Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Pradeepa's notes > Genito-Urinary Tract System > Flashcards

Genito-Urinary Tract System Flashcards

1
Q

urinary incontinence

A

involuntary leakage of urine - sudden, difficult to delay

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

stress incontinence

A

leakage on effort/excretion or on sneezing/cough

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

mixed incontinence

A

urgency + stress however one type predominant

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

risk factors for urinary incontinence

A

-old age
-pregnancy
-vaginal delivery
-obesity
-smoking
-constipation
-family history
-medicines (diuretics)
-caffeine inc urine production and can exacerbate incontinence

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

tx of urinary incontinence (urgency)

A

-non-drug modify fluid intake, weight loss, less caffeine
-drug tx
->1) bladder training 6WK at least
->2) antimuscarinic (oxybutynin or tolterodine)
->3) mirabegron

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

tx of urinary incontinence (stress)

A

-pelvic floor muscle training 3MT
-surgery or duloxetine

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

tx of urinary incontinence (mixed)

A

-bladder training >6wk + pelvic floor muscle training >3MT
-tx depends on dominating type

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

antimuscarinics examples

A

-fesoterodine, solifenacin, trospium, oxybutynin, tolterodine

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

nocturnal enuresis

A

involuntary urination during sleep = common children

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

non-drug tx of nocturnal enuresis

A

-children <5yr = no intervention needed
-advice on fluid intake, diet, toileting behaviour, use of reward systems
-no response to advice (>1-2 wet beds per week) - enuresis alarm
-> alarms in <7yr given depending on maturity, motivation, understanding
->alarms have less relapse than drug tx when discontinued
->review alarms after 4wk
->continue a min of 2wk of uninterrupted dry nights
-if alarm tx = x successful add/replace with desmopressin

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

nocturnal enuresis drug tx

A

-5yr+ = desmopressin
->if alarm = undesirable
->when needing rapid results (holiday)
->assess tx after 4wk continue for 3MT if pt = responding
->repeated courses should be withdrawn gradually at regular intervals
-specialist - desmopressin + antimuscarinic (oxybutynin/tolterodine)
-x responding to other tx; imipramine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

desmopressin + s/e

A

-more potent + longer duration of action than vasopressin
-no vasoconstrictor effect
-s/e; hyponatraemia + nausea

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

urinary retention

A

inability to voluntarily urinate

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

urinary retention causes

A

-urethral blockage
-medications; antimuscarinic drugs, sympathomimetics, TCA

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

acute urinary retention

A

-unable to urinate even though they have a full bladder
-medical emergency abrupt development over period of hours

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

chronic urinary retention

A

gradual over months inability to completely empty bladder

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

benign prostatic hyperplasia urinary retention

A

-most common in men with enlarged prostate
-symp; urinary retention, urgency, frequency, nocturia

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

acute urinary retention tx

A

-immediate catherisation due to pain
-provide alpha blocker for 2x days before removing catheter

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

chronic urinary retention tx

A

-catheter used long-term
->may cause recurrent UTI, urethra trauma, pain, stone formation

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

benign prostatic hyperplasia urinary retention tx

A

-alpha blockers relaxes smooth muscle
-pt = enlarged prostate, raised prostate antigens, high risk of progression so 5a-reductase inhibitors (finasteride/dulasteride)

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

alpha blockers used in urinary retention

A

-defuzosin, doxazosin, tamsulosin, terazosin
-advice pt if history of mictuntion syncope + postural hypotension

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

alpha blockers s/e

A

-dizziness
-postural hypotension
-1st dose can cause collapse due to hypotensive effect so taken before bed and lie down if dizzy, fatigue, sweating develops

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

5a reductase inhibitor s/e + cautions

A

-breast disorder
-sexual dsyfunction
-male breast cancer reported; lumps, pain/nipple discharge
-excreted in semen = condom if pregn partner
-women = child-bearing age avoid crushed broken tabs
-finasteride; reports of depression + rare cases of suicidal thoughts stop immediately + report

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

non-hormonal contraception - barrier method

A

-condoms, diaphragms, cervical caps
->petroleum jelly, baby oil + oil based prep can damage condoms, contraceptive diaphragms; cap = latex rubber

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
non-hormonal contraception - spermicidal contraceptives
used alongside barrier methods
26
non-hormonal contraception - IUD
-intra-uterine device = copper coil -CI in pelvic inflammatory disease or unexplained vaginal bleeding
27
progesterone only contraceptives
-levonorgestrel, norethisterone, desogestrel -no pill free week = OD - no additional precaution needed if started in 1st 5DY of cycle - needs 2DY precaution if taken after that -taken at same time each day for max efficacy ->desogestrel needs to be taken within 12HR otherwise missed dose ->other POP need to ben taken with 3HR otherwise - missed dose
28
parental progesterone only
-injections = 99.8% effective in correct usage -depot medroxyprogestrone acetate - every 12WK ->loss of bone density can occur ->delayed return to fertility of upto 1yr after tx cessation -implants = 99.95% effective in correct usage ->etongesterel (nexplanon) ->lasts up to 3yr ->MHRA ; neurovascular injury/migration of implant remove ASAP
29
Combined hormonal contraceptives
-tablets, patches, vaginal rings -not given 50yr+ -benefits; ->less risk of ovarian, endometrial + colorectal cancer ->aligns bleeding pattern ->less dysmenorrhea + menorrhagia ->manages symptoms of polystic ovaries, endometriosis, premenstrual syndrome ->improves acne ->less menopause symptoms ->maintains bone density in peri-menopausal (<50)
30
when to avoid CHC
--35yr = smokes -hypertension -multiple risk factors for cardiovascular; smoking, hypertension, BMI > or = 30, dyslipidemia, diabetes, -migraine with aura -new onset migraine w/o aura use pf CHC
31
Monophasic preparations
fixed amount of oestrogen + progesterone in each active tablet
32
multiphasic preparations
varying amount of each hormone
33
oestrogen
ethinylestradiol, mestrariol, estradiol
34
withdrawal bleeding
-women on 21DY regimen have a monthly withdrawal bleed during the 7DY hormone free interval -withdrawal bleeds x represent physiological -some packs = 28 per month supply = 21 active pills + 7 dummy to inc coherence)
35
switching to CHC from CHC
no additional contraception needed
36
switching to CHC from POP, LNG-IUD
7 day extra precaution needed
37
switching to CHC from copper IUD + other non-hormonal methods
-if CHC started up to day 5 of menstrual cycle no additional contraception needed -if started after day 5 * 7DY extra precaution needed
38
switching to CHC from others week 1 (day 3-7 of hormone free interval) + no UPSI since start of HFI
-CU-IUD = no extra precaution -POP = 2DY precaution -others = 7DY precaution
39
switching to CHC from others week 1 (day 3-7 of hormone free interval) + UPSI since start of HFI
-carry on with CHC intil -7 consecutive days -then act as week 2/3
40
switching to CHC from others week 2/3
no extra pre-caution required
41
reasons to stop CHC
-urgent medical review ->calf pain, swelling +/ redness (DVT) ->chest pain +/ breathlessness +/ coughing up blood (PE) ->loss of motor/sensory function (stroke) ->severe stomach pain (hepatotoxicity) -> v.high BP (haemorrhagic stroke) other reasons -signs of breast cancer/lumps nipple pain -50+ -new onset of migraine -persistent unscheduled vag bleed -high BP -high BMI >OR= 35 -DVT/PE -blood clotting abnormal -angina, heart attack, stroke or peripheral vascular disease -AF -cardiomyopathy
42
CHC + surgery
-discontinued for 4WK prior ->major elective surgery + surgeries to legs/pelvis ->surgery involving prolonged immobilisation to lower limb -use alternative methods of contraception -CHC recommends 2wk after full remobilisations -if discontinued x possible trauma/pt still on CHC -> consider thromboprophylaxis
43
s/e of hormonal contraceptives
headaches unscheduled bleeding mood change weight gain libido (sex drive) change
44
missed doses POP
-if pt vomits/omits/diarrhoea with 3HR of taking POP take another pill asap -consider missed dose if >12hr for desogestrel or >3hr for rest -take as soon as remembering -take next pill = usual time (2x a day if needed) -needs protection till 48hr of pills taken correctly (7DY for desogestrel) -need emergency contraception if UPSI happened between missed dose + 2DY after restarting meds
45
missed doses CHC
-if pt vomits/omits/diarrhoea with 3HR of taking CHC take another pill asap -late start after HFI (>9dy since last active pill) -emergency contraception if UPSI -take immediately + use condoms till 7 consecutive days
46
1 missed pill (48-72hr since last active pill)
-take asap no further action needed - providing consistent use in previous 7DY pills
47
2+ missed pills (72hr+ since last active pill)
-WK1 cycle consider emergency contraception if UPSI happened within HFI + WK1 take asap + use condom for 7DY -WK2/3 no emergency contraception needed take asap - 7DY condom -2+ pills missed in 7DY before HFI carry on taking pill throughout HFI
48
emergency contraception
-copper IUD -ulipristal 30mg -levonorgestel 1.5mg taken ASAP
49
copper IUD of emergency contraception
-1st line = most effective form of emergency contraception -can be inserted up to 120HR (5DY) after 1st UPSI -can be inserted up to 5DY after earliest estimated date of ovulation
50
hormonal methods of emergency contraception
-levonorgestrel - 72hr (3DY) -ulipristal -120hr (5DY) -2nd doses if vomited or diarrhoea in 3hr -ulipristal more effective than levonorgestrel for emergency contraception -unlike the CU-IUD, BMI lower effectiveness (esp levon) ->BMI >26/ weight >70kg = ulipristal or double dose of levon -ulpirstal + levon can be used = oral emergency contraception - more than once in same cycle (levo higher risk of s/e)
51
when to reinitiate levonorgestrel
-start regular hormonal contraception immediately -use condoms until effective
52
when to reinitiate ulipristal
-wait 5DY after taking ulipristal before starting regular hormones again ->use condoms during 5DY + till tx effective -if during wk1 - regular CHC ->CHC can be initiated immediately after ->ondom 7DY
53
levonorgestrel 1.5mg s/e + CI
-breast feeding no delay -caution in pt: malabsorption -can cause breast tenderness, DVT, fatigue + haemorrhage -avoid in severe liver impairment -CYP inducer interaction
54
Ulipristal 30mg s/e + CI
- 1 week delay -severe asthmatic controlled - glucocorticoids -cycle irregularities, D+V, altered mood, dizziness -CYP inducer interaction
55
CU-IUD s/e + CI
-MHRA = risk of uterine preforation ->severe pelvic pain after insertion, sudden change = period, pain during intercourse, unable to feel threads = check up -replace every 5-10yr -remove 1st trimester = pregn -same for levonorgestrel IUD = less pain/bleeding S/E -replace 3-10yr
56
erectile dysfunction
persistent inability to attain and maintain erection physical or psychological causes + s/e of drugs
57
erectile dysfunction 1st line tx
phosphodiesterase type 5 inhibitors -inc blood flow to penis + still requires sexual stimulation
58
erectile dysfunction 2nd line tx
intracavenosal, interauretival, topical alprotadil under medical supervision
59
erectile dysfunction max number of doses before classsed as non-responder
6 doses at max doses with sexual stimulation
60
phosphodiesterase type 5 inhibitors for erectile dysfunction s/e
flushing, dizzy, nasal congestion, migraine
61
phosphodiesterase type 5 inhibitors for erectile dysfunction CI
-nitrates/hypotension, unstable angina/stroke during intercourse. x have sexual activity
62
phosphodiesterase type 5 inhibitors for erectile dysfunction interactions
nitrates alpha blockers
63
phosphodiesterase type 5 inhibitors for erectile dysfunction short acting
avanafil, sildenafil + vardenafil = occasional PRN
64
phosphodiesterase type 5 inhibitors for erectile dysfunction long acting example
tadalafil - PRN/regular lower daily dose to allow for spontaneous activity
65
priapsm
-Introduction. Priapism is a disorder in which the penis maintains a prolonged, rigid erection in the absence of appropriate stimulation. -last longer than 4HR = medical attention
65
alpratadil
condom if partner = child bearing age, pregn, lactating
66
antimuscarinics adverse effects in elderly
constipation, dry mouth, flushing, dizziness, drowsiness, tachycardia
67
antimuscarinics CI
- single-closure glaucoma, GI obstruction -affects skilled performed tasks

Pradeepa's notes (12 decks)

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