GU Flashcards
Uric acid calculi
5% of nephrolithiasis.
Increased uric acid excretion is related to
increased intake or turnover of protein.
With an increased intake of protein, there is an increased breakdown of amino acids to uric acid through the enzyme xanthine oxidase.
Increased uric acid excretion is also seen during chemotherapy of lymphoproliferative diseases.
The Gleason grading system
based on a major and minor pattern of glandular differentiation and provides a sum score of ascending virulence.
The most common patterns identified are 3 and 4.
Score 6 (3 + 3) is least aggressive,
7 (3 + 4 or 4 + 3) moderately aggressive,
8 (4 + 4) and 9 (4 + 5 or 5 + 4) very aggressive.
Scores of less than 6 and greater than 9 are rare and represent the poles of the indolent to aggressive continuum
In females incontinence is due to what pathophys
laxity of the pelvic floor muscles
WITH
weakening of the pelvic ligaments,
can cause loss of normal urethral positioning in the pelvis, leading to stress incontinence
(NOT just loss support of bladder neck)
Bladder neck function is by and large controlled by
the sympathetic autonomic nervous system
innervation of the pelvic floor and external sphincter.
The extrinsic portion of the distal sphincter mechanism and the pelvic floor (levator) muscles receive somatic motor innervation from the spinal cord through the pudendal nerve.
In the nephron, potassium and acid balance are primarily regulated in:
The collecting tubule
Final urinary acidification with titration of ammonia phosphate and other titratable buffers occurs in the collecting tubule.
the management of vesicoureteral reflux consist of
ssessment
observation with suppressive antibiotics
Indeed in males most cases of posterior urethral valves can be managed with cystoscopy using an appropriately sized endoscope and endoscopic ablation of the valve.
the vast majority of children void within what time period after delivery
the first 24 hours after delivery.
Superficial transitional cell carcinoma managed by
transurethral resection and fulguration.
BUT HIGH RECURRENCE! (however low chance of becoming true invasive cancer)
NEEDS adjuvant intravesical agents educing recurrences and decreasing the possibility of progression of the tumor to muscular invasion
limited to the superficial layers, that is, the bladder epithelium. In many patients, multiple recurrences of transitional cell carcinoma can occur but do not appear to invade the deeper tissues, that is, progress to invasion.
loop of Henle
separation of NaCl from water reabsorption occurs.
distal tubule
Final of calcium excretion
phosphate transport
In the nephron, most of the filtered solute is reabsorbed in the:
Proximal convoluted tubule
Hyperoxaluria usually occurs in
short gut syndrome, characterized by increased oxalate absorption from the colon or in patients with a previous resection of long sections of small bowel or who have had intestinal bypass which excludes a substantial portion of the small intestine.
Which test is usually the most appropriate to order first if the patient has signs and symptoms suggesting urolithiasis?
Intravenous urogram (IVU).
