Disease of the kidneys & urinary tract Flashcards
What structures are present in the upper urinary tract?
Kidneys
Ureters
What are the 3 constrictions of the ureter?
Pelviureteric junction
Brim of the pelvis
Vesicoureteric junction
What structures are found in the lower urinary tract?
Bladder
Urethra
What sphincter contracts under sympathetic innervation during ejaculation? What does this prevent?
Internal urethral sphincter
Retrograde ejaculation
What is another name of the urethral opening?
External urethral meatus
When there is tightening of the foreskin on a penis, what condition can occur?
Phimosis
When the foreskin of a penis is retracted and gets stuck, what is this condition called?
Para-phimosis
What is the definition of proteinuria?
Urinary protein excretion >150mg/day
How many types of haemturia are there?
3
Macroscopic
Microscopic (microscopic or dipstick positive)
What is the definition of microscopic haemturia?
> 3 RBCs/ high power field
What is the deinfition of oligouria?
Urine output <0.5ml/kg/hr
What is the definition of anuria?
No urine production
What is the definition of polyuria?
> 3L/day
What is the definition of nocturia?
Waking up at night >1 to micturate
What is the definition of nocturnal polyuria?
Nocturnal urine output >1/3 of total urine output in 24hrs
What are the 6 different functions of the kidneys?
Body volume (ECF) Endocrine function Electrolyte balance Acid/Base balance Excretion of waste products Regulation of vascular tone
What is the mnemonic used to define AKI staging
R - risk I - injury F - failure L - loss E - endstage kidney disease
What are some of presenting symptoms of CKD?
Anaemia
Oedema
Hypetension
Tiredness
What type of cancer is common in the ureters & bladder?
Transitional cell carcinoma
What are the different types of obstruction?
Intra-luminal
Intra-mural
Extra-luminal
What are some of the presenting signs of ureteric disease?
Pain Pyrexia Haemturia Palpable mass Renal failure
What are some storage lower urinary tract symptoms?
Frequency
Nocturia
Urgency
Urge incontinence
What are some voiding lower urinary tract symptoms?
Poor flow
Intermittency
Terminal dribbling
What types of incontinence can occur?
Urge Stress Mixed Overflow Neurogenic
What is pneumaturia? What is it a sign of?
Bubbles in urine
Fistula present
What is the risk of bladder cancer in patient with frank haemturia?
25-30%
What is the risk of renal cancer in patient with frank haematuria?
0.5-1%
The micturition cycle is composed of what 2 phases?
Storage (or filling) phase
Voiding phase
Where is the micturition centre in the brain found?
Pons
What is the most common cause go bladder outflow obstruction?
Benign prostatic enlargment
What are the signs & symptoms of acute urinary retention?
Painful
Inability to void urine
Percussable bladder
What can cause acute urinary retention?
Benign prostatic obstruction UTI urethral stricture Alcohol excess post-operative event
What is the immediate treatment for acute urinary retention?
Catheterisation
What is the residual volume usually found in cases of acute urinary retention?
500-1000mls
What is the definition of chronic urinary retention?
Painless, palpable & permissible badder after voiding
What is the residual volumes associated with chronic urinary retention?
400 up to 2L
What are some of the causes of chronic urinary retention?
Detrusor muscle under activity (primary or secondary to BOO)
What are the 2 types of chronic urinary retention? Which is more urgent?
High pressure (emergency) Low pressure
What is the immediate treatment for chronic urinary retention?
Catheterisation
What are the 2 types of catheter?
Urethral
Suprapubic
What can occur following chronic urinary retention treatment?
Pathological diuresis (>200ml/hr)
What is required in order to diagnose UTI?
Microbiological culture from MSSU
Symptoms (at least 1)
What are some symptoms associated with UTI?
Dysuria
Urinary frequency & urgency
Fever
Flank pain
What are the 2 types of UTIs?
Complicated
Uncomplicated
What is classed as uncomplicated UTI?
Young sexually active female
What is classed as complicated UTI?
Older women
Men
Children
What types of organism cause UTIs?
E.coli Staph, saprophyticus Klebsiella Proteus Pseudomonas Staph aureus
What treatment would you use for UTI?
ABIs