Urinary Pathologies Flashcards
(60 cards)
1
Q
Lower UTI
A
bladder
urethra
2
Q
cystitis
A
bladder infection
3
Q
Upper UTI
A
kidney
glomeruli
4
Q
pyelonephritis
A
kidney infection, of renal pelvis and interstitium
5
Q
Who commonly gets UTI’s
A
- 8x more likely in women
- more common in elderly (inactivity/mobility)
6
Q
In elderly, UTI’s may cause:
A
confusion
7
Q
Factors that increase the risk of UTI
A
- age
- gender
- incontinence leading to cauterization
- sexual activity
- diabetes
- pregnancy
8
Q
S/S of UTI:
A
dysuria
increased freq and urgency
hematuria (blood)
9
Q
UTI’s may mimic?
A
musculoskeletal problem, back pain near costovertebral angle (flank) tenderness
10
Q
Risk factors of a kidney infection?
A
- ascending UTI or reflux of urine (neurogenic bladder)
2. kidney stones causing blockage
11
Q
what causes a neurogenic bladder?
A
stroke, paraplegia
-lower sphincter closes, bladder contracts and urine goes up to kidney instead of out
12
Q
Clinical manifestations of pyelonephritis (increased WBC):
A
- same as UTI
- fever
- chills
- hematuria
13
Q
Red Flags of pyelonephritis:
A
- back pain
- costovertebral angle tenderness
- may refer to shoulder
14
Q
unreliable test for kidney infection?
A
murphy percussion test
15
Q
most common neoplasm in renal
A
Renal Cell Carcinoma
16
Q
S/S of Renal Cell Carcinoma
A
- hematuria most common
- often silent symptoms at initial stages
- abdominal/flank pain develops later
- palpable abdominal mass
17
Q
Renal Cell Carcinoma usually metazoic to
A
lungs
liver
lymph
bones
18
Q
most common inherited kidney disease
A
Polycystic Disease
19
Q
accumulation of fluid in the kidneys causing a cyst to form
A
polycystic disease
20
Q
polycystic disease may be caused by:
A
obstruction or weak basement membrane
21
Q
what is the most common symptom of polycystic disease?
A
- Flank pain
- others: palpable, enlarged kidneys, hematuria, hypertension
22
Q
polycystic patients are at risk for
A
UTIs
hypertension
23
Q
third most common urinary tract disorder
A
kidney stones
24
Q
calcium deposits
A
kidney stones
25
- 4x greater in males
- diet (grapefruit juice increases risk, coffee decreases_
- obesity
- climate (warmer)
- 50% reoccurance
risk factors for kidney stones
26
Clinical manifestations of kidney stones: (red flags)
1. acute, excruciating flank & upper, outer abdominal pain
2. dull back pain progressing to worst pain ever
3. Cost. vet. angle. tenderness
4. may radiate into lower abdomen, bladder, and perineal area
27
other clinical manifestations of kidney stones:
1. nausea and vomiting
2. increased freq. and urgency
3. hematuria
4. asymptomatic
28
difference between musculoskeletal pain and renal/urethra pain?
musculoskeletal pain usually altered by position
29
- gradual loss of nephrons over a period of time
- decreased glomerular filtration and reabsorption
- decreased endocrine function of kidneys
Chronic Renal Failure and End Stage Renal Disease
30
how many nephrons must be lost in order to show S/S of Chronic Renal Failure
-50%
31
Risk Factors for Chronic Kidney Disesase
-Hypertension
-Diabetes
NSAIDS
Age
Smoking
Heredity
32
How does hypertension affect the kidneys?
-damages glomerulus arterioles, decreasing GFR and increasing protein filtration
33
System Changes with CKD
- Hematologic
- Cardiovascular issues
- neuromuscular
- Skeletal
- neurologic
- gastrointestinal
- physical performance
- Integumentary
34
Hematologic changes with CKD?
-anemia due to decreased RBC production
35
Cardiovascular issues with CKD?
- hypertension (due to increased renin)
| - increased Na+ and increased fluid volume
36
Neuromuscular changes with CKD?
- muscle cramping
- weakness
- myopathy
- sensory loss
- tremors
37
Skeletal changes with CKD?
- demineralization of bone due to loss of calcium in urine
| - PTH is released and takes calcium from bones which could lead to osteoporosis
38
Neurological Changes with CKD?
-increased remix alters nervous system function, memory loss, irritability, impaired judgement, seizers, coma at end stage
39
GI changes with CKD?
- anorexia
- nausea
- vomiting
40
Physical performance changes with CKD?
-impaired early in the course of the disease, not always
41
Integumentary changes with CKD?
- pallor
- bruising
- skin pigmentation
42
Chronic Renal Disease concerns for physical therapy?
- decreased RBCs leads to anemia and fatigue, weakness, dyspnea
- osteoporosis due to poor calcium regulation
- renal osteodystrophy because of Ca ++ loss, leading to bone pain
- memory loss, coma, decreased alertness
43
How can having chronic renal disease affect PT's?
pt. may have:
- decreased alertness
- poor concentration and memory
- difficulty following instructions (transfers, exercises, mechanics)
- fatigue and weakness meaning more rest
- potential osteoporosis
- interventions to prevent fractures
44
treatment for CKD?
- dialysis (hemodialysis in the clinic and peritoneal)
| - transplant
45
What is the number one cause of mortality in CKD?
CVD
46
three reasons why heart rate monitoring does not work well for measuring exercise intensity in those with CRD?
1. medications
2. abnormal heart rate due to disease
3. fluid status may alter HR
47
what causes a spastic bladder?
UMNL, stroke, spinal cord lesion
48
describe a spastic bladder?
- increased detrusor muscle tone and activity
- decreased urine volume
- increased freq. and urgency
- involuntary voiding
- incoordination of detrusor and sphincter muscles leading to decreased flow and reflux
49
what causes a flaccid bladder?
LMNL, below sacral level
Spina bifida
diabetes
50
describe a flaccid bladder?
- detrusor muscle inactivity and loss of sensation of bladder fullness
- causes bladder to overfill leading to overflow and incontinence
51
How can you treat a neurogenic bladder?
- catherization (intermittent or permanent)
- bladder retraining, EMG biofeedback
- control fluid intake
- surgery
52
4 types urinary incontinence?
1. Functional
2. Stress
3. Urge
4. Overflow
53
- normal urine control
| - have difficulty reaching toilet in time due to muscle or joint dysfunction
Functional Incontinence
54
- loss of urine during activities that increase intra-abdominal pressure such as couching, lifting, or laughing
- pelvic floor weakness
Stress Incontinence
55
Sudden, unexpected urge to urinate and the uncontrolled loss of urin
- overactive bladder
- UMNL
Urge incontinence
56
Frequent dribbling or leaking or ride from bladder that is full but unable to empty
- blocked or flaccid bladder
- LMNL
Overflow Incontinence
57
What type of incontinence is common after pregnancy?
Stress
58
Risk factors for urinary incontinence
- women
- pelvic floor weakness w/aging and pregnancy
- neurological disorders
- UTI
- medications
- prostatectomy or prostatic hyperplasia
59
caused by uncontrolled bladder contractions increasing freq. and urgency of voiding
-often by UMNL and uncoordinated actions of the detrusor and sphincter muscles
Urge Pathogenesis or urge incontinence
60
What types of incontinence have PT been beneficial for?
stress and urge incontinence but using biofeedback and pelvic floor exercises
