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Pathophysiology & Pharmacology > Urogenital System Pathology > Flashcards

Urogenital System Pathology Flashcards

1
Q

Anatomy: Renal

A
  • Kidneys
    ~ Situated just below the twelith
    thoracic vertebrae and above the
    third lumbar vertebrae.
    ~ Filters the blood of waste products.
    ~ Produces concentrated urine to
    excrete the waste products (urea,
    creatine, acids and salts).
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2
Q

Anatomy: Ureters, Bladder, Urethra

A
  • Ureters: Vessel which carries urine from the kidney to the bladder.
  • Bladder: Receptacle for urine from the kidneys.
  • Urethra: Vessel which carries urine from the bladder for elimination.
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3
Q

Anatomy: Male Genitalia

A
  • Prostate Gland
    ~ Surrounds the neck of the bladder
    and the urethra.
    ~ Secretes fluid that is a component of
    semen.
  • Spermatic Cord - Group of vessels.
    ~ Carry sperm from the testicles to the
    urethra.
    ~ Provide blood andnervous supply to
    the testes.
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4
Q

Monorchidism

A
  • Absence of one testicle
    ~ Congenital in 1 in 5000
    ~ Can also be due to trauma.
    ~ May exclude athlete from contact
    sports.
    > Due to a chance of trauma to only
    testicle = no kids
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5
Q

Scrotal and Testicular Trauma: S&S and Management

A
  • Pain
  • Bruising
  • Effusion
  • Muscle Spasm: Cremaster
    ~ Muscle responsible for contracting
    testicles up into body
  • Management
    ~ Persistent pain and effusion require a
    referral
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6
Q

Testicular Torsion

A
  • Spermatic cord twists compressing arteries and veins causing ischemia in the affected testicle
  • Cause
    ~ Trauma
    ~ Coughing or Vomiting
    ~ Developmental
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7
Q

Testicular Torsion: S&S and Management

A
  • S&S
    ~ Same as trauma except:
    > Persistent pain
    > Testicle is higher on rotated side
  • Management
    ~ Most common cause of testicle loss
    ~ 80-100% salvage rate if seen < 6
    hours.
    ~ Near 0% salvage rate if seen > 6
    hours.
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8
Q

Anatomy: Female Genitalia

A
  • Ovaries: Produces ovum and hormones (estrogen and progesterone).
  • Uterus: Reproduction organ for containing and nourishing the embryo.
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9
Q

General S&S of Underlying Condition: Hematuria

A
  • Blood in urine
    ~ Indicates either kidney or bladder
    pathology
    ~ Usually caused by infection or direct
    blow
  • Very serious
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10
Q

General S&S of Underlying Condition: Pain

A
  • Kidneys, Ureters and Bladder
    ~ May refer pain to the ipsilateral lower
    back or abdomen.
  • Prostate
    ~ May refer pain to the lower back or
    scrotum.
  • Uterus
    ~ May refer pain to the middle and low
    back.
  • Ovaries
    ~ May refer pain to the lower abdomen
    and sacrum.
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11
Q

General S&S of Underlying Condition: Hemospermia

A
  • Blood in semen
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12
Q

Urinary Tract Infection

A
  • Bacterial infections typically of bacteria that contaminate the perianal and genital areas and gain access through the urethra.
  • Cystitis
    ~ Infection affects bladder only
  • Pyelonephritis
    ~ Infection of kidney
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13
Q

Urinary Tract Infection: Predisposing Factors

A
  • Any condition that impairs free drainage of urine
    ~ Stagnation allows for multiplication of
    bacteria
  • Injury to the lining of the urinary tract
    ~ Permits bacteria to invade tissue
    > Rare but may be caused by a
    kidney stone
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14
Q

Urinary Tract Infection: S&S

A
  • Pain in Area of Infection
  • Frequent Urination
  • Pain with Urination
  • Hematuria
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15
Q

Urinary Tract Infection: Prevention

A
  • Free urine flow, large urine volume and complete emptying of the bladder protect against infection.
    ~ Flushes bacteria from the system
  • Acidic urine is also protective
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16
Q

Post Infection Glomerulonephritis

A
  • Glomeruli become inflamed following infection elsewhere. (strep).
    ~ Antibodies produced to fight pathogen
    bind to the pathogen and this complex
    gets trapped in the glomerulus
    inducing an inflammatory reaction.
    ~ Antibodies produced to fight
    pathogen bind to the glomerular
    capillaries and cause inflammation.
17
Q

Post Infection Glomerulonephritis: Effect of Inflammation

A
  • Causes swelling and possible blockage of glomeruli.
  • Leukocytes associated with inflammation can cause damage to the glomeruli.
  • Inflammation of the filtration system
18
Q

Post Infection Glomerulonephritis: S&S

A
  • Decreased filtration/urine production,
  • Hypertension
  • Hematuria
    ~ Urinary Casts: mass of RBCs and
    protein molded to shape of the
    tubules
19
Q

Renal Calculi (Kidney Stone)

A
  • Cause
    ~ Majority caused by excess calcium
    salts and it uric acid in the blood
    ~ Excess is filtered and removed at the
    kidney and stones can form.
20
Q

Renal Calculi (Kidney Stone): Predisposing Factors

A
  • Increased concentration of calcium salts in the blood.
  • Urinary Tract Infection
    ~ Reduces solubility of the salts/uric
    acid or bacteria can serve as a site for
    crystallization
  • Urinary Tract Obstruction
    ~ Due to stagnation of urine
    ~ Also predisposes to infection
  • Peeing too often or too little
21
Q

Renal Calculi (Kidney Stone): S&S and Management

A
  • Pain
    ~ Sudden, severe ipsilateral lower back
    > Renal colic
    > W/out trauma
    ~ Pain may radiate to the abdomen and
    or groin
  • Hematuria: if calculi injure the ureter.
  • Fever and Fatigue: If infection is present.
  • Management
    ~ Increased Fluid Intake: Clear stones
    and prevent new ones. (Painful)
    ~ Ultrasonic Disintegration/Lithotripsy
    (painful)
    ~ Endoscopic Removal
22
Q

Acute Renal Failure

A
  • Sudden loss of the ability of the kidneys to excrete wastes and concentrate urine
23
Q

Acute Renal Failure: Causes

A
  • Inadequate Blood Flow to the Kidney
    ~ Low Blood Pressure
    > CHF
    > Massive Hemorrhage
    > Dehydration
    > Extreme Endurance Sports
    • blood is needed elsewhere
    resulting in low BP
  • Injury to the Internal Structures of the Kidney
    ~ Trauma
    ~ High Blood Pressure
  • Obstruction of Urinary Outflow
    ~ Tumor
    ~ Stone
24
Q

Acute Renal Failure: S&S and Management

A
  • S&S
    ~ Decreased or No Urine Output
    > Sudden Weight Gain
    > Generalized Edema
    > Hypertension
    ~ Altered Mental State: confusion,
    seizure, coma
  • Management
    ~ Identify and treat any reversible
    causes of the kidney failure.
    ~ Rest the kidney.
    > Limit Fluids, protein and
    potassium
25
Q

Sports Hematuria

A
  • Blood in urine associated with sport participation
    ~ Usually found during urinalysis.
    ~ Less often seen by athlete while
    urinating.
    ~ Usually not a concern if caused by
    sports activity.
26
Q

Sports Hematuria: Cause

A
  • Traumatic
    ~ Participation in contact sports.
  • Non-Traumatic
    ~ During endurance activity blood is
    diverted away from non-essential
    organs to the muscles.
    > Can cause a degree of hypoxia in
    the kidney leading to low level
    damage
27
Q

Relative Energy Deficiency in Sport (RED-S)

A
  • Hormonal/physiological consequences of low energy availability.
  • Energy Expenditure (EE) > Energy
    Availability (EA)
  • Common sports affected:
    ~ Wrestling
    ~ Dance
    ~ Distance runners
    ~ Figure skating
28
Q

Female Athlete Components

A

Disordered Eating/Exercise (1)
/ \
Amenorrhea (2a) Osteoporosis (2b)

29
Q

Female Athlete Components: Caloric Imbalance

A
  • Often caused by disordered eating/excessive exercise
    ~ Low supply of calories leads to
    decreased pituitary hormone release
    (FSH and LH)
30
Q

Female Athlete Components: Amenorrhea

A
  • Decreased pituitary hormone release leads to decreased estrogen and progesterone production from the ovaries leading to amenorrhea
31
Q

Female Athlete Components: Osteoporosis

A
  • Normal estrogen levels inhibit osteoclast activity
    ~ Diminished estrogen levels lead to
    increased osteoclast activity
    decreasing bone density
  • Requires a few months of caloric imbalance
32
Q

Male Athlete Components

A

Disordered Eating/Exercise (1) —> Hyothalamic-Pituitary-Gonadal Supression (2) —> Osteoporosis (3)

33
Q

Male Athlete Components: Disordered Eating/Exercise

A
  • Caloric imbalance often caused by disordered eating/excessive Exercise
    ~ Increased severity required when
    compared to female athlete.
    ~ Low supply of calories leads to
    decreased FSH and LH
34
Q

Male Athlete Components: Hypothalamic-Pituitary-Gonadal Suppression

A
  • Decreased LH leads to lower levels of testosterone production
    ~ Libido
    ~ Muscle Mass
    ~ Mood
  • Decreased FSH leads to lower sperm content
35
Q

Male Athlete Components: Osteoporosis

A
  • Normal testosterone levels inhibit osteoclast activity
    ~ Diminished testosterone levels lead to
    increased osteoclast activity decreasing
    bone density
  • Requires a few months of decreased testosterone levels
36
Q

RED-S S&S

A
  • Weight Loss
  • Fatigue
  • Stress Fractures
  • May show signs of eating disorder (anorexia or bulimia).
37
Q

Anorexia

A
  • Person with abnormal body image that is obsessed with weight loss and greatly limits caloric intake and exercises excessively to lose weight.
  • Signs
    ~ Drops weight to about 20% below
    normal.
    ~ Denies Feeling Hungry
    ~ Exercises Excessively
    ~ Feels despite proof to the contrary.
    ~ Withdraws from social activities.
38
Q

Bulimia

A
  • Person with abnormal body image that is obsessed with weight loss who binges and purges food to lose weight.
  • Signs
    ~ Makes excuses to go to the bathroom
    immediately after meals.
    ~ Eats huge amounts of food, but
    doesn’t gain weight.
    ~ Uses laxatives or diuretics.
    ~ Withdraws from social activities.
39
Q

RED-S Management

A
  • Normalize eating habits/exercise levels.
  • Prescription of birth control pill or hormones to ensure estrogen and progesterone levels
  • Treatment/counseling for eating disorder

Pathophysiology & Pharmacology (20 decks)

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