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Pathology > Genitourinary > Flashcards

Genitourinary Flashcards

1
Q

what is loin to groin pain likely to be

A

pyelonephritis

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2
Q

how would you investigate LUTS?

A 
flowmeter
dipstick
international porstate symptom score
PSA and creatinine
frequency volume chart
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3
Q

causes of polyuria

A

behavioural

poorly controlled diabetes

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4
Q

nocturia causes

A

habit

congestive cardiac failure (ANP)

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5
Q

what is conservative treatment for BPE?

A

alpha blocker like tamulosin, they decrease smooth muscle tone, may lead to retrograde ejaculation

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6
Q

what can BPE complicate into?

A 
UTI
acute urinary retention
urinary incontinence
haematuria
bladder caliculi
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7
Q

what is acute urinary retention?

A

inability to voluntarily pass urine, caused by spinal cord compression, BPE, prostate cancer. Patient will have normal U&E

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8
Q

how is obstruction treated

A

fluid resus
pain management
antibiotics
restore flow using stents

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9
Q

causes of obstruction

A

PKD
ureter strictures
phimosis
BPE

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10
Q

voiding symptoms

A

dribbling
hesitancy
poor flow
intermittent stream

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11
Q

storage symptoms

A

urgency

nocturia

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12
Q

what does sidenafil inhibit?

A

phosphodiesterase

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13
Q

what makes up the lower urinary tract?

A

bladder
bladder neck (only in men)
urethra
urethral sphincter

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14
Q

what does Onuf’s nucleus do?

A

it stimulates storage, contracts the urethral sphincter, causes the guarding reflex

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15
Q

what do pontine centres control

A

detrusor nucleus

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16
Q

what is the sympathetic supply of the bladder?

A

hypogastric T10-S2

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17
Q

what is the parasympathetic supply of the bladder?

A

pelvic nerve S3-5

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18
Q

list some functions of angiotensin II

A

constricts efferent arteriole so increases GF pressure (so ACEi and ARBs can decrease renal function)
stimulates aldosterone secretion

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19
Q

4 functions of the kidney

A

filter and secrete
EPO production
activate 1,25 dihydroxyvitamin D
control blood pressure

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20
Q

what is resorbed in the proximal tubule?

A 
all by active transport
glucose
amino acids
HCO3
Na
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21
Q

what happens in the loop of Henle?

A

countercurrent multiplication system

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22
Q

where does aldosterone have its effect

A

collecting duct, increases plasma Na and decreases K and H, if very high then get hypokalaemic acidosis

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23
Q

what transporter is in the distal tubule?

A

Na/Cl

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24
Q

what transporter is in the ascending limb

A

Na/K

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25
Q

what can loop and thiazide diuretics cause?

A

alkalosis, hypokalaemia

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26
Q

what drugs can cause hyperkalaemia

A 
spironolactone
amiloride
ACE-is
ARBs
calcineurin inhibitors
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27
Q

what does hyperparathyroidism cause and increase in?

A

phosphate

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28
Q

what is the difference between calcitonin and calcitriol

A

calcitonin causes an increase in plasma calcium levels, it is secreted from thyroid
calcitriol is active vitamin D so it inhibits PTH, increases phosphate and calcium absorption so also increases plasma calcium levels

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29
Q

how does CKD cause decreased bone density

A

less hydroxylation of calcitriol so secondary hyperparathyroidism so hyperphosphataemia

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30
Q

what usually causes pyelonephritis

A

uropathogenic E coli

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31
Q

how is stress incontinence treated?

A

artificial urinary sphincter

sling

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32
Q

what is the osmolarity of normal saline?

A

similar to extracellular fluid which is 150mmol/L Na and Cl so 300

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33
Q

where are kidneys transplanted into?

A

iliac fossa

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34
Q

what might immunosuppression complicate into

A

infection

neoplastic risk

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35
Q

what metabolic problem could CKD patients have?

A

metabolic acidosis with hypocalcaemia and hyperkalaemia

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36
Q

why is there hyperlipidaemia in nephrotic syndrome?

A

the liver is activated

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37
Q

what does not happen in nephrotic syndrome?

A

kidney failure

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38
Q

treatment of nephrotic syndrome

A

ACEi
diuretics
underlying cause: DM, steroids

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39
Q

how is PKD treated?

A

monitor U&Es

treat hypertension and end stage renal disease, infections

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40
Q

most common nephropathy causes which syndrome?

A

IgA causes nephritic-because inflammation

41
Q

what metabolic problems are CKD patients at risk of?

A

acidosis
hyperkalaemia
hypocalcaemia

42
Q

causes of nephrotic syndrome

A

amyloidosis
minimal change nephropathy
DM
hepatitis

43
Q

how is amyloidosis detected

A

cOngO red stain, amylOidOsis, nephrOtic syndrome

44
Q

treatment for urate stones

A

allopurinol

45
Q

medical treatment for urotheliasias attack

A

diclofenac
ABC
antiemetic

46
Q

where should stones be treated

A

ureters because they may lead to sepsis

47
Q

options for urotheliasias

A

alpha blocker-tamulosin
percutaneous lithotomy
extracorporeal shock wave lithotripsy ESWL
nephrectomy

48
Q

how are STIs diagnosed

A

nuclei acid amplification tests from vaginal swab in women or first pass urine in men

49
Q

first sign of syphilis

A

chancre, a painless ulcer

50
Q

ADPKD symptoms?

A

hypertension
pain
haematuria

51
Q

what are renal cell carcinomas?

A

adenocarcinomas

52
Q

what inherited disease can cause renal cell carcinoma

A

von Hippel Lindau

53
Q

how are renal cysts classified

A

Bozniak classification

54
Q

what might varicocele be a sign of

A

renal cell carcinoma

55
Q

what can tyrosine kinase inhibitors be used for

A

CML

renal cel carcinoma

56
Q

symptoms of hypovolaemia

A

thirst and dizziness

57
Q

who is at risk of hypovolaemia

A

elderly
ileostomy
short bowel syndrome
on diuretics

58
Q

how much of extracellular fluid is intravascular

A

20%, rest is interstial-of a third

59
Q

where do renal stones form

A

on the papilla

60
Q

how much urine should one pass in a day

A

less than 2.7 litres

61
Q

how do you decrease detrusor activity-as in urgency incontinence

A

anticholingergic agents like oxybuynin or botulinum toxin A

62
Q

what does UMN lesion lead to in the bladder

A

reflex bladder, reflexes lead to involuntary urination

63
Q

what does LMN lesion lead to in the bladder?

A

areflexic bladder, will overflow

64
Q

how does MS affect the bladder

A

overactive and incomplete emptying

65
Q

what cancers will cause haematuria

A

kidney and bladder

66
Q

heart failure treatment in black men

A

hydralazine and isosorbate dinitirate

67
Q

causes of renal kidney injury

A

from acute tubular necrosis (haemorrhage, burns, pancreatitis), glomerulonephritis,

68
Q

some nephrotoxic drugs

A

amoidarone
lithium
gentamycin
NSAIDs

69
Q

what effect will Henoch-Schoenlein purpura have on the kidneys?

A

nephritic syndrome

70
Q

when is pANCA postitive

A

in Primary sclerosing cholangitis, PBC has +ve AMA

71
Q

when is cANCA positive?

A

in Goodpasture’s

72
Q

what can pyelonephritis complicate into?

A

emphysematous pyelonephritis
abscess
sepsis

73
Q

what is pyelonephritis

A

inflammation of renal pelvis and parenchyma

74
Q

most common testicular cancer

A

seminomatous

75
Q

what is testicular torsion?

A

twisting of spermatic cord causing testis to become ischaemic

76
Q

differentials of testicular lump

A

hydrocele
spermatocele
varicocele

77
Q

risk factor for testicular torsion

A

bell clapper deformity

78
Q

causes of acute tubular necrosis

A 
haemorrhage
burns
pancreatitis
diuretics
nephrotoxins
RENAL CAUSE
79
Q

most common cause of renal AKI

A

acute tubular necrosiss

80
Q

what causes infectious mononucleosis

A

epstein barre

81
Q

pre renal causes of AKI?

A 
skin/liver/heart failure
infection
haemorrhage
dehydration
thrombosis
renal artery stenosis
82
Q

why are nephrotic syndrome patients prone to infection?

A

IgGs lost in urine

steroids used for treatment

83
Q

how is post strep glomerulonephritis treated?

A

blood pressure control
diuretics
salt restriction

84
Q

renal complication of infective endocarditis

A

acute nephritic syndrome

85
Q

features of nephritic syndrome

A

haematuria
hypertension
oliguria

86
Q

pyelonephritis antibiotic?

A

co amoxiclav

87
Q

where does renal carcinoma usually occur

A

proximal convoluted tubule

88
Q

what are the signs of pyonephrosis and what should you do?

A

fever, infective markers, raised creatinine (signs of sepsis)
needs immediate decompression

89
Q

what kind of renal stones are the most dense

A

calcium phosphate-can be seen on AXR

90
Q

which renal stones are hard to see on X ray

A

cysteine

91
Q

what drugs predispose someone to stones

A

chemo

endinavir

92
Q

how are stones treated

A

ESWL or Percutaeneous nephrolithotomy

93
Q

what is suggested by symptoms of renal stones with creatinine not raised?

A

only partial obstruction

94
Q

what does testosterone treatment increase?

A

hyperplasia of prostate and it raises PSA but doesn’t increase risk of prostate ca

95
Q

what would you advise a patient with irritable bladder?

A

keep drinking plenty (conc urine irritates)

decrease caffeine

96
Q

what constitutes a wet overactive bladder

A

associated incontinence

97
Q

what UTI antibiotics can be used in pregnancy

A

amoxicillin, nitrofuantoin, (trimethoprim after 12 weeks)

98
Q

when can’t you use nitrofuantoin?

A

renal impairment

99
Q

what is mirabegron

A

beta 3 agonist to treat overactive bladder

Pathology (21 decks)

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