Brainscape's Knowledge GenomeTM

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


See full index

Urology > Bladder Disorders and Urinary Incontinence > Flashcards

Bladder Disorders and Urinary Incontinence Flashcards

1
Q

Hematuria:

  • signs of glomerular bleeding
  • what does the work up include?
A

Glomerlar bleeding signs:

  • red cell casts
  • dysmorphic RBC
  • hematuria with proteinuria w/ a large % being albumin.
Work up: 
-Clean catch urine culture  
-urine cytology 
-CT urography*
-US in pregos 
-cystoscopy
(cystoscopy and CT urography are always done together)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Cystitis:

  • pathogenesis
  • MC pathogen
  • presentation
  • dx
  • Tx for men and women
A

Pathogenesis:
-colonization of the vaginal introitus from fecal flora, ascension to the bladder via the urethra. if this ascends to the kidneys it becomes pyelonephritis

MC is e. Coli , others may include proteus and klebsiella

Presentation:

  • dysuria
  • frequency
  • urgency
  • suprapubic pain
  • hematuria
  • pyuria

Dx:

  • UA***** (will see + leukocyte esterase/ +nitrites)
  • ALL males should have a culture.
Tx: Women:
-Nitrofurantoin  
-Bactrim 
-Fosfomycin 
-reserve FQ for severe cases such as pyelonephritis
-phenozopyridine(anesthetic) 
MEN: 
-Bactrim 
-FQ
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Pyelonephritis:

  • pathogenesis?
  • sx
  • dx
  • tx
A

pathogenesis: cystitis gone wrong.

Sx: chills, flank pain w/ CVA tenderness, nausea, vomiting

Dx:

  • UA
  • Urine culture and sensitivities

Tx:
Outpatient: FQ (Cipro or levo)** may also use bactrim or augmentin but not used often.

Inpatient: PO FQ + Aminoglycoside

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

Noninfectious Cystitis:

  • sx
  • cause
  • work up
  • tx
A

Sx: -dysuria

  • frequency
  • urgency
  • suprapubic pain
  • hematuria
  • nocturia
  • pressure in pelvis

Cause:
-bubble baths, feminine hygiene sprays, tampons, radiation, chemo, tomatoes, artificial sweeteners, caffeine and chocolate.

Work up:

  • UA
  • UC
  • Sometimes cystoscopy

Tx:

  • avoid irritants
  • voiding routine*
  • Kegels
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Nongonococcal Urethritis in males:

  • cause
  • Manifestations
  • dx
  • tx
A

Cause: chlamydia

Manifestations:

  • urethritis:asymptomatic/ symptomatic
  • epididymitis: swollen, red, hot testicle
  • prostatitis

Dx: NAAT testing

Tx:
rocephin and azithromycin

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

Gonorrhea in Males:

  • manifestations
  • dx
  • tx
A

Manifestations:

  • urethritis: symptomatic
  • epididymitis: less than 35YO

Dx: NAAT

Tx:

  • Rocephin and Azithro
  • make sure to treat the partner, no sex until infection cleared, educate on safe sex, test for HIV
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Overactive Bladder:

  • pathophys
  • presentation
  • SE of medications used for tx
  • MOA of medications
  • tx
A

Pathophys: detrusor muscle contracts before bladder is filled. (irregularly at smaller volumes of urine)
-may be 2ndry to DM, stroke, spinal dz

Presentation:

  • urgency
  • frequency
  • nocturia

SE:
-anticholinergic SE, dry mouth, constipation, blurred visiion

MOA:
-increase bladder capacity
-block basal release of ach during bladder filling
(relaxes detrusor muscle so it doesnt spams)

Tx:

  • antimuscarinics such as:
  • -oxybutynin (Ditropan)
  • -Tolterodine (Detrol)
  • -Solifenacin (Vesicare)
  • Mirabegron (Mybetriq)
    • SE is HTN, dry mouth, incomplete bladder emptying.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Urinary Incontinence:

-related causes of morbidity

A

Morbidity:

  • perineal candida infection
  • cellulitis/pressure ulcers
  • UTI/Urospesis
  • Falls/Fxs
  • sleep deprivation
  • psychological: poor self esteem, social withdrawal, depression, sexual dysfunction
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Incontinence:

-causes

A 
Causes: 
DIAPPERS 
-Delirium 
-Infection 
-Atrophic Vaginitis 
-Pharmacologic; sedatives, diuretics, anticholinergics 
-Psychological: depression 
-Excessive urine production 
-Restricted mobility 
-Stool impaction
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Urge Incontinence:

  • etiology
  • presentation
A

etiology:
- uninhibited bladder contractions
- detrusor over activity
- bladder abnormalities or idiopathic

Presentation:
-sudden urge to void preceded or accompanied by leakage of urine

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

Stress incontinence:

-etiology

A

Etiology: leakage of urine with increased intra-abdominal pressure in the absence of bladder contraction (such as coughing/sneezing)

  • may be d/t urethral hypermobility or intrinsic sphincter deficiency
  • prostate surgery MC in men
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Mixed Incontinence:
-what two types of incontinence?

What is the MC type of incontinence in women?

A

Mixed incontinence is urge &/or stress leakage.

MC type of incontinence in women is mixed.

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

Overflow incontnence:

  • aka
  • what is this?
  • cause
A

aka: incomplete emptying

What is this: continuous leakage or dribbling of urine

cause:
- detruser underactivity:
- -low estrogen
- -aging
- -peripheral neuropathy
- -damage to spinal detrusor efferents (MS)
- -bladder outlet obstruction (BPH)

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

Nocturia:

-causes

A

Causes:

  • CHF
  • late evening beverages
  • sleep apnea**
  • sleep disturbances (chronic pain, depression)
  • detrusor overactivity
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Incontinence:

-dx tools

A

Dx:
-bladder diary (record time and volume of every incontinent and continent void over 42-78hrs, include activity, caffeine, sleep)

  • CV, Resp, Neuro, genital, prostate exams.
  • Post void residual (PVR less than 1/3 total voided volume is considered adequate voding)
  • Labs: renal function, serum calcium and glucose, UA, PSA for men, B12, urine cytology if hematuria or pelvic pain
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Incontinence:

  • tx
  • -CI?
A

Tx:

  • lifestyle changes:
  • -weight loss
  • -adequate fluid intake
  • -avoid caffeinated beverages and alcohol
  • -minimize evening fluid for nocturia
  • smoking cessation
  • behavioral therapy for urge, stress, mixed:
  • -bladder training
  • -pelvic muscle exercises: Kegals
  • -biofeedback
  • -pessiaries for organ prolapse or stress incontinence.

Pharmacotherapy: (urge and mixed)

  • anticholinergics w/ antimuscarinic activity:
  • -oxybutinin (antispasmodic)
  • -tolterodine or solifenacin

**CI with narrow angle glaucoma – anticholinergic effects.

-Miragebron (Myratriq)

Surgical therapy:

  • used for stress incontinence:
  • -midurethral sling
  • -bladder neck sling
  • -submucosal injection of urethral bulking agents (not used often)
17
Q

Which one of the incontinence medications is not recommeded in patients with uncontrolled HTN? What are the SE of this medication?

A

Miragebron (Myratriq)
-HTN, tachycardia, urinary retention, inflammation of nasal passages, dry mouth, constipation, abd pain, memory problems.

18
Q

incontinence:
- when to refer immediately
- when to elective referral

A

Immediate:

  • incontinence w/
  • -abd/pelvic pain
  • -hematuria w/o UTI
  • -suspected fistula
  • -complex neurologic conditions

Elective:

  • incontinence w/:
  • -persistent sx after adequat therapeutic trial
  • -uncertain dx
  • -elevated PVR taht does not resolve after tx
  • -prior pelvic surgery or radiation
  • -desiring surgical therapy for stress incontinence
19
Q

Intersitial Cystitis:

  • aka
  • presentation
  • dx
  • tx
A

aka: bladder pain syndrome

Presentation:

  • persistant pain or unpleasant sensation with filling of the bladder that is relieved with voiding*
  • gradual onset with worsening sx
  • urinary frequency, urgency, nocturia

dx:
- PE: tender suprapubic area
- -dyspareunia, irritable bowel, vulvodynia
- UA/UC to r/o cancer and infection
* these unpleasant sensation associated with lower urinary tract sx of more than 6wks duration in the absence of infection or identifiable causes

Tx: 
1ST LINE MANAGEMENT 
-educate expectations about pain relief and chronicity of condition 
-psychosocial support 
-self-care

2nd LINE MANAGEMENT:

  • PT
  • Meds:
  • -amitriptyline
  • -Pentosan polysulfate sodium (Elmiron)
  • -Hydroxyzine (1st generation antihistamine)

Urology (11 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions