GENITOURINARY SYSTEM Flashcards
What is the suffix for barbiturates?
-barbital
What is the primary indication of barbiturates?
- sedative-hypnotic
- anti-seizure
- anesthetic
What is the suffix of benzodiazepines?
-epam or -olam
What is the primary indication of benzodiazepines?
- sedative-hypnotic
- anti-anxiety
- anti-seizure
- anesthetic
What is the suffix of local anesthetics?
-caine
What is the primary indication of local anesthetics?
- local anesthetic
- anti-arrhythmics
What is the suffix of low-molecular-weight heparins?
-parin
What is the primary indication of low-molecular-weight heparins?
anticoagulants
Kidneys filter waste product & remove excess fluid from ____________.
blood
Kidneys serve as both ___________ organ & target of endocrine action to control mineral & water balance.
endocrine
True or False: Urine volume increases w/ age.
T
Responses to vasoconstrictor stimuli are ____________ & vasodilatory responses are ____________.
- enhanced
- impaired
What is the most common bacterial infection acquired in community & in hospitals?
UTIs
Bladder inflammation (____________) & urethra inflammation (____________) are usually involved in UTI.
- cystitis
- urethritis
For patients w/ stroke or dementia, what are the 2 risk factors of UTIs?
- impaired voiding
- poor perineal hygiene
Fecal-associated gram-___________ organisms esp e.coli cause UTIs.
negative
Where can pain be felt in UTIs?
- suprapubic
- lower ab
- groin
- flank
Where can pain be felt in urinary tract problems?
- shoulder
- back
- flank
- pelvis
- lower ab
W/ UTIs, the ____________ may become irritated resulting in ipsilateral shoulder or lumbar back pain (if kidney is involved).
diaphragm
For elderly adults, which clinical manifestations occur w/ UTIs?
- malaise
- anorexia
- mental status changes
What is the term for bacteria ascending from bladder to infect kidneys?
pyelonephritis
Which type of pyelonephritis is ascending UTIs or from bloodborne pathogens associated w/ infection elsewhere?
acute
Which type of pyelonephritis is from vesicoureteral reflex, urinary obstruction, analgesic nephropathy, or bacterial infection superimposed on structural/functional abnormality?
chronic
What’s the most common cause of chronic pyelonephritis?
vesicoureteral reflex
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
acute
Immunocompromised people w/ acute pyelonephritis are at risk for bacterial & fungal ___________ of kidneys.
seeding
True or False: Chronic pyelonephritis symptoms vary depending on causative process or may not be present at all.
T
Out of these renal neoplasms, which one is most common?
- renal cell carcinoma
- urothelial carcinoma
- renal sarcoma
- wilms tumor
- renal lymphoma
renal cell carcinoma
What is the male:female ratio of renal cell carcinoma?
2:1
True or False: Renal cell carcinoma cannot be treated with surgery so radiation & chemotherapy are preferred.
F
Out of these 5 subtypes of RCC, which one is most common?
- conventional or clear cell
- papillary
- chromophobe
- collecting duct
- unclassified
conventional or clear cell
Which race has the highest risk for RCCs?
African Americans
Which medications increase risk for RCCs?
- diuretics
- analgesic pain meds (aspirin, acetaminophen, & ibuprofen)
Occupational exposure to ___________ & cadmium can increase risk for RCCs.
asbestos
Where is the most common metastatic tumor of RCC?
sternum
What is another term for renal calculi?
nephrolithiasis
What is the term for urinary stone disease?
renal calculi
Where do the majority of the stones in renal calculi develop?
kidneys
What are the 4 basic types of renal calculi?
- calcium stone
- uric acid stone
- stuvite stone
- cysteine stone
True or False: There’s lower incidence of renal calculi in industrialized counties & areas w/ high temp & humidity.
F
What disease are these illnesses & disorders associated w/?
- idiopathic hypercalciuria
- renal tubular acidosis
- primary hyperparathyroidism
- hyperoxaluria
renal calculi
True or False: Acidic urine pH is associated w/ renal calculi.
T
Excess intake of supplemental ____________, sodium, sucrose, & animal protein increases risk for renal calculi.
calcium
What are the 5 steps of renal calculi pathogenesis?
- supersaturation
- nucleation
- crystal growth
- aggregation
- stone formation
What size are crystals in stone formation?
> 20 um
In 90% of renal calculi cases, where does acute & severe colicky flank pain radiate to w/ hematuria?
groin & perineal areas
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.
- glomerular
- 3
Which disease accounts for 30-50% of developing CKD?
diabetes
Which disease accounts for >25% of developing CKD?
HTN
CKD pathogenesis involves ____________ & release of angiotensin II.
hyperglycemia
Release of angiotensin II results in ______________ of arterioles & arteries which happens in attempt to keep pressure adequate for filtration.
vasoconstriction
Release of angiotensin II attracts inflammatory cells which release ___________ & growth factors.
cytokines
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.
glomerular filtration
Glomerular filtration rate assesses how much __________ passes through filters each min.
blood
Production of __________ & cystin C are used to estimate GFR.
creatinine
Which CKD stage is normal? What is the eGFR?
G1, >= 90
Which CKD stage is mildly decreased? What is the eGFR?
G2, 60-89
Which CKD stage is mildly to moderately decreased? What is the eGFR?
G3a, 45-59
Which CKD stage is moderately to severely decreased? What is the eGFR?
G3b, 30-44
Which CKD stage is severely decreased? What is the eGFR?
G4, 15-29
Which CKD stage is kidney failure end-stage renal disease? What is the eGFR?
G5, < 15
W/ CKD, what is present in abnormal lab?
- elevated BUN (blood urea nitrogen) & creatinine
- protein in urine
Which CKD stage is where damaged capillaries allow small amounts of albumin to be excreted in urine?
G2
Which CKD stage is more noticeable bc albumin levels increase in urine & decrease in blood –> edema?
G3
Which CKD stage is where there’s proteinuria, kidneys no longer able to excrete toxins, & HTN occurs bc of renin production?
G4
Which CKD stage is where there’s uremia (cluster of symptoms)?
G5
What are the 2 types of dialysis?
- hemodialysis
- peritoneal dialysis
What are the 2 types of peritoneal dialysis?
- continuous ambulatory peritoneal dialysis
- continuous cycling peritoneal dialysis
The process of micturition & continence involves a complex interplay of which 4 factors?
- nerves
- detrusor smooth muscle of bladder
- internal urethral sphincter
- external urethral sphincter, part of pelvic floor muscles
Nerves for normal bladder function are associated w/ ____________ of brain, brainstem, parasympathetic, & preganglionic sympathetic.
cortex
Which muscle associated w/ normal bladder function is involuntary & which is voluntary?
- involuntary: internal urethral sphincter
- voluntary: external urethral sphincter
Only ___-___% of incontinent adults seek medical care.
20-50
Urinary incontinence is a significant contributory factor related to ___________ in older adults, pressure sores, skin breakdown, UTIs, institutionalization, depression, & isolation.
falls
How many categories of urinary incontinence are there? Which 2 are most common?
- 8
- stress & urge
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
stress
Urgency urinary incontinence is often related to ___________ instability.
detrusor
Which hormone deficiency is related to incontinence risk?
estrogen
Which category of prostatitis is most seen in PT clinic?
III: chronic pelvic pain syndrome
What is the name for category I of prostatitis?
acute bacterial
What is acute bacterial prostatitis a result of?
- GU infection (bacteria or virus)
- STIs
Which type of prostatitis has pain in these areas?
- suprapubic
- rectal
- sacral
- low back
- perineum
acute bacterial
Which type of prostatitis is recurrent infection of prostate?
chronic bacterial (category II)
Which 2 types of prostatitis are associated w/ sexual dysfunction?
II & IIIA/IIIB
Which 2 types of prostatitis have low grade symptoms?
acute & chronic bacterial
Which prostatitis has flare-ups of pelvic pain?
chronic bacterial
Which type of prostatitis is pain & urinary dysfunction w/ inflammation but w/o infection?
chronic prostatitis/chronic pelvic pain syndrome (IIIA)
Which type of prostatitis is pain & urinary dysfunction w/o inflammation or infection?
chronic prostatitis/chronic pelvic pain syndrome (IIIB)
Which 2 types of prostatitis have irritative & obstructive voiding?
I & IIIA/IIIB
Which type of prostatitis has GU, lower ab/pelvic, & low back pain?
IIIA & IIIB
Which type of prostatitis is asymptomatic inflammatory?
IV
True or False: WBCs & inflammatory markers found in semen or prostate tissue in category IIIB prostatitis.
F
What is the term for non-malignant enlargement of prostate gland to where prostate volume is > 30 mL?
benign prostatic hyperplasia
BPH goes along w/ lower urinary tract symptoms & bladder ____________ syndrome.
outlet
____% of men over 50 experience symptoms of BPH.
70
What are the 5 risk factors of BPH?
- over 40
- fam history
- diabetes
- heart disease w/ use of B blockers
- obesity
True or False: As men age, the ratio of new prostate cells to old ones shifts in favor of more cell death.
F
The increased growth of new prostate cells (___________) occurs primarily inward encroaching on urethra.
hyperplasia
What are some symptoms of BPH?
- storage dysfunction
- voiding dysfunction
- painful urination
- blood in urine
- unexplained lower back, pelvis, hip, or upper thigh pain
- sexual dysfunction
What are 2 methods in which BPH are assessed?
- digital rectal exam (DRE)
- prostate specific antigen (PSA) blood test
PSA is secreted by prostatic ___________ cells & the norm is < 4 ng/mL.
epithelial
What is gynecomastia?
enlargement of the male breast
True or False: Prostate cancer is the most common cancer in men & most common cause of male death from cancer.
F
1 in ___ American men will get prostate cancer.
6
______________ (glandular cells) accounts for 98% of primary prostatic tumors.
adenocarcinoma
True or False: Prostate cancer starts inwards & spreads outwards.
F
What are some risk factors of prostate cancer?
- over 50
- african american
- in the US
- fam history
- red meat, high fat diet
Most prostatic adenocarcinomas are characterized by small to moderate disorganized glands that infiltrate ___________ of prostate.
stroma
Where does prostate cancer metastasize to?
lymphatic & bone
True or False: Bony metastasis of prostate cancer happens more often to axial skeleton than appendicular.
T
A dull, vague ache in rectal, ____________, or lumbar spine may be felt in prostate cancer.
sacral
What is the term for painful spasm of anal sphincter w/ straining?
tenesmus
