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BDS2 BAMS - Renal medicine > 3 Renal outflow > Flashcards

3 Renal outflow Flashcards

1
Q

What are the different types of urinary tract disease

A
  • urinary tract infection
  • urinary tract obstruction (renal stones, tumours, prostatic hypertrophy)
  • urinary tract malignancy
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2
Q

Who are most prone to UTIs

A
  • girls (anatomy)
  • immunosuppressed
  • poor bladder emptying
  • low urinary flow rates
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3
Q

what areas do UTIs affect

A

mostly the bladder but can affect as far as the kidney

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4
Q

what usually causes UTIs

A

e.coli

staph, fungi, virus and TB possible too

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5
Q

UTIs can cause cystitis what does this mean

A

bladder inflammation

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6
Q

what does healthy urine consist of

A

sterile

- i.e. detecting any bacteria implies infection

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7
Q

what type of urine sample should be taken

A

a mid-stream urine sample (MSSU)- washes out any organisms

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8
Q

what, if found in a mid stream urine sample are indicitive of a problem

A
  • white cells
  • blood
  • bacteria
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9
Q

whats a sure way to get a sample of urine unaffected with e.g. skin bacteria

A

suprapubic sterile aspiration

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10
Q

if urine is infected what can this cause

A
  • cystitis
  • renal infection
  • prostate infection

(urethritis can occur in isolation - gonococcal)

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11
Q

How can a UTI infect the kidneys

A

via urine reflux

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12
Q

symptoms of UTIs

A
  • dysuria
  • urinary frequency
  • cloudy urine
  • offensive smelling urine
  • supra-pubic pain
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13
Q

How do you treat UTIs

A
  • diagnosis!
  • increase fluid intake
  • frequent micturation
  • occasionally antibitics required
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14
Q

what different things can cause urinary tract obstruction

A
  • renal calculi (kidney stones)
  • prostatic disease (hypertrophy/prostatic malignancy)
  • uriinary tract strictures
  • external compression
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15
Q

symptoms of renal calculi

A

pain as stone goes through ureter

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16
Q

What different types of prostate disease can cause renal obstruction

A
  • prostatis (inflammation of the prostate)
  • benign prostatic hypertrophy (hyperplasia of the prostate)
  • prostatic cancer (adenocarcinoma)
17
Q

how can you reduce renal obstruction with someone who has prostatis

A

little you can do apart from making the urethra wider

18
Q

how can prostate inflammation lead to infection

A

bladder has to work harder as urethra squished, can end up with partially emptied bladder, infection

19
Q

how common is benign prostatic hypertrophy

A

almost normal for old men (80% over 80 have BPH)

- 100% if they live long enough as prostate keeps growing

20
Q

syptoms of urine outflow obstruction (BPH)

A
  • slow stream
  • hesitancy
  • frequency
  • urgency
  • nocturia
  • incomplete voiding
21
Q

treatment for BPH

A
  • alpha-blocking drugs
  • surgery (transurethral or open prostatectomy) n.b. will probably lead to incontanence
  • hormone therapy
22
Q

is prostatic cancer linked to BPH

A

no, usually happens to one area within the prostate

23
Q

Why is diagnosis often delayed

A
  • might not affect urination (depends on location of tumour)
  • prostatic specific antigen (PSA) test has problems with specificity and sensitivity
  • can’t vaccinate as not viral
24
Q

what is the prostatic specific antigen (PSA) blood test useful for

A

monitering prostatic malignancy progression

25
Q

what is used to diagnose prostatic malignancy

A

MRI most useful (PSA blood test good for monitoring once known as positive)

26
Q

Treatment for prostatic malignancy

A
  • surgery (radical prostatectomy)
  • radiotherapy
  • hormone treatment (anti-androgens & LHRH analogues, block hormone-dependent tumour growth)
27
Q

How does prostatic malignancy affect bones

A
  • widespread bone metastasis (osteosclerosis)
28
Q

where can renal calculi develop

A
  • bladder

- kidneys

29
Q

what are the different stone types of renal calculi

A
  • calcium and oxalate (radiopaque)

- uric acid (not radiopaque)

30
Q

how are renal calculi’s treated

A

lithotrypsy

BDS2 BAMS - Renal medicine (3 decks)

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