Brainscape's Knowledge GenomeTM

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


See full index

Urology > Bladder Disorders & Urinary Incontinence > Flashcards

Bladder Disorders & Urinary Incontinence Flashcards

1
Q

Signs of Glomerular Bleeding

A

Red cell casts: glomerulonephritis
Dysmorphic RBCs
Proteinuria with hematuria with a large percentage being albumin

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

Etiologies for Non-glomerular Hematuria

A 
UTI: acute cystitis, pyelonephritis
Kidney trauma
Stones: calyx, ureter
Contamination at menstruation or postpartum
Fistula
Endometriosis
BPH
Vigorous exercise
Post strep glomerular nephritis
IG nephropathy
Cancer: over 40
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Risk Factors for Malignancy

A 
Age: 35+
Smoking history
Occupational exposure to chemicals/dyes
Hx of gross hematuria
Hx of chronic cystitis or irritative voiding symptoms
Hx of pelvic irradiation
Exposure to cyclophosphamide
Hx of chronic indwelling FB
Hx of analgesic abuse
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Hematuria Work-Up

A

Urine culture
Urine cytology
Imaging: CT IVP, US (pregnant women)
Cystoscopy

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

Negative Work-up of Hematuria in Young & Middle-age Patients

A

Mild glomerular disease

Predisposition to stone disease

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

Negative Work-up of Hematuria in Patients at High Risk for Malignancy

A

Need annual UA

May need another work-up in 1-3 years

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

Monitoring for Mild Glomerular Disease

A

BP: every 6 months
GFR/CrCl: yearly
Proteinuria: yearly

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

Reasons for Cystitis

A

UTI
Pyelonephritis
Non-infectious
STI-Male

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

Pathogenesis of Cystitis

A

Colonization of the vaginal introits from fecal flora
Ascension to the bladder via the urethra
Can ascend to the kidneys (pyelonephritis)

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

Most Common Pathogens in Microbiology

A

E. coli (75-90%)
Proteus
Klebsiella

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

Clinical Presentation of UTI

A 
Dysuria
Frequency
Urgency
Suprapubic pain
Hematuria
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Clinical Presentation of Pyelonephritis

A 
Symptoms of cystitis may or may not be present
Chills
Flank pain with CVA tenderness
N/V
Appears ill
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Diagnostic Tests for Cystitis

A

UA
Positive leukocyte esterase +/- nitrites
Consider urine culture with sensitivities

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

Diagnostic Tests for Pyelonephritis

A

UA

Urine culture & sensitivities

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Treatment of Cystitis in Women

A

Nitrofurantoin
Bactrim
Fosfomycin
Phenozopyridine (Pyridium)

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

Differential for Men with Cystitis

A

Prostatitis
Urethritis secondary to STI
Urinary tract abnormality
Nephrolithiasis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Treatment of Cystitis in Men

A

Trimethoprim-sulfamethoxazole (Bactrim)

Fluoroquinolone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Outpatient Treatment for Pyelonephritis

A

Mild to moderate illness
Fluoroquinolone resistance low: Cipro or levoquin
Other: Bactrim or Augmentin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Inpatient Treatment for Pyelonephritis

A

Oral fluoroquinolone + aminoglycoside

Extended spectrum cephalosporin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Symptoms of Non-infectious Cystitis

A

Similar to cystitis with nocturne

Pressure in pelvis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Irritants of Non-infectious Cystitis

A 
Bubble baths
Feminine hygiene sprays
Tampons
Spermicidal jellies
Chemoradiation
Foods: tomatoes, artificial sweeteners, caffeine & chocolate
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Work-up of Non-infectoius Cystitis

A

UA
Urine culture
Sometimes cystoscopy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Treatment of Non-infectious Cystitis

A

Avoiding irritants
Voiding routine
Kegel’s

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Manifestations of Chlamydia in Males

A

Urethritis: symptomatic or asymptomatic
Epididymitis
Prostatitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Diagnosing Chlamydia in Males

A

NAAT testing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Treatment of Chlamydia

A

Azithromycin

Rocephin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Presentation of Gonorrhea in Males

A

Symptomatic urethritis

Epididymitis: age

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Diagnosing Gonorrhea in Males

A

NAAT testing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Treatment of Gonorrhea

A

Azithromycin

Rocephin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Presentation of Overactive Bladder Without Incontinence

A

Urgency
Frequency
Nocturia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Pathophysiology of Overactie Bladder Without Incontinence

A

Detruser muscle contracts irregularly at small volumes
Usually idiopathic
Can be secondary to DM, stroke, spinal disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Treatment of Overactive Bladder

A

Anti-muscarinics

33
Q

SE of Anti-muscarinics

A

No spit
No shit
No pee
No see

34
Q

MOA of Anti-muscarinics

A

Increase bladder capacity

Block basal release of acetyl choline during bladder filling

35
Q

Anti-muscarinic Agents for Overactive Bladder

A

Oxybutynin (ditropan)
Tolterodine (Detrol)
Solifenacin (Vesicare)

36
Q

New Agent for the Treatment of Overactive Bladder

A

Mirabegron (Myrbetriq)

Beta 3-adrenoceptor agonist

37
Q

SE of Mirabegron (Myrbetriq)

A

HTN
Incomplete bladder emptying
Dry mouth

38
Q

Medical Morbidity of Urinary Incontinence

A

Perineal candida infection
Cellulitis & pressure ulcers
UTIs & urosepsis
Falls & fractures from slipping on urine
Sleep interruption & deprivation
Psychologically: poor self esteem, social withdrawal, depression & sexual dysfunction

39
Q

Reasons for Sexual Dysfunction with Urinary Incontinence

A

Afraid of leaking urine during sex

40
Q

Pathophysiology of Incontinence

A

Non-intact micturition physiology

Lack of functional ability to toilet oneself

41
Q

Risk Factors for Incontinence

A 
Obesity
Functional impairment
Parity (# of pregnancies)
Family history
Smoking
Age
DM
Stroke
Depression
Estrogen depletion
Genitourinary surgery
Radiation
42
Q

Transient Causes of Incontinence

A 
D: delirium
I: infection
A: atrophic vaginitis
P: pharmacologic
P: psychological
E: excessive urine production
R: restricted mobility
S: stool impaction
43
Q

Pharmacologic Causes of Incontinence

A

Sedatives
Diuretics
Anti-cholinergics

44
Q

Excessive Urine Production Causes of Incontinence

A 
Diuretics
ADH problems
Psychogenic polydipsia
DM
Hypercalcemia
45
Q

Incontinence Questions for Screening

A

In the past 3 months have you leaked urine?
Which precipitants led to leakage?
Which precipitant caused leakage most often?
Do you ever wear pads, tissue or cloth in your underwear to catch urine?

46
Q

Important History for Incontinence

A

Questions about incontinence
Precipitants
Bowel & sexual function
Status of other medical conditions, parity, & meds
Any prior continence therapy, particularly surgical treatments

47
Q

Etiology of Urge Incontinence

A

Uninhibited bladder contractions
Detrusor over activity
May be due to bladder abnormalities or idiopathic

48
Q

Presentation of Urge Incontinence

A

Sudden urge to void: nocturia, frequency
Preceded or accompanied by leakage of urine
More common in older women
Also seen in men

49
Q

Define Stress Incontinence

A

Leakage of urine with increased intra-abdominal pressure in the absence of a bladder contraction

50
Q

Stress Incontinence Due to

A

Urethral hypermobility

Intrinsic sphincter deficiency

51
Q

Mixed Incontinence

A

Most common type in women

Vary in predominance and/or bother of urge or stress leakage

52
Q

Define Incomplete Emptying

A

Continuous leakage or dribbling of ruine

53
Q

Causes of Incomplete Emptying

A

Detruser underactivity

Bladder outlet obstruction

54
Q

Reasons for Detrusor Underactivity

A

Low estrogen
Aging
Peripheral neuropathy due to DM, chemo, B12 deficiency, meds, ETOH
Damage to the spinal detrusor efferents (MS)

55
Q

Possible Etiologies of Nocturia

A

CHF
Late evening beveragesSleep apnea
Sleep disturbances: chronic pain, depression
Detrusor overactivity

56
Q

Diagnostic Tool for Bladder Issues

A

Bladder diary

57
Q

Bladder Diary

A 
Record time & volume of continent & incontinent voiding
Activity
Caffeine intake
House of sleep
Episodes of nocturia
58
Q

Physical Exam in a Patient with Urinary Incontinence

A 
Heart
Lungs
Neurologic conditions
Check for cystocele/rectocele, atrophy
Have patient cough: look for leakage
Examination of the prostate
Cognitive & functional status
59
Q

Post-Void Residual

A

How much urine is left in the bladder after the patient empties their bladder

60
Q

Labs for Urinary Incontinence

A 
Renal function
Serum calcium & glucose
UA
PSA for men if indicated
Urine cytology if there is hematuria or pelvic pain
Increased post-void residual
61
Q

Treatment of Urinary Incontinence

A 
Weight loss
Adequate but not excessive fluid intake
Avoid caffeinated beverages & alcohol
Minimize evening fluid intake for nocturia
Smoking cessation
Behavioral therapy
Pessiaries
Pharmacotherapy
62
Q

Behavioral Therapy for Urinary Incontinence

A

Bladder training: frequent voluntary voiding, relaxation techniques for urge incontinence
Kegel exercises
Biofeedback

63
Q

Pharmacotherapy for Urge & Mixed Incontinence

A

Tolterodine (Detrol LA)
Solifenacin (Vesicare)
Oxybutynin (Ditropan): IR, ER, Patch

64
Q

SE of Anti-muscarinics

A 
Dry mouth
Blurred vision
Constipation
Drowsiness
Decreased cognitive function
65
Q

Contraindication of Anti-muscarinics

A

Narrow angle glaucoma

66
Q

MOA of Oxybutynin (Ditropan)

A

Direct antispasmodic effect on detrusor muscle

67
Q

MOA of Miragebron (Myratriq)

A

Causes bladder relaxation

68
Q

SE of Miragebron (Myratriq)

A 
HTN
Tachycardia
Urinary retention
Inflammation of the nasal passages
Dry mouth
Constipation
Abdominal pain
Memory problems
69
Q

Surgical Therapy for Incontinence

A

Used for stress incontinence

Abdominal or vaginal approaches

70
Q

Vaginal Surgical Therapy Includes

A

Midurethral sling
Bladder neck sling
Submucosal injection of urethral bulking agents

71
Q

Mesh Related Complications of Surgeries Performed Prior to New Guidelines

A 
Mesh exposure (erosion)
Dyspareunia
Infection
urinary problems
Bleeding
Organ perforation
Deaths associated with bowel perforation or hemorrhage
72
Q

When to Immediately Refer for Urinary Incontinence

A 
Incontinence with abdominal and/or pelvic pain
Hematuria in the absence of UTI
Suspected fistula
Complex neurological conditions
Abnormal findings
73
Q

When to Electively Refer for Urinary Incontinence

A

Persistent symptoms after adequate therapeutic trial
Uncertainty in diagnosis
Significantly elevated PVR that doesn’t resolve after treatment of precipitants
Prior pelvic surgery or pelvic irritation
Desiring surgical therapy for stress incontinence

74
Q

Presentation of Interstitial Cystitis

A

Persistent pain or “unpleasant” sensation with filling of the bladder, relieved with voiding
Gradual onset with worsening symptoms
Urinary frequency
Urgency Nocturia

75
Q

Diagnosis of Interstitial Cystitis

A 
Through PE
Tender suprapubic area
Dyspareunia
Irritable bowel 
Vulvodynia
UA & culture
76
Q

Define Interstitial Cystitis

A

Unpleasant sensation perceived to be related to the urinary bladder, associated with lower urinary tract symptoms of more than 6 weeks duration in the absence of infection or other identifiable causes

77
Q

1st Line Management of Interstitial Cystitis

A

Patient education noting reasonable expectations about pain relief & chronicity of condition
Psychosocial support
Self-care & behavior modification

78
Q

2nd Line Management of Interstitial Cystitis

A

PT: patients with pelvic muscle pain
Meds: amitriptyline, pentosan polysulfate sodium (PPS), hydroxyzine

79
Q

MOA of Pentosan Polysulfate Sodium (PPS)

A

Reconstitues deficient protective glycosaminoglycan layer over the urothelium

Urology (12 decks)

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