final: urinary Flashcards
1
Q
what is a major excretory system of the body
A
urinary system
2
Q
what does the urinary system eliminate
A
waste products and excessive products
3
Q
nitrogenous waste is formed by
A
protein metabolism
4
Q
urine is formed by what?
A
ammonia into urea
5
Q
what 4 things does urine contain
A
- excess H2O
- excess ions
- metabolic wastes
- toxic substances
6
Q
what does the kidney do
A
filters blood removing wastes and forming urine
7
Q
where on the spine is the kidney located
A
T12 to L3
8
Q
where is the arterial supply from in the kidney
A
renal arteries off aorta
9
Q
venous supply in the kidneys is from
A
renal veins
10
Q
where do the renail veins drain from in the kidney
A
inferior vena cava
11
Q
what kind of organ are the kidneys
A
retroperitoneal paired organs
12
Q
which kidney is lower
A
right
13
Q
why is the right kidney lower
A
due to location of liver
14
Q
when in the supine position where does the kidney span from
A
superior T12 to inferior L3
15
Q
what is the goal of external anatomy of the kidney
A
protection
16
Q
what is the renal capsule structure
A
transparent tough fibrous layer that surrounds the kidneys
17
Q
what is the purpose of the renal capsule
A
prevent infections from surrounding area to spread to kidney
18
Q
what is the structure of adipose in the kidney
A
perirenal fat capsule that covers renal capsule
19
Q
what is the purpose of adipose in the kidneys
A
protects from trauma and damage
holds kidneys in place
20
Q
what is the structure of the renal fascia
A
dense fibrous CT
21
Q
what does the renal fascia do?
A
anchors kidneys and adrenal glands to abdominal wall
22
Q
what is the renal fascia surrounded by
A
adipose
23
Q
what are the lower kidneys more susceptible to
A
blunt trauma
24
Q
what is a sign of kidney traume
A
hematuria
25
what are the six functions of the urinary system?
1. . excretion
2. regulation of BV and BP
3. regulation of blood solute concentration
4. regulation of extracellular fluid pH
5. regulation of RBC synthesis
6. regulation of vitamin D synthesis
26
what happens in excretion
filters waste and body's plasma volume
27
what happens in the regulation of BV and BP
control ECF of body, and is dependent on hydration
28
what does the regulation of BV and BP produce
large volume of dilute urine or small volume of concentrated urine
29
what does the regulation of BV and BP control
BV, thereby control BP via urine production
30
what is produced when BP falls
renin
31
what happens in the regulation of blood solute concentration
regulates ion concentration
32
what happens in regulation of extracellular fluid pH
secretes variable amount of H to regulate pH
33
what happens in regulation of RBC synthesis
erthyropoietin causes RBC synthesis in red bone marrow
34
what happens in regulation of vitamin D synthesis
control blood Ca levels by regulating vitamin D synthesis
35
the renal corupuscle is entirely in
renal cortex
36
the renal tubule begins where
begins in cortex , then medulla, back to cortex
37
what does the PCT do in the nephron
returns filtered substances to blood
38
what does the loop of henle do in the nephron
conserves H2O and solutes
39
what does the DCT do in the nephron
last ditch effort to rid blood of additional waste products
40
what does the collecting duct do in the nephron
hormonal regulation of urine concentration
41
the collecting ducts collects from multiple nephrons and sends urine to papillary duct into .....
renal papilla-> minor calyx-> major calyx-> renal pelvis-> ureter-> urinary bladder-> urethra
42
what is a twisted capillary network
glomerulus
43
blood enters glomerular capillaries and filtered fluid=
filtrate
44
the glomerular capsule has 2 layers called?
parietal and visceral
45
what is contained in the visceral layer
specialized cells called podocytes
46
what do podocytes do
wrap around glomerular capillaries
47
what is the parietal layer made of
simple squamous ET
48
what are the three characteristics that enhance glomerular filtration
1. porous capillaries
2. porous visceral layer
3. high pressure
49
what happens in porous capillaries
glomerulus- highly permeable
50
what does it mean to be highly permeable
large proteins and blood cells are too big
51
what is contained in porous visceral layer
filtration slits
52
where are filtration slits
gaps between podocyte cell processes
53
where is there high pressure in the renal corpuscle
in glomerular capillaries due to smaller diameter efferent vs afferent arteriole
54
what is in the filtration membrane
capillary endothelium, basement membrane, podocytes of bowmans
55
what is the first major step in urine production
filtration membrane filterws blood and filtrate enters lumen
56
what is a regulatory structure?
juxtaglomerular apparatus
57
what does the juxtaglomerular apparatus consist of
afferent arteriole cells and specialized cells in DCT
58
what are juxtaglomerular cells
specialized smooth muscle cells around entry
59
what does it mean by entry
entry of renal corpuscle from afferent arteriole
60
what are macula densa
specialized cells of DCT
61
where is macula densa found
between afferent and efferent arterioles
62
what is the macula densa next to
renal corpuscle
63
what does the macula densa detect
rate of fluid flow in DCT
64
what does the macula densa give
feedback to filtration system
65
decreased flow in DCT causes?
dilation of afferent arteriole-> increased GFR and tubular flow
66
the juxtaglomerular apparatus secrete
renin
67
what does renin play a role in
regulating filtrate formation and BP
68
in the renal tubule the rest of the nephron action is?
fluid modification to finalize urine formation
69
what does the renal tubule consist of
PCT, loop of henle, DCT, collecting duct
70
what ET is the PCT
simple cuboidal
71
PCT is simple cuboidal with what
microvilli extending into lumen
72
what does the microvilli extending into the lumen do in the PCT
increase surface area
73
the loop of henle has two limbs which are
ascending and descending
74
describe the descending limb
thin near inferior bend and narrows
75
what ET is in the descending limb
simple cuboidal-> simple squamous
76
what kind of ET is in the ascending limb
simple squamous-> simple cuboidal as thickens
77
where does the ascending limb travel
closer to renal corpuscle becoming DCT as near macula densa
78
what is shorter than the DCT
PCT
79
what ET is the DCT
simple cuboidal ET
80
the cells in DCT are smaller with
less microvilli
81
several DCT attach where
to 1 collecting duct
82
what ET is collecting duct
simpe cuboidal
83
the collecting duct has a larger diameter and forms?
bulk of medullary rays
84
where does the collecting duct span from
renal cortex and extend through medulla toward renal pyramid tips
85
what are two nephron types
cortical and juxtamedullary
86
where is the cortical distibuted
renal corpuscles distributed throughout the cortex
87
which nephron type is shorter loop and more superficial
cortical
88
what is an example of cortical nephrons
peritubular capillaries
89
where are juxtamedullary nephrons
next to medulla
90
where are juxtamedullay nephrons found
renal coruposcules deep in cortex
91
if cortical nephrons are short and superficial what are juxtamedullay
long loop and extend deep into medulla
92
what do longer loops do
conserve H2O
93
example of juxtamedullay nephrons
vasa recta
94
efferent arteriols have what kind of oxygen content
high
95
describe the blood vessel wall for efferent arterioles
not thin and cant distend like a vein
96
do efferent arterioles have smaller or large diameter than afferent
smaller
97
peritubular capillaries are wrapped around the?
tubues
98
where do the peritubular capillaries branch from
efferent arterioles
99
peritubular capillaries are seen with
cortical nephrons
100
peritubular capillaries surround what?
PCT, DCT, and loop of henle
101
what are straight tubes
vasa recta
102
vasa recta are specialized parts of?
peritubular that extend deep into the medulla
103
vasa recta surround what
loop of henle and collecting ducts
104
what returns blood to circulation via renal veins
peritubular capillaries and vasa recta
105
when there is increase in constriction, it decreases renal blood flow which does what in the afferent arteriole
it decreases downstream pressure-> decrease GFR and urine production protect glomeruli from fluctuation in systemic BP
106
what happens in afferent arterioles when there is a significant drop in BP
the opposite effect with dilation of afferent arteriole-> preservation of blood flow to kidney
107
what cells release renin
juxtamedullary
108
when does renin get released , in response to
decrease stretch to preserve GFR
109
what reinforces high glomerular pressure and reduces hydrostatic pressure in peritubular capillaries
efferent arterioles
110
what are 3 steps in urine formation
1. filtration
2. reabsorption
3. secretion
111
what happens in filtration
it removes unwanted substances from blood
112
what happens in the glomerulus
initial formation of ultrafiltrate
113
what happens in reabsorption
it moves H2O and nutrients back into the bloodstream
114
what structure is involved in reabsorption
renal tubule
115
what happens in secretion
waste ions secreted from blood (last ditch)
116
in secretion what happens
the complete formation of urine
117
in secretion blood goes into
renal tubule
118
filtration occurs in
renal corpuscle
119
reabsorption occurs in
PCT and loop minimal in DCT, collecting duct
120
secretion occurs in
DCT, minimal in PCT
121
what is filtration based on
size/ charge of molecules
122
what does not go through filtratation
blood cells and most proteins
123
filtration only removes substances that are?
small enough to FIT through filtration membrane
124
what is the renal fraction
CO% flowing through kidneys/ minute
125
how is the renal blood flow rate calculated
CO x renal fraction
126
how do you calculate renal plasma flow rate
renal blood flow rate x % plasma portion of whole blood
127
what does the filtration fraction=
% plasma filtered from blood
128
how do you calculate glomerular filtration rate
renal plasma flow rate x filtration fraction
129
what percent is filtration
99%
130
it is reabsorbed where
in the blood
131
what % is GFR in urine
1
132
GFR asses severity of
renal disease
133
what are the two mechanisms for regulation of GFR
intrinsic and extrinsic
134
intrinsic mechanisms are controlled by
autoregulation
135
autoregulation is due to what
renal corpuscle structures
136
myogenic mechanisms help with what
affernet arteriole diameter
137
how does the myogenic mechanism work
it causes the smooth muscle to stretch and change in BP
138
tubuloglomerular feedback does what
matches filtrate flow past the macula densa of JGA to GFR
139
the increased flow from the tubuloglomerular feedback causes what
JG cells of afferent arteriole to constrict
140
GFR decreases due to
less glomerular capillary pressure
141
extrinsic mechanisms are controlled by
ANS and hormones
142
in severe conditions (hemorrhage or dehydration) mean arterial pressure does what
drops
143
SNS significantly decreases what
renal blood flow and GFR
144
why does the SNS decrease renal blood flow and GFR
to keep BP homeostatically stable
145
what does intense stimulation with shock or vigorous exercise cause
a decrease rate of filtrate formation to a few ml/min
146
if xs shock what happened to the afferent arterioles
vasoconstriction
147
Xs shock can also cause
renal damage
148
if there is vasoconstriction of afferent arterioles and renal damage you have to treat
quick
149
if you have low BP what happens
JG cells secrete enzyme renin to keep GFR stable
150
70% of tubular reabsorption occurs in
PCT
151
what do transport proteins do
move H2O and filtered molecules back into blood via peritubular capillaries
152
tubular reabsorption has retention of what
solutes that are useful
153
what is tubular reabsorption necessary to do
prevent xs dehydratoin
154
nearly 99% of solutes and H2O are quickly returned to what
blood in renal tubules
155
in renal tubules there is quick what removal
toxic
156
99% of filtrate volume out of renal tubule and into IF which goes to
peritubular capillaries and into renal veins
157
what are examples that have been reabsorbed
AA, Glc, Frc, Na, K, Ca`
158
in tubular secretion what are examples that are last ditched
toxic by-products of metabolism and drugs or molecules not normally made in body
ammonia is toxic by-product of protein metabolism
K
ACh
Epi
bile pigments
urea
uric acid
drugs
toxins
morphone
159
what does the antiport do
kidneys secrete H which regulate pH
160
renin goes to angiotensin to
aldosterone hormone
161
renin+ angiotensinogen-> angiotensin I + ACE->
vasoconstriction and aldosterone secretion from adrenal cortex
162
what does the hypothalamus make
aldosterone
163
where is aldosterone stored
post pit
164
when osmolality of blood and IF increases what happens
stimulation and ADH are released
165
when ADH is release water is
conserved
166
ANF is secreted by
right atrial cells
167
when is ANF secreted
when there is more stretch than normal
168
ANF secretion occurs when increased stretch of right atrium when what is high
BV
169
ANF decreases what
BV
170
ANF also inhibits what
ADH secretion and increases urine volume
171
when there is inhibition of ADH secretion it lowers what
BV and BP
172
ANF dilates arteries to decrease
peripheral resistance and lower BP
173
what are water channels called
aquaporins
174
what are aquaporins
membrane proteins that form holes in a membrane
175
what is the function of aquaporins
they move water across cell membranes in response to osmotic gradient created by active solute transport
176
what do aquaporins increase
permeability of DCT and CD to H2O
177
when your over hydrated what happens to ADH production
it decreases
178
when ADH production decreases what happens to osmolality of urine
falls low to 100
179
when you over hydrated what happens to the number of aquaporins in the collecting duct
it decreases
180
when ur over hydrated there is decreased what from collecting ducts
water reabsorption
181
large quantity of dilute urine excreted=
diuresis
182
when your dehydrated what is released and by what
ADH by posterior pit
183
when your dehydrated solute concentration of urine does what
rises
184
when your dehydrated there is an increase or decrease in auquaporins in collecting duct
increase
185
99% of water in filtrate is reabsored in what when ur dehydrated
blood
186
when water in filtrate is reabsorbed into blood it allows us to do what without H2O
survive
187
small quanity of very concentrated urine is excreted when you are over or dehydrated
dehyrdated
188
what are chemicals that increase rate or urinary production/output
diuretics
189
alcohol causes diuresis via what
inhibition of ADH secretion
190
other diuretics increase flow via inhibition of
Na then H2O reabsorption
191
examples of diuretics (5)
Anti-HTN meds
CHF edema
cirrhosis of liver
diet pills
caffeine
192
what do loop diuretics do
they are potent and inhibit medullary gradient and act on the ascending loop
193
what is an osmotic diuretic
thiazides
194
thiazides are less potent and act on
DCT
195
what do thiasizdes do
carries water out with substances
196
when using diuretics there can be complications which include
dehydration and electroylte imbalance
197
filtrate loses what in urine
H2O, nutrients, ions, AA, glc
198
what does urine gain in filtrate
substances in xs, nitrogenous waste products, toxins, drugs
199
what is a clear, yellow to amber, aromatic
urine
200
is urine acidic or basic
acidic`
201
why is urine slightly acidic
it is 95% H2O and 5% solutes
202
urine is urochrome pigment , seen with what
Hgb destruction
203
are urine increases concentration what happens
it darkens
204
you can have abnomal urine color from what
different foods, bile pigments or blood in urine, medications or vitamins
205
cloudy urine may indicate
infections
206
when does odor increase
as u sit
207
why does odor increase when u sit
ammonia due to bacteria metabolism
208
uncontrolled DM=
fruity acetone smell
209
in urine waster is highest in concentration then urea then ?
ions (Na, K)
210
when you have very high concentration of solutes in urine or when abnormal substances are present=
pathology
211
what is the pH of urine
6
212
urine pH can change from what two aspects
body metabolism and diet
213
what pH does urine vary around
4.5-8
214
what would an acidic diet look like
high protein intake and whole wheat products
215
what would an alkaline diet look like
vegetarian intake, bacterial infection in urinary tract
216
what is specific gravity
ratio of mass of substance to mass of volume of distilled water
217
what does high specific gravity indicate
dehydration, pyelonephritis
218
what does low specific gravity indicate?
dilute urine, renal damage
219
how do you measure specific gravity
measure with hydrometer
220
muscular tube that urine passed from kidney to urinary bladder
ureter
221
the ureter enters the bladder via what and into where
posterolaterial surface into trigone area
222
the ureter move urine via
peristalsis
223
what is a hollow, muscle, urine storage site
urinary bladder
224
where is urinary bladder in males vs females
males: anterior to rectum
females: anterior to vagina
225
what is seen in urinary bladder as it is in the stomach
rugae
226
where is the trigone area
bottom
227
does the trigone area expand as it fills
no acts as a funnel
228
what ET is in the urinary bladder
transitional epithelial tissue
229
what is in the first layer
binucleate
230
what becomes flat as it distends
dome
231
what muscle is in the urinary bladder and what layers does it contain
detrusor muscle: longitudinal layer, circular layer, longitudinal
232
what does the destrusor muscle do
forces urine out
233
what is cystitis
inflammation due to bacterial infection
234
what is the common bacteria in a urinary infection
e. coli
235
what transport urine to outside of body
urethra
236
2 types of ET in urethra
stratified or pseudostratidied columnar epithelium
237
what is the area called where the urinary bladder and urethra meet
internal urethral sphincter
238
what does the internal urethral sphincter prevent
urine leakage from urinary bladder
239
what does the internal urethral sphincter do in males vs females
males: it contracts to keep semen from entering urinary bladder during sex
female: it plays a role in preventing urine leakage
240
what does the external urethral sphincter do
voluntary control of urine passage
241
whats the difference between male and female urethra
male is passage for sperm
female is passage for urine
242
what are the 3 parts of the urethra for males
prostatic, membranous, spongy
243
what is the 9th leading type of cancer
bladder cancer
244
when you have bladder cancer, you need early ID to detect prior to
penetration of muscle wall
245
if you detect prior to penetration of the muscle wall you have what kind of survival of
5 years
246
what is bladder cancer due to mostly 50% and second mostly 30%
cigarette smoking
environmental carcinogens
247
what is bladder cancer a combo of
heavy drinking and smoking
248
blood in urine is called
hematuria
249
ID for bladder cancer
cytoscopy
250
how do you do a cystoscopy
put the catheter into urinary bladder to look for abnormality
251
treatment for bladder cancer
transurethral resection of bladder tumor
immunotherapy with intravesiclar delivery of BCG
252
what deos severe treatment for bladder cancer call for
neobladder
253
what is the act of urination/ void to empty bladder
micturition
254
when urine reaches >200 ml what happens
stretch receptors start to give the urge to void and eventually u arent able to control it
255
u can also have the urge to micturate from what
irritation of bladder or urethra by bacteria infection
256
what are 3 factors that control distension
1. wall of urinary bladder contains large fodlds like stomach
2. transitional et distends
3. smooth muscle wall of urinary bladder stretch urine enters
257
2 types or urinary issues
incontinence vs retention
258
what exercise do we do to strenthgen micurition
kegels
259
with micturition how much remains
10
260
women completely do what
void to gravity
261
what do males rely on to void
bulbospongiosus muscle
262
what is incontinence
u cant control voluntarily
263
when do u experience incontinence
infant
emotional
stress
pregnant
cough
laugh
NS problem
Age
264
what is stress incontinence
sudden increase in intra-abdominal pressure which forces urine out
265
is stress incontinence common in pregnancy
yes
266
what is urge incontinence
strong urge to go, sudden onset. leak urine
267
what is urge incontience due to
bladder cancer
inflammation
infection
stones
268
bladder retraining is needed when you have
urge incontinence
269
what is overflow incontinece
dribbles when overfills
270
when do you experience retention
often after surgery
benigh prostatic hyperplasia
271
how do u treat retention
catheter
272
what are kidney stones called
renal calculi
273
what is renal calculi
hard deposits that form inside the kidneys
274
what is renal calucli composed of
minerals and salts
275
when does renal calculi form
when urine is concentrated
276
what does concentrated urine cause
minerals crystalize and stick together
277
where can renal calculi occur
kidney
ureter
urinary bladdder
278
renal calculi is a common cause of what
urinary tract obstruction
279
do renal calculi recur
yes
280
renal calculi is reduced if
adequate H2O and physically active
281
what are risk factors of renal calculi
men
race
geographic location
decreased fluid intake
diet
familt history / personal history
obesity
digestive diseases/ surgery
medical conditions
vitamin/ medications
282
order of how race affects kidney stones
white, hispanics, black, asian
283
what kind of geographic lcocation affects kidney stones
warm, dry climate
284
what kind of diet influences kidney stones
high in protein, sugar, NaCl-> xs calcium to filter
285
what kind of digestive diseases affect kidney stones
gastric bypass, IBD, chronic diarrhea
286
what kind of medical conditions affect kidney stones
DM
HTN
metabolic syndrome
hyperparathyroidism
multiple UTIs
287
what type of vitamins and medications affect kidney stones
vit c
xs laxatives
calcium based antacids
meds for migraine and depression
288
what are the four types of kidney stones
calcium oxalate or phosphate
struvite
uric acid
cystine
289
types of kidney stones are based on ?
minerals that comprise the stone or location and size
290
where is oxalate kidney stones made
made in liver
291
oxalate can also be absorbed in
diet
292
where is oxalate found
in certain fruits, veggies, nuts chocolate
293
where do you get calcium phosphate kidney stones from
metabolic conditions
meds to treat migraines and seizures
294
when do struvite kidney stones form
they form in response to UTI
295
do struvite kidney stones grow slow or fast
fast and large
296
how do uric acid kidney stones form from (6)
chronic diarrhea
malabsorption
high protein
DM
metabolic syndrome
genetic factors
297
when do cystine kidney stones form
with cystinuria when the kidneys excrete too much cystine AA
298
which kidney stones are rare
cysteine
299
what are complex stones, very large
staghorm calculi
300
where does staghorn calculi fill
minor and major calyces and renal pelvis
301
staghorn calculi can cause high what
morbidity
302
untreated staghorn calculi can lead to what 3 things
recurrent UTI's
urosepsis
death
303
how do you treat staghorn calculi
aggressively
304
what is the gold standard treatment for staghorn calculi
percutaneous nephrolothotomy
305
what is percutaeneous nephrolithotomy
removal of staghorn calculi through skin vs surgery
306
how do you do percutaenous nephrolithotomy
by passing the needle using U/S, Xray, CT to guide placement and insert the tube sheath along the needle to break up the stone to remove
307
what do u place after treatment for staghorn calculi
nephrostomy tube
308
what does the nephrostomy tube do
drain urine into bag and allow to heal
309
when do you remove the nephrostomy tube
4-6 weeks after heal
310
if percutaneous nephrolithotomy does not work what do you do
nephrectomy
311
when do symptoms of staghorn calculi occur
with stone movement in kidney and entrance into ureter
312
is the stone lodges what happens
there is blocked flow of urine and kidney swells and ureter spasms
313
where is there severe, sharp pain when u have staghorn calculi
in flank/back, below rubs and it radiates to groin
314
where can pain radiate in staghorn calculi
lower abdomen and groin
315
pain comes in
waves
316
what do you feel with staghorn when u urinate
pain and burning sensation
317
what can you note with staghorn
hematuria
urge to urinate with small amount yield
N/V
fever and chills
318
what color is the urine with staghorn
cloudy with pink, red, brown
319
five ways for diagnosis and imaging
history
check blood work
check urinalysis
imaging
retrieve and analyze stones
320
when looking at a patients history what would u observe
include diet habits
age of 1st stone
stone analysis
complications
321
when looking at blood work what would u look for
elevated calcium or uric acid
322
what do u check in urine anylsis
calcium oxalate
323
what is imaging used for
determine location, severity of the obstruction
324
how do u retrieve stones
through passed stones sponteneously or via aggressive intervention
325
what are treatment goals for kidney stones
manage acute pain
promote stone passage
reduce size of current stones
prevent new stone formation
326
ways to remove stones
percutaneous nephrolithotomy
uretroscopy
ultrasonic
laser lithotripsy
extracorporeal shock wave therapy
pt gland surgery
327
how to prevent recurrence
increase fluid intake
avoid dark-colored soft drinks
avoid dietary oxalate
eat less animal protein
limit sodium intake
328
what is urinary urgency, frequency and nocturia and incontinence
OAB
329
do u have UTI with OAB
no
330
symptoms of OAB
involuntary contraction of detrusor muscle
331
is OAB more common in males or females
females
332
what is OAB linked to
excessive caffeine or alc
slow to get to bathroom
333
risk factors for women with OAB
vaginal birth
episiotomy
pelvic organ prolapse surgery
decreased estrogen
334
risk factors for men with OAB
enlarged prostate with urinary obstruction
surgery for prostate cancer
335
can medications affect OAB
yes (diuretics, antidepressants, analgesic, sedatives)
336
diagnosis for OAB
detailed H&P
urinalysis
questionarries
neuro exam
rectal and pelvic exam
check postvoid residual urine
337
1st line of treatment for OAB
behavioral therapy
338
what did behavioral therapy include
pelvic floor exercises
bladder training
timing void
mgmt of fluid intake
339
2nd line of treatment for OAB
pharmacological therapy
340
what does pharmacological therapy include
topical vaginal estrogen
drugs that increase erethral sphincter contraction
341
what happpens if u do not treat OAB
impairs quality of life
health
skin breakdown
sleep issues
falls
depression
nursing home admission
342
inflammation of the bladder due to bladder infection
cystitis
343
most common site of UTI is the
bladder
344
symptoms of cystitis
dysuria
frequency
urgency
suprapubic and low back pain
345
serious symptoms of cystitis is
hematuria
cloudy urine
flank pain
346
elederly symptoms of cytitis
asymptomatic bacteriuria= confusion vague abdominal discomfort
347
causes of cystitis
having sex
wipe back to front
348
diagnosis for cystitis
urine dipstick testing
349
if urine dipstick shows + for leukocyte or nitrate reductase it means
uncomplicated
350
if u have symptomatic diagnosis what do u do
urine culture
check antibiotic sensitivity
351
what does uncomplicated treatment for cystitis look like
treat with MO specific antibiotic for 3-7 days
352
what does complicated treatment of cystitis look like
7-14 days of treatment
follow up urine culture in 1 week after initiation then monthly
353
what is acute pyelonephritis
infection of 1 or both upper urinary tracts
354
is acute pyelonephritis more common in women or men
women
355
symptoms of acute pyelonephritis
acute onset: fever, chills, flank/groin pain
frequency, dysuria, costovertebral tenderness prior to systemic S&S
356
elderly symptoms
nonspecific= low grade fever and malaise (feeling of discomfort)
357
causes of acute pyelonephritis (5)
renal calculi
pregnant
female sexual trauma
instruments for medical procedures
neurogenic bladder
358
diagnosis for acute pyelonephritis
urinalysis
urine culture
clinical S&S
359
uncomplicated treatment for acute pyelonephritis
treat with MO specific antibiotic for 2-3 weeks
follow up urine cultures at 1 AND 4 weeks post treatment if symptoms recur
360
complicated treatment for acute pyelonephritis
blood cultures and urinary tract imaging
