UTI, BPH & Prostate Cancer

Question 0

What is the effect of Renal Failure on Potassium levels?

Answer 0

Since the kidneys excrete Potassium, if the kidneys fail, then Potassium will not be excreted and instead level of Potasium in he body will increase causing Hyperkalemia.

Question 1

What is Aldosterone’s effect on Sodium and Potassium?

Answer 1

As the adrenal glands secrete more Aldosterone, this causes the body to retain Sodium and excrete Potassium.

Question 2

How does the kidney regulate oxygen?

Answer 2

The kidney stores Erythropoietin, which stimulates bone marrow to produce RBCs. RBCs carry hemoglobin which carries oxygen to cells.

Question 3

What is the kidneys role in Vitamin D metabolism?

Answer 3

the kidneys Re responsible for the final conversion of inactive vitamin D to its active form. Vitamin D is used for the metabolism of calcium.

Question 4

Urethrocele Vs. Cystocele Vs. Rectocele

Answer 4

1) Urethrocele - The bulging of the anterior vagina wall into the urethra.
2) Cystocele - Herniation of the bladder wall into the anterior vaginal vault.
3) Rectocele - Herniation of the terminal rectum into the posterior vagina.

Question 5

Anti-Diuretic Hormone is also known by what other name?

Answer 5

Vasopressin

Question 6

What is the link between the Glomerulus and the hormone Renin?

Answer 6

Renin is a hormone directly involved in the control of arterial BP; it is essential for the proper functioning of the Glomerulus.

Question 7

Define Functional Capacity

Answer 7

A marked sense of fullness and discomfort with a strong desire to void usually occurring when the bladder contains 35 mL or more of urine.

Question 8

What are the 4 age-related changes associated with the renal system?

Answer 8

1) Thickening of the renal arteries
2) ⬇ in the weight of the kidneys
3) Blood flow ⬇ by about 10% per decade
4) ⬇ bladder capacity

Question 9

Approximately what percentage of blood passing through the glomeruli is filtered into the nephron?

Answer 9

Under normal conditions, about 20% of the blood passing through the glomeruli is filtered into the nephron, Mounting two about 180 L/day of filtrate.

Question 10

Enlargement of the prostate causes which 4 renal problems?

Answer 10

1) Anuria
2) Oliguria
3) Frequency
4) Obstruction of urine flow

Question 11

What is the normal ratio of BUN to creatinine?

Answer 11

10:1

Question 12

What are the 3 primary signs of Glomerulonephritis?

Answer 12

1) Hematuria
2) Edema
3) Azotemia (excessive nitrogenous wastes in the blood)
4) Proteinuria ( > 3 to 5 g/day)

Question 13

(T/F) Dietary protein is restricted when renal insufficiency and nitrogen retention (elevated BUN) develop?

Answer 13

True

Question 14

What are the 3 types of Lower UTIs?

Answer 14

1) Cystitis - Bladder inflammation
2) Prostatitis
3) Urethritis

Question 15

What are the 4 types of Upper UTIs?

Answer 15

1) Acute & Chronic Pyelonephritis - Infection of renal pelvis, tubules, and interstitial tissue of the kidneys.
2) Renal abscess
3) Interstitial nephritis
4) Perineal abscess

Question 16

How does Ascorbic Acid (i.e., cranberry juice) help to prevent recurring urinary infections?

Answer 16

By making the urine more acidic

Question 17

Which medication is a urinary analgesic administered for urinary discomfort associated with UTIs and what should you tech your patient about it?

Answer 17

Phenazopyridine (aka Pyridium) - Teach patients that this med will turn their urine dark orange.

Question 18

Which types of fluids/drinks are discouraged in patients with UTIs and why?

Answer 18

Coffee, citrus, cola, alcohol, spices and tea because they irritate the urinary tract.

Question 19

What are the differences in the manifestations of Acute and Chronic Pyelonephritis?

Answer 19

1) Acute Pyelonephritis - Usually manifested by enlarged with interstitial infiltration e of inflammatory cells.
2) Chronic Pyelonephritis - Kidneys become scarred, contracted, and non-functional.

Question 20

In short, explain the following kinds of Incontinences:

1) Stress
2) Urge
3) Reflex
4) Overflow
5) Functional
6) Iatrogenic

Answer 20

1) Stress - Results from sneezing, coughing or changing positions because of pelvic floor dysfunction.
2) Urge - Strong urge to void but unable to hold it.
3) Reflex - When the patient doesn’t feel the urge to and as a result becomes incontinent.
4) Overflow - When the patient is unable to completely empty their bladder and as a result becomes incontinent because of the overflow.
5) Functional - When physical or mental impairment make it difficult for the patient to reach the bathroom in time.
6) Iatrogenic - Incontinence as a result of meds.

Question 21

Which class of meds are the first to choice for incontinence and what is the mechanism of action?

Answer 21

Anti-Cholinergics - Inhibits bladder contraction

Question 22

Which 2 surgeries, if recent, is a contraindication for urinary catheterization?

Answer 22

1) Radical prostatectomy

2) Urethral reconstruction

Question 23

Urinary stones are formed in the urinary tract as a result of an increase in which 6 substances?

Answer 23

1) Calcium oxalate
2) Calcium phosphate
3) Uric acid
4) Cystine
5) Uric acid
6) Struvite (Magnesium, ammonium phosphate)

Question 24

How does cranberry juice help to manage the mucous in patients with urinary diversions?

Answer 24

Cranberry juice helps to acidifying the urine and manage mucous production.

Question 25

Which 2 metabolic defects are associated with renal stone formation?

Answer 25

1) Hyperparathyroidism | 2) Hyperurecemia (Gout)

Question 26

Why is the course of antibiotic treatment for acute Prostatitis so long?

Answer 26

Because most antibiotics diffuse poorly from the plasma into the prostatic fluid.

Question 27

Which 4 conditions can cause an elevated Prostate-Specific Antigen (PSA) level in the absence of prostate cancer?

Answer 27

1) BPH 2) TURP 3) Acute urinary retention 4) Acute Prostatitis

Question 28

What are the 8 SxS of Cystitis?

Answer 28

1) Frequency, urgency hand burning 2) Voiding small amounts to none 3) Lower abd discomfort & back pain 4) Cloudy, dark, foul-smelling urine 5) Hematuria 6) Bladder spasms 7) Chills & fever 8) N & V

Question 29

What are the 9 SxS of Pyelonephritis?

Answer 29

1) Frequency, urgency hand burning 2) Voiding small amounts to none 3) Flank pain on the affected side 4) Cloudy, dark, foul-smelling urine 5) Hematuria 6) Bladder spasms 7) Chills & fever 8) Nausea 9) ⬆ WBC in urine

Question 30

What is a dipstick urinalysis used for and what does it test for?

Answer 30

Used for UTIs and tests for presence of nitrates, WBCs, and leukocyte esterase.

Question 31

What is Urised?

Answer 31

Urised is a urinary antiseptic, analgesic and anticholinergic combination used to treat UTIs. It is sometimes prepared with methylene blue which tints urine blue or green.

Question 32

Can immobilization cause the formation of urinary stones?

Answer 32

Yes

Question 33

What is the treatment in regards to pH when managing urinary stones of the following composition: 1) Calcium Oxalate 2) Cystine 3) Uric Acid 4) Struvite

Answer 33

1) Calcium Oxalate - ⬇ pH 2) Cystine - ⬆ pH 3) Uric Acid - ⬆ pH 4) Struvite - ⬇ pH

Question 34

Which type of urinary stone is the medication Allipurinol used to treat?

Answer 34

Uric Acid urinary stones

Question 35

Which type of urinary stone is caused by a urea-splitting bacteria?

Answer 35

Struvite urinary stones

Question 36

Besides a sharp, severe pain at the location of the stone, what are the 4 other signs of a urinary stone?

Answer 36

1) Lumbar pain 2) N & V 3) Hematuria 4) Diaphoresis

Question 37

What is Lithotripsy?

Answer 37

Shock wave used to break up urinary stones so that they can be passed

Question 38

Does BPH predispose men to the development of prostate cancer?

Answer 38

No

Question 39

What is the difference between BPH and prostate cancer in regard to the enlargement of the prostate?

Answer 39

BLH enlarges the prostate inward and closes off the urethral while prostate. Cancer enlarges the prostate outwards.

Question 40

What are the obstructive and irritation symptoms of BPH?

Answer 40

1) ⬆ urinary fx 2) Nocturia 3) Hesitancy 4) Abdoominal strain with urination 5) ⬇ in volume and force of stream 6) Incomplete emptying

Question 41

Which medication is used to treat BPH, how does it work, how long does it take to work and what are the 4 listed side effects?

Answer 41

1) 5-alpha reductive inhibitors (i.e., Finasteride) - works by ⬇ size of the prostate by suppressing androgen. 2) Takes 3-6 months for improvement 3) Side effects include ⬇ libido, ⬇ volume of ejaculation, ED, and hair growth.

Question 42

How do Alpha-Adrenergic drugs work to manage BPH, how long do they take to work and what are the 3 listed side effects?

Answer 42

1) Alpha-Adrenergic drugs promote smooth muscle relaxation in the prostate and facilitates urine flow. 2) Takes 2-3 weeks to work 3) Side effects include Orthostatic hypotension, retrograde ejaculation and nasal congestion.

Question 43

What are the 4 possible complications of TURP post-op?

Answer 43

1) Bleeding 2) Clot retention 3) Dilutional hyponatremia 4) Retrograde ejaculation

Question 44

Prostate cancer is usually Asymptomatic in the early stages, but patients may eventually experience which 4 symptoms that are also common in patients with BPH?

Answer 44

1) Dysuria 2) Hesitancy 3) Dribbling 4) Fx

Question 45

What is a Radical Prostatectomy, how long does the patient catheterized, and what are the 5 major post-op complications?

Answer 45

1) Radical Prostatectomy is the removal of the prostate, seminal vesicles, and part of the bladder neck in order to treat cancer. 2) Patients are catheterized for 1-2 weeks with a leg bag 3) Major complications include ED,incontinence, hemorrhage, retention and infection