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INTERNAL MED FINAL > GENITOURINARY SYSTEM > Flashcards

GENITOURINARY SYSTEM Flashcards

1
Q

What is the suffix for barbiturates?

A

-barbital

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2
Q

What is the primary indication of barbiturates?

A
  • sedative-hypnotic
  • anti-seizure
  • anesthetic
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3
Q

What is the suffix of benzodiazepines?

A

-epam or -olam

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4
Q

What is the primary indication of benzodiazepines?

A
  • sedative-hypnotic
  • anti-anxiety
  • anti-seizure
  • anesthetic
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5
Q

What is the suffix of local anesthetics?

A

-caine

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6
Q

What is the primary indication of local anesthetics?

A
  • local anesthetic
  • anti-arrhythmics
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7
Q

What is the suffix of low-molecular-weight heparins?

A

-parin

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8
Q

What is the primary indication of low-molecular-weight heparins?

A

anticoagulants

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9
Q

Kidneys filter waste product & remove excess fluid from ____________.

A

blood

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10
Q

Kidneys serve as both ___________ organ & target of endocrine action to control mineral & water balance.

A

endocrine

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11
Q

True or False: Urine volume increases w/ age.

A

T

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12
Q

Responses to vasoconstrictor stimuli are ____________ & vasodilatory responses are ____________.

A
  • enhanced
  • impaired
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13
Q

What is the most common bacterial infection acquired in community & in hospitals?

A

UTIs

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14
Q

Bladder inflammation (____________) & urethra inflammation (____________) are usually involved in UTI.

A
  • cystitis
  • urethritis
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15
Q

For patients w/ stroke or dementia, what are the 2 risk factors of UTIs?

A
  • impaired voiding
  • poor perineal hygiene
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16
Q

Fecal-associated gram-___________ organisms esp e.coli cause UTIs.

A

negative

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17
Q

Where can pain be felt in UTIs?

A
  • suprapubic
  • lower ab
  • groin
  • flank
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18
Q

Where can pain be felt in urinary tract problems?

A
  • shoulder
  • back
  • flank
  • pelvis
  • lower ab
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19
Q

W/ UTIs, the ____________ may become irritated resulting in ipsilateral shoulder or lumbar back pain (if kidney is involved).

A

diaphragm

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20
Q

For elderly adults, which clinical manifestations occur w/ UTIs?

A
  • malaise
  • anorexia
  • mental status changes
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21
Q

What is the term for bacteria ascending from bladder to infect kidneys?

A

pyelonephritis

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22
Q

Which type of pyelonephritis is ascending UTIs or from bloodborne pathogens associated w/ infection elsewhere?

A

acute

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23
Q

Which type of pyelonephritis is from vesicoureteral reflex, urinary obstruction, analgesic nephropathy, or bacterial infection superimposed on structural/functional abnormality?

A

chronic

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24
Q

What’s the most common cause of chronic pyelonephritis?

A

vesicoureteral reflex

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25
Q

Which type of pyelonephritis is associated w/ these symptoms?
- abrupt
- fever, chills, malaise, headache, & flank pain
- tenderness over costovertebral angle (murphy sign)
- bladder irritation including dysuria, urinary freq, & urgency

A

acute

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26
Q

Immunocompromised people w/ acute pyelonephritis are at risk for bacterial & fungal ___________ of kidneys.

A

seeding

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27
Q

True or False: Chronic pyelonephritis symptoms vary depending on causative process or may not be present at all.

A

T

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28
Q

Out of these renal neoplasms, which one is most common?
- renal cell carcinoma
- urothelial carcinoma
- renal sarcoma
- wilms tumor
- renal lymphoma

A

renal cell carcinoma

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29
Q

What is the male:female ratio of renal cell carcinoma?

A

2:1

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30
Q

True or False: Renal cell carcinoma cannot be treated with surgery so radiation & chemotherapy are preferred.

A

F

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31
Q

Out of these 5 subtypes of RCC, which one is most common?
- conventional or clear cell
- papillary
- chromophobe
- collecting duct
- unclassified

A

conventional or clear cell

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32
Q

Which race has the highest risk for RCCs?

A

African Americans

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33
Q

Which medications increase risk for RCCs?

A
  • diuretics
  • analgesic pain meds (aspirin, acetaminophen, & ibuprofen)
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34
Q

Occupational exposure to ___________ & cadmium can increase risk for RCCs.

A

asbestos

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35
Q

Where is the most common metastatic tumor of RCC?

A

sternum

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36
Q

What is another term for renal calculi?

A

nephrolithiasis

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37
Q

What is the term for urinary stone disease?

A

renal calculi

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38
Q

Where do the majority of the stones in renal calculi develop?

A

kidneys

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39
Q

What are the 4 basic types of renal calculi?

A
  • calcium stone
  • uric acid stone
  • stuvite stone
  • cysteine stone
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40
Q

True or False: There’s lower incidence of renal calculi in industrialized counties & areas w/ high temp & humidity.

A

F

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41
Q

What disease are these illnesses & disorders associated w/?
- idiopathic hypercalciuria
- renal tubular acidosis
- primary hyperparathyroidism
- hyperoxaluria

A

renal calculi

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42
Q

True or False: Acidic urine pH is associated w/ renal calculi.

A

T

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43
Q

Excess intake of supplemental ____________, sodium, sucrose, & animal protein increases risk for renal calculi.

A

calcium

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44
Q

What are the 5 steps of renal calculi pathogenesis?

A
  1. supersaturation
  2. nucleation
  3. crystal growth
  4. aggregation
  5. stone formation
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45
Q

What size are crystals in stone formation?

A

> 20 um

46
Q

In 90% of renal calculi cases, where does acute & severe colicky flank pain radiate to w/ hematuria?

A

groin & perineal areas

47
Q

Chronic kidney disease is decreased kidney function shown by estimated ___________ filtration rate of < 60 mL/min per 1.73 m2 or markers of kidney damage or both for duration of at least ___ months.

A
  • glomerular
  • 3
48
Q

Which disease accounts for 30-50% of developing CKD?

A

diabetes

49
Q

Which disease accounts for >25% of developing CKD?

A

HTN

50
Q

CKD pathogenesis involves ____________ & release of angiotensin II.

A

hyperglycemia

51
Q

Release of angiotensin II results in ______________ of arterioles & arteries which happens in attempt to keep pressure adequate for filtration.

A

vasoconstriction

52
Q

Release of angiotensin II attracts inflammatory cells which release ___________ & growth factors.

A

cytokines

53
Q

Release of angiotensin attracts inflammatory cells which changes structure of glomerulus –> mesangial expansion, enlargement of glomerulus –> interstitial fibrosis & glomerular sclerosis –> reduce ___________ ___________ rate –> unable to adequately regulate fluid, electrolytes & pH balance or remove metabolic wastes from blood.

A

glomerular filtration

54
Q

Glomerular filtration rate assesses how much __________ passes through filters each min.

A

blood

55
Q

Production of __________ & cystin C are used to estimate GFR.

A

creatinine

56
Q

Which CKD stage is normal? What is the eGFR?

A

G1, >= 90

57
Q

Which CKD stage is mildly decreased? What is the eGFR?

A

G2, 60-89

58
Q

Which CKD stage is mildly to moderately decreased? What is the eGFR?

A

G3a, 45-59

59
Q

Which CKD stage is moderately to severely decreased? What is the eGFR?

A

G3b, 30-44

60
Q

Which CKD stage is severely decreased? What is the eGFR?

A

G4, 15-29

61
Q

Which CKD stage is kidney failure end-stage renal disease? What is the eGFR?

A

G5, < 15

62
Q

W/ CKD, what is present in abnormal lab?

A
  • elevated BUN (blood urea nitrogen) & creatinine
  • protein in urine
63
Q

Which CKD stage is where damaged capillaries allow small amounts of albumin to be excreted in urine?

A

G2

64
Q

Which CKD stage is more noticeable bc albumin levels increase in urine & decrease in blood –> edema?

A

G3

65
Q

Which CKD stage is where there’s proteinuria, kidneys no longer able to excrete toxins, & HTN occurs bc of renin production?

A

G4

66
Q

Which CKD stage is where there’s uremia (cluster of symptoms)?

A

G5

67
Q

What are the 2 types of dialysis?

A
  • hemodialysis
  • peritoneal dialysis
68
Q

What are the 2 types of peritoneal dialysis?

A
  • continuous ambulatory peritoneal dialysis
  • continuous cycling peritoneal dialysis
69
Q

The process of micturition & continence involves a complex interplay of which 4 factors?

A
  • nerves
  • detrusor smooth muscle of bladder
  • internal urethral sphincter
  • external urethral sphincter, part of pelvic floor muscles
70
Q

Nerves for normal bladder function are associated w/ ____________ of brain, brainstem, parasympathetic, & preganglionic sympathetic.

A

cortex

71
Q

Which muscle associated w/ normal bladder function is involuntary & which is voluntary?

A
  • involuntary: internal urethral sphincter
  • voluntary: external urethral sphincter
72
Q

Only ___-___% of incontinent adults seek medical care.

A

20-50

73
Q

Urinary incontinence is a significant contributory factor related to ___________ in older adults, pressure sores, skin breakdown, UTIs, institutionalization, depression, & isolation.

A

falls

74
Q

How many categories of urinary incontinence are there? Which 2 are most common?

A
  • 8
  • stress & urge
75
Q

What incontinence are these factors of pathogenesis associated w/?
- weakness or loss of tone in PFM
- internal urethral sphincter failure
- hyper-mobility of ureterovesical junction
- damage to pudendal nerve

A

stress

76
Q

Urgency urinary incontinence is often related to ___________ instability.

A

detrusor

77
Q

Which hormone deficiency is related to incontinence risk?

A

estrogen

78
Q

Which category of prostatitis is most seen in PT clinic?

A

III: chronic pelvic pain syndrome

79
Q

What is the name for category I of prostatitis?

A

acute bacterial

80
Q

What is acute bacterial prostatitis a result of?

A
  • GU infection (bacteria or virus)
  • STIs
81
Q

Which type of prostatitis has pain in these areas?
- suprapubic
- rectal
- sacral
- low back
- perineum

A

acute bacterial

82
Q

Which type of prostatitis is recurrent infection of prostate?

A

chronic bacterial (category II)

83
Q

Which 2 types of prostatitis are associated w/ sexual dysfunction?

A

II & IIIA/IIIB

84
Q

Which 2 types of prostatitis have low grade symptoms?

A

acute & chronic bacterial

85
Q

Which prostatitis has flare-ups of pelvic pain?

A

chronic bacterial

86
Q

Which type of prostatitis is pain & urinary dysfunction w/ inflammation but w/o infection?

A

chronic prostatitis/chronic pelvic pain syndrome (IIIA)

87
Q

Which type of prostatitis is pain & urinary dysfunction w/o inflammation or infection?

A

chronic prostatitis/chronic pelvic pain syndrome (IIIB)

88
Q

Which 2 types of prostatitis have irritative & obstructive voiding?

A

I & IIIA/IIIB

89
Q

Which type of prostatitis has GU, lower ab/pelvic, & low back pain?

A

IIIA & IIIB

90
Q

Which type of prostatitis is asymptomatic inflammatory?

A

IV

91
Q

True or False: WBCs & inflammatory markers found in semen or prostate tissue in category IIIB prostatitis.

A

F

92
Q

What is the term for non-malignant enlargement of prostate gland to where prostate volume is > 30 mL?

A

benign prostatic hyperplasia

93
Q

BPH goes along w/ lower urinary tract symptoms & bladder ____________ syndrome.

A

outlet

94
Q

____% of men over 50 experience symptoms of BPH.

A

70

95
Q

What are the 5 risk factors of BPH?

A
  • over 40
  • fam history
  • diabetes
  • heart disease w/ use of B blockers
  • obesity
96
Q

True or False: As men age, the ratio of new prostate cells to old ones shifts in favor of more cell death.

A

F

97
Q

The increased growth of new prostate cells (___________) occurs primarily inward encroaching on urethra.

A

hyperplasia

98
Q

What are some symptoms of BPH?

A
  • storage dysfunction
  • voiding dysfunction
  • painful urination
  • blood in urine
  • unexplained lower back, pelvis, hip, or upper thigh pain
  • sexual dysfunction
99
Q

What are 2 methods in which BPH are assessed?

A
  • digital rectal exam (DRE)
  • prostate specific antigen (PSA) blood test
100
Q

PSA is secreted by prostatic ___________ cells & the norm is < 4 ng/mL.

A

epithelial

101
Q

What is gynecomastia?

A

enlargement of the male breast

102
Q

True or False: Prostate cancer is the most common cancer in men & most common cause of male death from cancer.

A

F

103
Q

1 in ___ American men will get prostate cancer.

A

6

104
Q

______________ (glandular cells) accounts for 98% of primary prostatic tumors.

A

adenocarcinoma

105
Q

True or False: Prostate cancer starts inwards & spreads outwards.

A

F

106
Q

What are some risk factors of prostate cancer?

A
  • over 50
  • african american
  • in the US
  • fam history
  • red meat, high fat diet
107
Q

Most prostatic adenocarcinomas are characterized by small to moderate disorganized glands that infiltrate ___________ of prostate.

A

stroma

108
Q

Where does prostate cancer metastasize to?

A

lymphatic & bone

109
Q

True or False: Bony metastasis of prostate cancer happens more often to axial skeleton than appendicular.

A

T

110
Q

A dull, vague ache in rectal, ____________, or lumbar spine may be felt in prostate cancer.

A

sacral

111
Q

What is the term for painful spasm of anal sphincter w/ straining?

A

tenesmus

INTERNAL MED FINAL (6 decks)

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