3. Renal Outflow Disease

Question 1

Urinary tract (UT) diseases include (3)

Answer 1

UT infection (UTI)
UT obstruction (UTO)
UT malignancy

Question 2

Examples of UTO include (3)

Answer 2

Renal stones
Tumours
Prostate hypertrophy

Question 3

Urinary tract infections cause (2)

Answer 3

Usually E. coli infection

Also staph, fungi, virus, TB possible

Question 4

Why are UTIs more common in females

Answer 4

Due to length of urethra

Question 5

How do you decrease risk of UTI

Answer 5

Increased hydration/urine output

Question 6

UTI predisposing factors (2)

Answer 6

Poor bladder emptying

Low urinary flow rates

Question 7

Definition of cystitis

Answer 7

Bladder inflammation

Question 8

Features of urine (2)

Answer 8

Sterile

Bacteria/blood/defence cells suggest infections

Question 9

Indication of UTI

Answer 9

Microscopic haematuria

Question 10

UTI investigation

Answer 10

MSSU (mid-stream sample of urine) - microscopy, culture, sensitivity
For completely sterile urine sample, use supra-pubic aspiration

Question 11

Infected urine can cause (£)

Answer 11

Cystitis
Renal infection (urinary reflux)
Prostate infection

Question 12

UTI symptoms include (5)

Answer 12

Dysuria
Urine frequency
Cloudy urine
Offensive smelling urine
Supra-pubic pain

Question 13

UTI treatment involves (3)

Answer 13

Increase fluid intake
Frequent micturition
Occasionally antibiotics

Question 14

Antibiotic treatment of UTI (2)

Answer 14

Trimethoprim (gold standard)

Amoxicillin

Question 15

UT obstructions include (4)

Answer 15

Renal calculi
Prostatic disease
UT strictures
External compression

Question 16

Urinary outflow obstruction symptoms include (6)

Answer 16

Slow stream
Hesitancy
Frequency
Urgency
Nocturia
Incomplete voiding

Question 17

Types of prostate diseases include (3)

Answer 17

Prostatitis (prostate inflammation)
Benign prostatic hypertrophy
Prostatic cancer (adenocarcinoma)

Question 18

Definition of benign prostatic hypertrophy

Answer 18

Hyperplasia of the prostate

Question 19

How common is benign prostatic hypertrophy

Answer 19

80% in men over 80yrs

Question 20

Treatment for benign prostatic hypertrophy (2)

Answer 20

Drug-based (a-adrenergic blocking drugs)

Surgery

Question 21

Surgical treatment for benign prostatic hypertrophy involves (2)

Answer 21

TURP - transurethral prostatectomy (remove part of prostate that is compressing urethra)
Open prostatectomy

Question 22

Prostatic malignancy is how common (2)

Answer 22

90% of men > 90yrs

10% have symptomatic disease

Question 23

What is PSA and when is it used (@)

Answer 23

Prostatic specific antigen

Useful for monitoring disease activity in those known to have the disease

Question 24

Prostatic malignancy treatment involves (3)

Answer 24

Surgery (radical prostatectomy)
Radiotherapy
Hormone tgeratment (anti-adreogens, LHRH analogues)

Question 25

Proastatic malignancy will metastasise

Answer 25

Skeletal system (bone), resulting in osteoporosis

Question 26

Renal canaliculi are (2)

Answer 26

Stones in kidney/bladder

In 5% of population

Question 27

Renal canaliculi treatment involves

Answer 27

Lithotripsy (ultrasonic sound energy)