence

36
Q

duloxetine is off label medication for which condition

A

urinary stress incontinence

37
Q

beta 3 adrenergic agonists, TCAs and alpha blockers are used in the treatment of what condition

A

urinary urge incontinence

38
Q

tibial nerve stimulation is used as treatment in what condition

A

urinary urge incontinence

39
Q

CI in gastric retention and glaucoma

A

antimuscarinics

40
Q

DDI with potassium chloride

A

anticholinergics

41
Q

what are the perks of farifenacin and solifenacin

A

these are the anticholinergics used in UI that have less cog impairment

42
Q

what are the perks of oxybutinin

A

anticholinergic often MC prescribed d/t cost

43
Q

mirabegron and vibegron

A

beta 3 agonists. used in patients who cannot tolerate anticholinergic therapy

44
Q

when is sacral neuromodulation used?

A

refractory interstitial cystitis
urinary overflow incontinence (high risk of failure)

45
Q

SE is HTN, tachycardia, UTI

A

beta 3 agonists

also see: dry mouth, constipation

46
Q

DDI with QT prolonging drugs

A

Beta 3 agonists

47
Q

urethral dilation, urethrotomy and urethroplast are all treatments for what

A

urethral stricture

Clin med A 2 (30 decks)

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