Week 12 Flashcards
(26 cards)
What is Urolithiasis?
Development of renal calculi (kidney stones) in the renal system
What is the cause of Urolithiasis?
Elevated urinary levels of salts, organic or inorganic acids
Who is at higher risk of developing kidney stones?
Genetic predisposition Urinary tract infection Cystic kidney disease Hyperparathyroidism Hypercalciuria
What are the clinical manifestations of Urolithiasis?
Severe and shooting pain
Lower back pain (CVA)
What is the diagnostic criteria of Urolithiasis?
History of pain
CT, renal ultrasonography, IVP (intravenous pyelogram)
Urinalysis
Collecting excreted stones
What is the treatment of Urolithiasis?
Pain control (pharmacy)
Calculi removal
Extracorporeal shockwave lithotripsy (ESWL) - ultrasound shock waves that crush the stones to make them easy to pass through urine
Percutnaneous Nephrolithotomy - Stone is too large for EWSL so removed using a nephroscope
Ureteroscopic Stone - stones that are located in the mid or distal portions of the ureters
What is urinary incontinence?
Inability to voluntarily prevent the discharge of urine
What are the causes of Urinary Incontience?
Impaired muscle contraction
Altered neural transmission
Hormonal stimulation
Mechanical factors
What are the clinical manifestations of urinary incontinence?
The urge to pass urine & volumes exceeding bladder capacity
What is the diagnostic criteria of urinary Incontinence?
History of patterns and triggers
Post residual volume (determines adequate bladder emptying)
Urodynamic testing - Cystometry & Cystometrogram
Endoscopic tests
What is the treatment of Urinary Incontinence?
Bladder training Intravaginal support devices Pelvic floor strengthening Drugs Surgical - relief of mechanical obstruction
What is polycystic kidney disease? (PKD)
Growth of fluid filled cysts bilaterally in the kidneys. It’s a leading cause of ESRF
What is the pathophysiology of PKD?
Pressure on renal blood vessels which obstructs perfusion. It leads to tissue degeneration and obstructed tubular flow.
What are the CM of PKD?
Hypertension Enlarged kidneys Altered fluid/electrolyte balance Renal calculi Diverticular disease Urinary tract infection Accumulation of nitrogenous wastes Impaired function in organ systems
What is the diagnostic criteria of PKD?
Family history
Genetic testing (mutations of PKD1 & 2)
Physical Exam - greater than 3 cysts
Laboratory confirmation of renal failure
What is the treatment of PKD?
Pain control - Analgesics
Treatment of urinary infection - Antibiotics
Blood pressure control
Promotion of renal function
Supportive care during end-stage renal disease
Dialysis (hemodialysis & peritoneal)
Renal transplant
What is diverticular disease?
Infection of the diverticula due to fecal matter. The intestine may perforate leading to hemorrhage, abscess, sepsis & peritonitis
What are the CM of diverticular disease?
Altered stool elimination
Intermittent & unpredictable lower abdominal pain
Nausea
Vomiting
What is the diagnostic criteria of diverticular disease?
Physical Exam for abdominal tenderness & distension
Laboratory Analysis - bloody stools, low hemoglobin and hematocrit indicating anemia/complete blood count indicating infection
Imagine studies X-ray, ultrasound, CT for inflamed or ruptured diverticula
What can prevent diverticular disease?
Dietary alterations:
Diet high in fiber & low in fat
Avoidance of foods that may lead to constipation
Regular Fluid intake/preferably water
Daily exercise
Pharmacologic Medications - laxatives or antispasmodic for cramping
What is the treatment for diverticular disease?
Management of symptoms Control of infection Bowel rest Prevention of complications Surgical correction of perforated diverticula
What is functional fecal Incontinence (Encopresis)?
Inappropriate fecal soiling frequently in children. Withholding of feces from pain or fear of defecation.
What are the CM of Encopresis?
Absence of retentive posturing (purposely avoiding defecation by voluntary contraction of the pelvic floor and buttocks)
Absence of organic disease
Age over 4 years
What is the diagnostic criteria of Encopresis?
Stool pattern Related factors Diet history Emotional stress Associated urinary symptoms Family history of constipation
