Urinary System & Male genital tract Flashcards Preview

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Flashcards in Urinary System & Male genital tract Deck (32):
1

What are the risk factors for someone developing a urinary tract infection?

- females more likely
- sexual intercourse
- pregnancy
- diabetes
- urinary tract obstructions eg. stones or catheters

2

If an infection is found in these places what are they called:
- urethra
- bladder
- prostate
- kidney

- urethra = urethritis
- bladder = cystitis
- prostate = prostatitis
- kidney = pyelonephritis

3

What is the most common bacteria causing UTI's?

E. coli

4

What are the symptoms of cystitis?

- frequency
- dysuria (pain on urinating )
- urgency
- haematuria
- suprapubic pain

5

what are the symptoms of pyelonephritis?

- high fever
- rigors
- vomiting
- loin pain and tenderness

6

What are the symptoms of prostatitis?

- flu-like symptoms
- few urinary symptoms
- swollen and tender prostate on PR examination

7

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

8

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)

9

What are the causes of acute renal failure?

PRE-RENAL
- sepsis
- ischaemic necrosis

RENAL
- ATN (damage to tubules due to ischaemia or nephrotoxins)

POST RENAL
- due to obstruction in urinary tract (eg. stones, tumours)

10

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)

11

Chronic renal failure is split in to 5 grading stages. Symptoms usually do not occur until grade 4. What do these grades depend on?

GFR

12

What are the common causes of chronic renal failure?

- diabetes
- glomerulonephritis ( inflammation of the glomerular)
- renovascular disease
- hypertension
- polycystic disease

13

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

14

What are stones?

- can occur anywhere in renal tract
- crystal aggregates that form in the collecting ducts
- seen more in men

15

What are the risk factors that may cause stones?

- dehydration
- 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)

16

What are the symptoms of renal stones?

- may be asymptomatic
- loin to groin pain (colic pain)
- pain on weeing

17

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

18

What are the risk factors for someone getting renal cell carcinoma?

- more predominant in males
- usually between 50-70 years
- smoking
- obesity
- hypertension
- exposure to asbestos
- certain hereditary conditions

19

How are renal cell carcinomas normally found.

- 50% found accidently by imaging
symptoms such as
- haematuria
- loin pain
- abnormal mass
- para neoplastic syndromes eg. polycythaemia, hypercalcaemia and hypertension

20

How do you treat renal cell carcinoma?

- radical nephrectomy
- chemotherapy

21

What are the most common malignant and benign conditions in the bladder?

- transitional cell carcinoma (malignant)
- cystitis (benign)

22

You test for transitional cell carcinoma by urine cytology, cystoscopy and biopsy. How does transitional cell carcinoma present?

- classically painless haematuria
- frequency
- urgency
- dysuria

23

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

24

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 :-
increased frequency
hesitancy
nocturia (weeing at night)
terminal dribbling (cant stop weeing)
- can lead to increased risk of infection
- enlarged prostate on examination

25

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 )

26

What are the risks of developing prostate cancer?

- age
- race (black people)
- family history
- hormone levels
-diet - increased with increased fat consumption

27

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 )
- hesitancy
- poor stream
- terminal dribbling
- examination shows a hard irregular prostate
- similar to BPH except prostate irregular

28

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

29

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

30

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

31

Testicular tumours are most common malignancy in males aged 15-44 years. What are the risk factors and presentations of testicular tumours?

risk factors
- undescended testis
- infant hernia
- infertility
presentation
- painless testicular lump

32

The most common type of testiculat tumours is seminoma. What are the treatment options for testicular tumours?

- orchidectomy and a combination of radiotherapy and chemotherapy