Flashcards in Urinary System & Male genital tract Deck (32):
What are the risk factors for someone developing a urinary tract infection?
- females more likely
- sexual intercourse
- urinary tract obstructions eg. stones or catheters
If an infection is found in these places what are they called:
- urethra = urethritis
- bladder = cystitis
- prostate = prostatitis
- kidney = pyelonephritis
What is the most common bacteria causing UTI's?
What are the symptoms of cystitis?
- dysuria (pain on urinating )
- suprapubic pain
what are the symptoms of pyelonephritis?
- high fever
- loin pain and tenderness
What are the symptoms of prostatitis?
- flu-like symptoms
- few urinary symptoms
- swollen and tender prostate on PR examination
What are the treatments of UTI's?
- drink plenty of fluids
- urinate often (double voiding)
- Antibiotics (trimethoprim usually)
- Imaging - if recurrent or male or non-resolving
- severe may require hospital admission, especially pyelonephritis and elderly
What is acute renal failure?
a significant deterioration in renal function occurring over hours or days
- low urine volume (oliguria)
- rising plasma urea and creatinine levels
- usually occurs with other severe illnesses (pre-renal)
What are the causes of acute renal failure?
- ischaemic necrosis
- ATN (damage to tubules due to ischaemia or nephrotoxins)
- due to obstruction in urinary tract (eg. stones, tumours)
How do you treat acute renal failure?
- find and treat the cause
- treat exacerbating factors (hypovolaemia, sepsis ect.)
- stop nephrotoxic drugs (NSAIDs, ACE, vancomycin, gentamycin )
- may need renal replacement therapy (dialysis or haemofiltration)
Chronic renal failure is split in to 5 grading stages. Symptoms usually do not occur until grade 4. What do these grades depend on?
What are the common causes of chronic renal failure?
- glomerulonephritis ( inflammation of the glomerular)
- renovascular disease
- polycystic disease
What is glomerulonephritis?
- group of disorders
- damage to glomerular filtration.
- cause leak of protein or blood into the urine
- usually deposition of immune complexes in nephron
What are stones?
- can occur anywhere in renal tract
- crystal aggregates that form in the collecting ducts
- seen more in men
What are the risk factors that may cause stones?
- dietary factors (increase chocolates, tea and rhubarb)
- drugs (loop diuretics, antacids, corticosteroids, aspirin, theophylline)
- renal tract abnormalities
- reccurent UTI's
- metabolic abnormalities(hyperthyroidism, hyperparathyroidism and cancer)
What are the symptoms of renal stones?
- may be asymptomatic
- loin to groin pain (colic pain)
- pain on weeing
How do you mange treatment of stones?
- imaging options (KUB-xray or CT scan)
- pain relief
- drink plenty
- small stone will pass
- may need intervention if great than 5mm
What are the risk factors for someone getting renal cell carcinoma?
- more predominant in males
- usually between 50-70 years
- exposure to asbestos
- certain hereditary conditions
How are renal cell carcinomas normally found.
- 50% found accidently by imaging
symptoms such as
- loin pain
- abnormal mass
- para neoplastic syndromes eg. polycythaemia, hypercalcaemia and hypertension
How do you treat renal cell carcinoma?
- radical nephrectomy
What are the most common malignant and benign conditions in the bladder?
- transitional cell carcinoma (malignant)
- cystitis (benign)
You test for transitional cell carcinoma by urine cytology, cystoscopy and biopsy. How does transitional cell carcinoma present?
- classically painless haematuria
What is the treatment plan for transitional cell carcinoma?
- depends on stage and spread
- small lesions at early stage can be managed with diathermy and cystoscopy
- later stages - radical cystectomy or palliative chemo/ radiotherapy
What are the signs and symptoms of benign prostatic hyperplasia? This is an increase in the number of cells resulting in nodule formation.
- usually lower urinary tract obstruction :-
nocturia (weeing at night)
terminal dribbling (cant stop weeing)
- can lead to increased risk of infection
- enlarged prostate on examination
What are the treatments for benign prostatic hyperplasia?
- if small treat conservative (reduce fluids (at night), reduce alcohol and caffeine, scheduled voiding)
- medical treatment: alpha blockers (reduces the smooth muscle tone in the prostate)
- TURP - transurethral resection of the prostate(scrape out excess tissue )
What are the risks of developing prostate cancer?
- race (black people)
- family history
- hormone levels
-diet - increased with increased fat consumption
prostate cancer is diagnosed with raised prostate specific antigen level and by biopsy. What are the signs and symptoms of prostate cancer?
- may be asymptomatic
- nocturia (weeing at night )
- poor stream
- terminal dribbling
- examination shows a hard irregular prostate
- similar to BPH except prostate irregular
What are the treatments of prostate cancer?
- just watch and wait in elderly
- local disease can be treated with radical prostatectomy
- hormonal therapy and radiotherapy
- often metastasized to the bone
Testicular torsion is twisted spermatic cord causing blockage of blood flow. what are the symptoms?
- sudden onset of pain in one testis
- pain in abdomen, nausea and vomiting
- testis is hot, swollen and tender
- the testis may lie high and transversely
- most common in 11-30 years old
How do you diagnose and treat testicular torsion?
- test by USS with Doppler or exploratory surgery
- treat: urgent surgery if still viable
- they will fix both testis.
- may need orchidectomy
Testicular tumours are most common malignancy in males aged 15-44 years. What are the risk factors and presentations of testicular tumours?
- undescended testis
- infant hernia
- painless testicular lump