Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Pathology Year 2 > 15. The Urinary System and the Male Genital Tract > Flashcards

15. The Urinary System and the Male Genital Tract Flashcards

1
Q

Overview

A 
Urinary tract infections
Kidneys
Bladder
Prostate
Testis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Urinary Tract Infections (1)

A

Very common disorder of the urinary tract

Risk factors include:
Females>males
Sexual intercourse
Pregnancy
Diabetes
Urinary tract obstructions e.g. stones or catheters
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Urinary Tract Infections (2)

A

Bacteruria: bacteria in the urine, may be asymptomatic or symptomatic.

Urinary Tract Infection (UTI): the presence of pure growth of >10^5 organisms in fresh urine.

E.coli is the most common causative organism (>70% of community UTIs).

Other organisms include: Staphylococcus, Proteus and Klebsiella

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Cystitis

A

frequency, dysuria, urgency, haematuria, suprapubic pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Pyelonephritis

A

high fever, rigors, vomiting, loin pain and tenderness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

prostatitis

A

flu-like symptoms, few urinary symptoms, swollen tender prostate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Management

A

Drink plenty of fluids.

Urinate often (double voiding).

Antibiotics (trimethoprim usually first line treatment in uncomplicated UTIs).

Imaging – US in non-resolving UTIs, children, men and pyelonephritis.

Severe cases may require hospital admission specially pyelonephritis and in the elderly

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Kidney Function (1)

A

Maintinance of water, electrolyte and acid-base homeostasis.

Excretion of many toxic metabolic waste products (urea and creatinine).

Hormonal function
Renin – help control blood pressure
Erythropoietin- stimulates production of RBCs in the bone marrow and helps in the production of vitamin D.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Kidney Function (2)

A

The functional unit is the nephron (consisting of a glomerulus and a renal tubule).

Filtration of most small molecules from the blood in the glomerulus.

Selective reabsorption in the renal tubule of most of the water and some molecules.

Maintenance of the acid-base balance.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Acute Renal Failure

A

over hours or days

There is a low urine volume (

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Causes

A

Pre-renal
Hypoperfusion, sepsis
Renal
ATN damage to tubules due to ischaemia or nephrotoxins
Post-renal
Renal tract obstruction (eg stones, tumours)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Management

A

Treat exacerbating factors ( hypovolaemia, sepsis.. etc).

Stop nephrotoxic drugs ( NSAIDs, ACE-I, gentamycin and Vancomycin)

May need renal replacement therapy (haemofiltration/dialysis)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Chronic Renal Failure

A

depending on the glomerular filtration rate (GFR)

GFR is the volume of fluid filtered from the glomerular capillaries into the Bowman’s capsule per unit time

Symptoms usually occur by stage 4

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Chronic Renal Failure stage

A 
1 = >90
2 = 60-89
3 = 30-59
4 = 15-29
5 =
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Chronic Renal Failure Common Causes

A 
Glomerulonephritis
Diabetes 
Renovascular disease 
Hypertension
Polycystic disease

Managed under nephrology team. Treat reversible causes. Avoid exacerbating factors, avoid nephrotoxic drugs.

May progress to renal replacement therapy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Glomerulonephritis

A

A group of disorders where there is damage to the glomerular filtration apparatus. This may cause a leak of protein or blood into the urine.

Usually there is a deposition of immune complexes in one part of the nephron

17
Q

Stones

A

Crystal aggregates that form in the collecting ducts of the kidneys and can deposit anywhere in the renal tract.

Life time incidence 15%

Peak age 20-40 years.

Male: female = 3:1

18
Q

Risk Factors (1)

A

Dehydration
Dietary factors ( increase chocolates, tea and rhubarb)
Drugs ( loop diuretics, antacids, corticosteroids, theophylline and aspirin)
Renal tract abnormalities
Recurrent UTIs
Metabolic abnormalities (hyperparathyroidism, hyperthyroidism and cancer)

19
Q

Risk Factors (2)

A

Patient may be asymptomatic (found accidently on x-ray or blood on dipstick ).

Pain. Kidney stones causes loin pain. Ureteric stones case renal colic (from loin to groin). Bladder and urethral stones cause pain on micturition with interrupted flow. Patients often can’t lie still from the pain.

20
Q

Management

A

Imaging options: KUB-xray (80% of stones are visible). CT scan (99% of stones visible).

Prompt pain relief

Stones 5mm or causing obstruction may need intervention

21
Q

Renal Cancer

A

Renal cell carcinoma

85% of all renal cancers.

Usually presents between the ages of 50 and 70 years.

2:1 male predominance .

Smoking an important risk factor along with obesity, hypertension, exposure to asbestos and certain hereditary conditions.

22
Q

Presentation

A

50% incidental findings on abdominal imaging.

Haematuria.

Loin pain.

Abdominal mass.

Para neoplastic syndromes: e.g. polycythaemia, hypercalcaemia and hypertension.

23
Q

Treatment

A

Radical nephrectomy +/- chemotherapy

24
Q

Bladder

A

Cystitis is the commonest benign condition

Transitional cell carcinomas are the most common malignant condition in the bladder

25
Q

Transitional Cell Carcinoma

A

Presentation:
Classically – painless haematuria
Frequency, urgency and dysuria can occur.

Tests:
Urine for cytology
Cystoscopy and biopsy

26
Q

Treatment

A

Depends on stage of disease and spread

Small lesions at early stage can be managed with diathermy on cystoscopy.

Later stages – radical cystectomy or palliative chemo/radiotherapy

27
Q

Prostate

A

Prostate is a gland that is located at the base of the bladder and around the first part of the urethra.

In normal adults weighs around 20gm.

Helps in the secretion and maintenance of semen and spermatozoa.

28
Q

Benign Prostatic Hyperplasia

A

Common

Hyperplasia: increase in the number of cells.

BPH: increase in number of cell resulting in the formation of nodules. Prostate weighs 60-100gm

40s = 20%
60s = 70%
80s = 90%
29
Q

Signs and symptoms (1)

A

Usually those of lower urinary tract obstruction: increased frequency, hesitancy, nocturia, terminal dribbling.

Can lead to an increased risk of infection.

Enlarged prostate on PR.

30
Q

Signs and symptoms (2)

A

If small and not symptomatic then conservative, reduce fluid intake (specially 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

31
Q

Prostate Cancer (1)

A

Age
Race (more common in black people and very uncommon in Asian people)
Family history
Hormone levels
Diet – increased risk with increased fat consumption

32
Q

Prostate Cancer (2)

A

Signs and symptoms:
May be asymptomatic (has a slow course)
Nocturia, hesitancy, poor stream and terminal dribbling
Examination shows a hard irregular prostate

Diagnosis:
Raised PSA (prostate specific antigen) but may be normal in 30% of cases
Biopsy

33
Q

Treatment

A

Depends on stage of disease, age of patient and comorbidities

In elderly men with many comorbidities – watchful waiting may be an option

Local disease can be treated with radical prostatectomy

Hormonal therapy and radiotherapy for more advanced cases

34
Q

Testicular torsion (1)

A 
Sudden onset of pain in 1 testis. 
Pain in abdomen, nausea and vomiting.
Testis is hot, swollen and tender. 
The testis may lie high and transversely. 
Most common 11-30 years old.
35
Q

Testicular torsion (2)

A

Tests: USS with Doppler but may need exploratory surgery

Treatment: Surgery, URGENT, if still viable bilateral fixation (orchidopexy) if abnormal then orchidectomy

36
Q

Testicular Tumours (1)

A

Most common malignancy in males aged 15-44 years old.

Risk factors include: undescended testis, infant hernia and infertility.

Presentation: painless testicular lump often noted after trauma or infection

37
Q

Testicular Tumours (2)

A

Germ cell tumours
Different categories
Most common is seminoma

Treatment depends on type of tumour and stage
Usually involves an orchidectomy and a combination of radiotherapy and chemotherapy

38
Q

Summary

A 
Urinary tract infections
Kidneys- acute and chronic renal failure, renal stones, renal cancer
Bladder-infection, TCC
Prostate-BPH, prostate cancer
Testis- torsion, germ cell tumours

Pathology Year 2 (22 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions