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6431 > genitourinary > Flashcards

genitourinary Flashcards

1
Q

loss of urine associated with activities that increase intraabdominal pressure

A

stress incontinence

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2
Q

Involuntary loss of urine usually preceded by a strong, unexpected urge to void

A

Urge incontinence

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3
Q

Urge and stress incontinence together

A

mixed incontinence

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4
Q

an involuntary loss of urine associated with incomplete emptying

A

overflow incontinence

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5
Q

function of bladder volume

A

Overactive bladder

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6
Q

effects urine flow in men

A

prostate, or BPH

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7
Q

hypermobility of the bladder neck bladder is competent at rest, increase in abdominal pressure leads to increased closure pressure

A

anatomic stress urinary incontinence-

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8
Q

Open bladder neck at rest, mild increase in intra abdominal pressure can result in leakage

A

Intrinsic sphincter deficiency

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9
Q

instability of the detrusor muscle during bladder filling due to idiopathic or neurogenic causes. Causes the bladder neck to open and incontinence to occur

A

detrusor overactivity

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10
Q

incontinence related to spinal cord injuries below t11 or l1, may be caused by MS, SM or spina bifida

A

neurogenic bladder

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11
Q

Resnick’s DIAPPERS mnemonic

A 
Delirium or confused state
Infection- urinary
Atrophic urethritis, vaginitis
Pharmaceuticals
Psychological, especially severe depression
Excess urinary output (CHF, hyperglycemia)
Restricted mobility
Stool impaction
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12
Q

systems involved in physical examination for incontinence

A

Abdominal, genitourinary, pelvic, and rectal components

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13
Q

Management of stress incontinence

Behavioral therapies include…

A

Behavioral therapies: timed or double voiding, smoking cessation, weight loss, pelvic muscle exercises pessary, bowel management

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14
Q

Management of stress incontinence

Medical therapies include…

A

Alpha-adrenergic agonists: methoxamine, phenylephrine, oxymetazoline, tetrahydrozoline, xylometazoline
Tricyclic antidepressants: Remeron (mirtazipine),
estrogen

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15
Q

what do alpha-adrenergic agonists do

A

bind a alpha receptors on vascular smooth muscle and induce smooth contraction and vasoconstriction. Mimics sympathetic adrenergic nerve activation

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16
Q

how do tetracyclic antidepressants work

A

act by inhibiting reuptake of neurotransmitters serotonin and or noradrenaline in the brain thus elevating mood. Used less due to side effects

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17
Q

managing stress incontinence

Surgical therapies include:

A

Bladder neck suspensions, slings, artificial sphincters

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18
Q

Urge incontinence

behavioral therapie…

A

bladder training, schedule voiding, minimize bladder irritants, suppression of urge

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19
Q

Urge incontinence

Medical management:

A

anticholinergic- antimuscarinics, vaginal estrogen

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20
Q

how do anticholinergics work

A

blocking acetylcholine prevents impulses from the parasympathetic nervous system from reaching smooth muscle and causing contractions, cramps or spasms

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21
Q

anticholinergic medications

A

dicyclomine, chlordiazepoxide, atropine, scopolamine, glycopyrrolate

22
Q

how do antimuscarinic medications work

A

inhibiti the functions of parasympathetic nervous system : atropine scopolamine

23
Q

urge incontinence management

surgical therapies

A

neurosacral modulation, bladder augmentation, botox injections

24
Q

Health promotion to reduce incontinence

A

Weight management, tobacco cessation, exercise. food and fluid adjustments

25
Q

second most common malignant neoplasm in men

A

Prostate Cancer

26
Q

Most common type of prostate cancer

A

Adenocarcinoma located in the posterior peripheral zone of the prostate

27
Q

important predictor of prognosis

A

Histologic grading

28
Q

most common sites of prostate cancer metastasis

A

lymph node and bone

29
Q

presenting sx of prostate Cancer

A

urinary hesitancy, urgency, nocturia, frequency and hematuria, asymptomatic in early stages of disease. Sx increase in intensity during a 1-2 month period as opposed to slow increase in BPH

30
Q

abnormal digital rectal exam, but negative PSA

A

refer to urology for evaluation

31
Q

most sensitive and specific screening method for prostate cancer

A

DRE combined with PSA

32
Q

what is a PSA

A

enzyme secreted by the prostate gland

33
Q

medication that can increase PSA

A

finasteride, dutasteride

34
Q

PSA value in early prostate cancer

A

4-10ng/ml

35
Q

PSA value that is suggestive of prostate cancer

A

10ng/ml or more

36
Q

scans to detect metastasis of prostate cancer

A

radionuclide bone scan- bone metastasis

CT scan of abdomen and pelvis- lymphnodes, if postive ct of chest may be indicated to rule out lung involvment

37
Q

Prostate cancer labs

A

PSA, CBC w/differential

38
Q

Prostate cancer other diagnostics

A

Needle biopsy, pelvic ct scan, pelvic MRI, bone scan

39
Q

Differential dx prostate cancer

A

Bone pain, hematospermia, macroscopic hematuria, renal failure, sx of advanced prostate cancer

40
Q

sx of possible spinal cord compression

A

acute neurologic symptoms such as weakness, numbness, urinary retention, urinary incontinence or fecal incontinence.

41
Q

American Joint Committee on Cancer (AJCC) TNM

TNM stands for

A

Extent of primary tumor (T category)
Whether the cancer has spread to nearby lymph nodes (N category)
Absence or presence of distant metastases (M category)

42
Q

Categories with most treatment options

A

T1 and T2

43
Q

T1 and T2 treatment options

A

active surveillance, radiation therapy, and Surgery

44
Q

TX for

Prostate cancer T3 level, without metastatic spread

A

may be offered radiation therpay , hormonal therapy, or combination, as well as surgery

45
Q

treatment for histological grade 2 very high-risk

A

radical prostatectomy, radiation therapy with or without hormonal therapy or androgen deprivation therapy

46
Q

Hormone treatments for prostate cancer

A

oral estrogens, orchiectomy, luteinizing hormone-releasing hormone (LHRH), agonists, antiandrogens, and pregestational agents.

act by initially stimulating pituitary gonadotropin production and later inhibiting it.

47
Q

PSA level after a radical prostatectomy

A

should fall to 0.2ng/ml

48
Q

prostate radiation therapy PSA levels

A

PSA levels should fall and continue to decrease for 12 months after completion of therapy

49
Q

complications of prostate cancer

A

metastatic disease

50
Q

risks of prostate surgery

A

hemorrhage, injury to the obturator nerve, ureter, or rectum. Incontinence and impotence are also potential complications

6431 (5 decks)

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