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Pathopharm I > Urologic Problems > Flashcards

Urologic Problems Flashcards

1
Q

UTI most common sites

A

Lower urinary tract & bladder

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2
Q

Reasons UTI common in women

A

Short urethra
Incomplete emptying
Urethral irritation

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3
Q

UTI risk factor

A

Protein in urine is a great risk for microorganism growth

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4
Q

UTI most common bacteria

A

E.coli

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5
Q

Bacteriuria

A

Bacteria in the urine NOT causing infection but places at risk for UTI

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6
Q

Urethritis

A

Infection in the urethra

Lower UTI

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7
Q

Cystitis

A

Infection in the bladder

Lower UTI

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8
Q

UTI Uncomplicated S/S

A

Asymptomatic, urgency, frequency, dysuria, hematuria, cloudy/foul urine, fever/chills/fatigue

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9
Q

UTI Uncomplicated diagnosis

A

H&P, UA, URINE CULTURE, CBC—leukocytosis

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10
Q

UTI Uncomplicated treatment

A

ANTIBIOTICS, ↑fluids, avoid irritants (i.e., caffeine), loose cotton clothes, frequent urination, probiotics

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11
Q

UTI: Protective Factors

A 
Acidic pH
Presence of urea
Men: prostatic secretions
Women: urethral gland secretions
Unidirectional urine flow
One-way valve at ureteral attachment to bladder
Immune system
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12
Q

UTI: Risk Factors

A

Catheters
Female sex (perineal irritation)
Older age (nursing home up to 50% have bacteriuria)
Pregnancy
Sexual activity (spermicide use with diaphragm or condom)
Urinary obstruction/reflux

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13
Q

UTI: Risk Factors

A

Immobility: urinary stasis
Bowel/urine incontinence
Decreased cognition
Bad personal hygiene

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14
Q

UTI in men

A

More likely to have recurrent UTI’s because bacteria can hide deep in the prostate/ BPH causing urinary retention

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15
Q

Urethritis/lower UTI s/s

A

Dysuria

Most common: ASYMPTOMATIC

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16
Q

Cystitis (bladder)/lower UTI s/s

A 
Frequency
Urgency
Suprapubic discomfort
Dysuria
Hematuria
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17
Q

UTI s/s in children

A 
Fever
Irritability
Poor feeding
Vomiting
Diarrhea
Ill appearance
Old enough to verbalize? 
Can be sign of sexual abuse
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18
Q

UTI s/s in elderly

A 
Anxiety
CONFUSION
Lethargy
Anorexia
Falls
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19
Q

Lower UTI pharm

A

trimethoprim-sulfamethoxazole (Bactrim)
ciprofloxacin
nitrofurantoin (Macrodantin/Macrobid)

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20
Q

trimethoprim-sulfamethoxazole (Bactrim) for lower UTI

A

First-line

Don’t give if sulfa allergies

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21
Q

ciprofloxacin for lower UTI

A

For patients with sulfa allergies

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22
Q

nitrofurantoin (Macrodantin/Macrobid) for lower UTI

A

For recurring lower UTIs

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23
Q

Urinary tract analgesic

A

phenazopyridine (Pyridium)

24
Q

phenazopyridine (Pyridium) indication

A

Relief of PAIN due to UTI

25
phenazopyridine (Pyridium) MOA
Dye used in paint; local analgesic action
26
phenazopyridine (Pyridium) SE
Well tolerated | REDDISH-ORANGE URINE
27
Anatomy
Bladder is composed of smooth muscle (detrusor muscle); holds about 300-500 mL of urine; pelvic floor muscle help control bowel and bladder
28
Overactive bladder
Occurs when bladder muscles involuntarily contract even when urine volume is low
29
Overactive bladder causes
``` Neurological conditions (CVA) DM UTIs Hormonal changes during menopause Badder tumors/stones ```
30
Overactive bladder s/s
Sudden urge to urinate (may experience urgency incontinence) Increased frequency (usually >8x in 24 hrs) Nocturia (wake up >2x during the night)
31
Overactive bladder causes
``` Neurological disorders Diabetes UTI's Hormonal changes Tumors/stones Obstructions ```
32
mirabegron (Myrbetriq) class
Antispasmotic (urinary) | Beta-3 adrenergic agonists--me
33
mirabegron (Myrbetriq) MOA
Selectively stimulates beta-3 adrenergic receptors, relaxing bladder smooth muscle
34
mirabegron (Myrbetriq)/antispasmotic route
PO
35
mirabegron (Myrbetriq)/antispasmotic SEs
HTN—must monitor BP Urinary retention UTI Headache
36
Incontinence
Involuntary urine loss
37
Incontinence and older adults
NOT normal symptom of aging but may be related to functional changes associated with aging
38
Urgency incontinence
Involves the involuntary leakage of urine immediately after a sudden sensation to urinate
39
Urgency incontinence cause
Overactive detrusor muscle that suddenly contracts
40
Urgency incontinence risk factors
Older age Bladder infection that irritates the bladder lining Bladder outlet obstruction (enlarged prostate) CNS conditions (Parkinson’s, dementia, MS, CVA) Drugs (diuretics, alcohol)
41
Stress incontinence
Occurs when urine is involuntarily lost with increases in intraabdominal pressure Precipitated by effort or exertion such as sneezing, coughing, or just bending down
42
Stress incontinence causes
Loss of pelvic muscle and/or loss of fascial support of bladder and urethra; without support any increase in intraabdominal pressure changes normal angle between bladder and urethra and urethra cannot close all the way, causing leakage of urine
43
Stress incontinence risk factors
Age (loss of pelvic floor muscle) Obesity Childbirth-related trauma Pelvic surgery
44
Mixed incontinence
Combination of urge and stress | Common in older women
45
Overflow incontinence
Occurs when bladder is too full | Common in BPH-urinary retention
46
Functional incontinence
Related to physical & environmental limitations | Inability to get to toilet in time
47
Transient incontinence
Usually related to disease process Sudden onset; reversible Often related to UTI, constipation, or fecal impaction
48
Incontinence complications
Skin irritation/inflammation Redness, pain, and itching Swelling, blisters, dryness Damaged skin now vulnerable to infection Damp/warm skin is breeding ground for bacteria and fungi Areas at risk areas: genitals, between buttocks, inner thighs
49
oxybutynin (Oxytrol) class
Anti-cholinergic
50
oxybutynin (Oxytrol) MOA
Blocks the action of acetylcholine (rest/digest) | Acetylcholine activates bladder smooth muscle contractions
51
oxybutynin (Oxytrol)/anti-cholinergic indications
Overactive bladder, incontinence
52
oxybutynin (Oxytrol)/anti-cholinergic SEs
Dry mouth, constipation
53
oxybutynin (Oxytrol)/anti-cholinergic form/route
Can be in extended- release forms | Only given PO
54
Transient incontinence
Causes by medical conditions | Incontinence type most likely associated with a UTI
55
Stress incontinence
Occurs due to weakness or injury to the urinary sphincter or pelvic floor muscles
56
Overflow incontinence
Often caused by an overdistended bladder

Pathopharm I (10 decks)

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