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Gu Flashcards

1
Q

What’s normals output per day?

What amount do you usually void?

A

1500 ml/ say

Usually void when 200-600ml

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2
Q

5 function of kidney and wtd?

A
  1. Remove wast from blood in urine form
  2. Regulate electrolytes and acid base balance
  3. Control BP from agiotensin release
  4. Regular RBC production
  5. Synthesis of vitamin D to active form
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3
Q

What’s bowmans capsule

A

Glomerulus here and filter for urine

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4
Q

Proximal tubule wtd

A

Site of reabsorption

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5
Q

Loop of henle wtd

A

Site for further filter ruins through reabsoption . Where diuretics work ex: lasix and bumex

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6
Q

Collecting tubules wtd

A

release urine

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7
Q

What forms urine?

A

Glomerular filtration

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8
Q

Geriatric consideration 9

A
  1. Yearly decrease in glomerular p 35-45
  2. Decrease flow to kids
  3. acid base imbalance
  4. Poly pharmacy incr drug metabolites filt by kids
  5. Hypernatremia and fvd more common- thirst sensn
  6. Being prostate hyperplasia
    7 Incomplete bladder empty and bladder wall contr 8 decrease
    9 Urinary incontinence
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9
Q

Risk factors for GU disorders 8

A 
strep disorder chronic renail failure 2-3wks later
increase age- uti BPH
invasive procedure- cysto, foley ut
immobile- stones
diabetes- renal F, neurogenic bladder
hypertension- renal failure 
multiparous women- stress incont
neurologic disorder- parkinson and mutliple scler
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10
Q

Signs and symptoms of urinary tract disease Pain where 5 places

A
  1. pain
  2. ureteral- cva flank radiates to abdomen thighs and gental area
  3. bladder- lower abd and suprapubic area
  4. urethra- male penis to meatus female urethra to meatus cariable severe w voiding
  5. prostatic- perineum and rectum
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11
Q

changes in voiding 11

A

frequency, urgency, dysuria, nocturia, retention, incontinence, hesitancy, enuresis, hematuria, proteinuria, bacteria

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12
Q

frequency- def and 3 diseases
urgency - def and 2 disease
dysuria

A

more often- infection. disease, diuretics
urgency- strong desire, prostate and infection
painful

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13
Q

incontinence

nocturia- important

A

involuntary loss of urine

more than 2x night

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14
Q

hesitancy

enuresis

A

delay in voidign

involuntary during sleep

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15
Q

output of urine hr

A

30ml/hr

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16
Q

anuria how much

A

less than 55ml in 24 hrs- hemodialysis

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17
Q

polyuria how much

2 diseas

A

more than 2500ml in 24 hrs

DKA CHF

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18
Q

UTD s/s overall

A

pain in 5 places
changes in voiding
GI symptoms- share autonomic innervation, N/V abd distention discomfort diarrhea

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19
Q

name 3 disease that urologic disorder may mimic that make diagn difficult.
3 s/s for each

A

appenditis- fever, chill, pain on right side
ulcer- open sore upper abd painn
cholecystitis- rigid abd, NV

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20
Q

health history important

A

onset, duratiob, hx of uti, fever, chillsm decr urine, discharge

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21
Q

physical exam

kidney- skin

A
  • inspect edema, pallor, hydration
    shouldnt be able to palpate on attempt
    costovertebral angle tenderness
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22
Q

what is costvertebral angle tenderness CVA

A

patient behind, 12 rib, tenderness,

where intercoastal ribs meet

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23
Q

physical exam bladder 3

A

palpate for fullness location

height usually if distended

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24
Q

meatus exam3

A

edema redness and drainage

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25
Q

prostate exam

A

digital rectal exam- hyperplasia- enlargement of prostate in older men

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26
Q

urinalysis
what is ass
how to do

A

idenify abnmlty
clean catch or midstream is used
midsteam is better and clean before

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27
Q

urine C and S

cult and sens.

A

identify bacteria and totreat w appr antibiotic

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28
Q 
normal UA result 
color 
opacity 
sp gvty 
osmot
ph 
negative 
RBC, WBC
Sediment and bacteria
A
  1. yellow to amber
    clear- opacity ,
    odor- faintly romatic
    GLucose ketones protein negative- if present renal disease diabetes
    RBC, sediment, bacteria and WBC negative
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29
Q

Spec gravity on UA
range
why decrease and increase 3 for each

A

normal 1.005 - 1.03
decrease- diab insipidus- glumernephritis, renal failure

incr- chf, hep disorders, dehydr.

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30
Q

normal osmolality on UA

A

250-900-

ability of kidneys to dilute and concentrate

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31
Q

ph on UA

ranges

A

5.8- 8
average is 6
more than 7- uto, alkaline diet, alkalosis (lighhead confused twitching) meds

less than 5- high protein fever and acidosis (SOB, sleepy tachycardia)

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32
Q

what is GFR ?

norm range

A

rate which glumeruli filter blood

125 ml per minute

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33
Q

what can affect GFR

A

age

usually decreases with age

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34
Q

creatinine measure ?
how to
1 implemen

A

most accurate meas of glumer. filtration
do 24 hr urine collection to check level
also do serem creatinine halfway through 12 hrs

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35
Q

GFR equatn

A

volume of urine x urine creatinine divided by serum creatine

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36
Q

what urine creatine level vs serum

A

serum 0.7 to 1/4

urine - 125

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37
Q

BUn level and important

how effected, and 5

A

10-20- end product of protein met, kids excrete nitrogen waste
can affects by (meds, dehydr), prtn intake, tissue breakdown fluid volume changes

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38
Q

Glucose when show on UA 4

A

stress, pregnancy, high carb meal and BG 170

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39
Q

KUB image xray
why
asses 2

A

limited purpose
kids, ureter bladder size position
calculi or lesions

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40
Q

Ultrasonography

2 imple

A

use sounf depth of structure below skin

done on full bladder no special care p

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41
Q

Bladder US

2 consid

A

measures urine volume bladder

portable and handheld

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42
Q

CT or MRI
to see
consider

A

cross section view kid and GI tracr

can use oral or IV contrast

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43
Q

Nuclear scan what is
shows
implementation

A

injection radioisotope
shows kidney perfusion
increase fluids for excretion

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44
Q

Intrav Pyelogram IVP
can see 5
implementation5

A

visualize entire unrinary tract
show calculi, size and shape tumor, pyelonephritis

check alergies for contrast, laxitive night a, NPO 8hrs
or clear liquids, may feel flushed, warm salty taste when inj dye

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45
Q

how to check pedal oulses

A

at same time

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46
Q

voiding cystourthrograogy
how its done
1 thing checks

A

catheter contract into bladder for xrays taken while voiding
shows ureter reflex (pee coming back ureters-bad)

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47
Q

renal angio gram
how done to check what 2 things
implnt-5

A

catheter stick in femoral iliac art, dye inject to check tumors or cyst
imp- check bleeding, color, pulse and temp of extr,
VS

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48
Q

cystoscopy
whats done
implnt- 5
PC- 3

A

lens insertered in urethra up to bladder

imp- NPO p midnt, monitor UTI, may have sligh pink urinep, warm moist heat/sitz bath disccofort, monitor retention

PC- bleeding, infection, dysuria

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49
Q

Percut Renal bx
used for what 2
impt- 7
pt report 2 things why

A

needle to get tissue, not done as much
diagn or progression of disease

impltn- NPO p midnt, prone immediate after the BR x 8hrs, IVF p prevent clots, respon to anagesics, asses bleeding (ASA and anticoag), monitor urine,avoid stenuos actvty for 2 wks

Pt report backache, flank pain radiate to groin (clot in ureter)

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50
Q

when use renal or uretal brush bx

2

A

privide specific info p abnm crat finding of ureter or

pelvis detected

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51
Q

Chronic kidney disease GFR

A

GFR decrease more than 3 months

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52
Q

chronic kidney disease can result in

whhat ?

A

end stage renal disease ESRD

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53
Q

4 risk factors for chronic kidney disease

A

CAD DM HTN obesity

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54
Q

5 causes pf chronic kidney diseas

A

DM HTN, (glum.nephritis pye.nephritis), herdity or congenital disorders, and renal cancer

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55
Q

5 manifestation of chronic kidney disease

A 
increase creatinine
anemia- decr erythoprotein by kids
metablic acidosis- lethargy and tachypnea
calcium and phosphorus 
fluid retention
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56
Q

what 3 disease to treat to drecease pregression of CKd

A

HTN
hyperglycemia
proteinuria

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57
Q

Nephrosclerosis
def and 2 factors
tx-3

A

hard renal art d/t HTN DM

treatment control BP amd BG, renal replcmnt thpy

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58
Q

acute glum.nephritis def AGN

A

inflammation of kid affects capillary bundle of glum

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59
Q

onset of Acute Gum.nephritis usually follows what 6 disease

A 
URI (strep) 2-3wks before AGN- cause injury 
impetigo
mumps
hep B 
HIV infections, 
varicella
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60
Q

S/s AGN 6

A 
hematuria- may be cola color RBC
edema
azotemia- lot waste prodct in blood thats usually
 filtered out by kids 
mailase 
decrease out 
CVA and flank
61
Q

Diagnt test for AGN 4

1 impl

A

UA, CBC, step titer, renal bx

may have low Hand H from blood loss

62
Q

potential comps AGN 4

A

ESRD
Hypersensitivity encephalopathy
HF- bloated, SOB, chest pain
Pulmonary edema- wheezing distant h.s

63
Q

Elderly pts AGN

PC 4

A

circulatory overload
dyspnea
cardiomegaly
atyp neuro change

64
Q

Med managemnt to treat symp of AGN 5

A

antibiotic- strep PCN 1- emycin 2
diuretic- if HTN
bedside until protein and hemauria subside
sterioids-inflammaton
diet- low protein low sodium fluids restrictied , high cal and carb
CHO- energy and protein

65
Q

what last resort for recovery AGN

A

dialysis

66
Q

Notify s/s for of what 2 PC in AGN?

3 s/s for one

A

renal failure- fatigue nasea vomitting decr urine

infecton

67
Q

AGN- what to give for emergy and reduce protein

A

CHO liberally

68
Q

Chronic glom. nephritis
what happens
who may present to first 3

A

HTN, hyperlipidemia, dm nephrosclerosis may present in first
KIdney shrisk 1/5 normal size and arteries thicken
acute may go to chronic

69
Q

Sympt CGN
general
ss that specfc- 5

A

HTN edema, incr BUN and CRTN

weight loss, nocturia, headache, dizziness retinal changes

70
Q

What complication occur late in CGN

A

peripheral neuropathy and confusion

71
Q

lab abdn CGN 6 all

2 spec

A

hyperkal, acidosis, anemia hypoalbumin

increase phosph decrease calcium

72
Q

Intervention CGN 3

A

HBV- dairy products, eggs, meats- good
calories to spare protein
detection of UTI

73
Q

Discharge Teaching 4-

long term

A

BP control,
dialysis, assess site, fluid rest
diet
Rept- NV decrease urin output hematuria edema

74
Q

Nephrotic syndr
5 causes and dx
ss
intervention

A

CGN, DM, lupus MYELOMA, renal vein thrombosis

dx- needle bx of kidney

ss- PROTEINURIA- color 3.5g/d. PITTING EDEMA- periobital- hypoalb,hyplip

same as AGN- antibiotic , bedrest, steriods diet,
diuretic

75
Q

Renal trauma- cause ,
how pt feel/ happens 5
ss-5
mngt- 6

A

cause by injry to flank, back, upper abd pain- bruising or lacercn, rupture kidney- decr HR

ss pain hematuria (mo com)swelling in flank ECCHYMOSIS wounds, SHOCK with hemmorage

contol hemorhage ,pain,infection, H/H freq , tx quick if surg,
br-hematuria minot lacn- until hem clear

76
Q

bladder injury - def, 3PC, mngt

A

pelvic trauma with multiple trauma to low abd when when

PC-hemorrhage, shock, SEPSIS- treat quickly
mangt- surgery repair of laceration

77
Q

UTI
common sites
causes 2

A

pathogen in bladder, urthrea prostate kidney (pye.nephritis) sterile above ureter- upper or lower
GI contamination commn cause- pressure on female urethr sex icr risk

78
Q

urethrovesical refux
AKA
how happens

A

can be from reflex urine

coughing sneezing incr force urine to urethra, press back normal urine flows back into bladder BACTERIA

79
Q

Risk factor UTI 6

A 
retention
urine stasis and residual 100ml and less 
bladder destn and obstr 
met diseas DM and gout 
Nueroloic disorders and cogn impairment 
decrease host defnese
pregnancy
80
Q

Prevention of UTI 5

A 
void q 2-3 hrs 
front to back, shower instead bath 
cotton under[aons 
pericare p and a intercouse- void imm
drink fluids-
81
Q

UT drinks iriitants 4 and 2 drink to have

A

coffee tea cola alohol

acidity urine with abs of Vit C and Cranberry - bring down ph

82
Q

cystitis (lowe UTI)
3 causes
ss-6
mngt 2 meds

A

bladder inf from ureter- urine backflow, fecal contm, cath

ss/ freq and urgency, burn urine (hesitancy) noctiria
suprapubic pain, hematuria, NV PYURIA (pus)

sulfa and macrodantin 3-4 day or 7-10 days longer if complct/ reoccurant fluid intake

83
Q

Urethritis
important
ss/ males 3 females-4
mngt-3

A

males usually caused by gono (us caused by chymd)
ss- m- inflam, purulent drainage burnign urine
f- may have none /may discharge/can result in steriltiy and usually not dign
mng- antibiotic F/u, secual part tested, hydrated

84
Q

Acute Plyenephritis
causes- 7
ss- 5 halmark
tx 4

A

infec renal pelvis, tube kidney tiss, freq sec to urine back up and obstr
causes- bact infect- E coli most commen, from
proteus, psuedomonas, staph, strep

CVA Flan, Fever childs dysuria, freq and urg MAIlaise. PUS, BCTRA and white cells in urine

tx antibiotic, fluid, rest, drink acidity

85
Q

Chronic Pyelonephritis
1 imp
ss4
tx7

A

persistant kid infla can lead to chr renal fail

s/s usually asympt-vague flank pain, fatuwye occasional
fever bacturia

tx antibiotic 2-6mo, antiemtic, fluids, pain meds, urin sesptics- discomfort, br

86
Q

UTI all diet

acid food -6

A

fluid 3000 day

acid- canberry, prune vit c bread meats eggs

87
Q 
Urinary antiinfective 
med name 
do 
s.e-3
imp3
A

nitrofurantoin
disinfect urn tract
s.e- nv, gi upsey, DiaRrhea
impl - give c food may discolor urine i and o

88
Q 
sulfonamide 
med 
do 
se3 
implnt4
A

co-trimozalone
bacteriostatic
s.e- gi upset headache HYPOGLYCEMIA
imp-c lots fluids, fullcorsem monitor BG I and o

89
Q

Flouroniqinolen
med
do 5
se

implication

A

levofloxacin
bacterstaic, coli, monas enter coccas URETHRITS
s.e- tendonitis/rupture, gi headache HYPER OR HYPERGLYCEMIA
imp- sensty reatn, muscloskelt compkant monitor BG

90
Q

Anagecis UTI
med
1 per action se impl

A

phenazopyridine
action mucosa
s.e - will discolor urine
impl- not anti biotic

91
Q

UrOlithiasis
important 5
what ist cause 3

A

stones inn bladder calculi, more commen in men, uncommon in blaks and kids
cause ischemia, elim prob, an UTI
ss- usual sever pain,
most common caise of urin obstn

92
Q

Factors favor stone8

meds diet, disease, body func

A 
lower fluid- 
change in ph 
diet- hi calcium, vit D  oxalates (spinach beets fied potatoe nut butters)
immobility 
obstrn- also infection 
foreign body
met fact- hyperthyr. hi uric acid genetic systiine met, 
Inflamm bowel disease 
fam history 
meds- laxatice anatacis ASA DIAmox
93
Q

calcium stone 3

A

most comm
small to big
staghorns

94
Q

oxalate stoen

A

oxalate diet

second most commin

95
Q

struviate stone 2

A

bacteria alkaline in urine

96
Q

uric acid 3

A

increase u.a dehrdtion low urine ph

97
Q

cystine 1

A

rare inherited decfect of cystine an amino acid

98
Q

Stone manifestation renal pelvis 3

A

deep ache in CVA down to bladder nv renal colic

99
Q

stone manif ureter

A

obctrn

UTI hematuria retention id obstr

100
Q

General stone s/s 3

A

diaphoresis restless pain in GI (nv diarrh)

101
Q

PC of stones 4

A

obstn- renal impairment
pylen- infection
tissue irrtn- renal abcess contr to cancer
urosepsis

102
Q

s.s obst 1

A

small but freq voiding

103
Q

UTI ss5

A

chills fevr dysuria freq and hesist

104
Q

Relieve pain stones 3

A

narcotic heat pad/ bath

position of comfort

105
Q

PC of stones

A

UTI, VS for infection, all urine strain in guage for pa

106
Q

PT teachign stonnes 7

diet, do at home call md

A 
restrict ptn- 60g day 
na 3-4 g
avoide oxalate 
dont want to limit calcium- ostepars. 
high fluid 1-2hrs more than 2l day water, awakenin 
straining urine home 
MD UTI sign or increase pain
107
Q

Stones managmet surgical 4

A

ESWL- shock- icr fld, pass in few days
ureteroscopy- lazer destroy- basket
Perct nephrostomy/ nephrolith.- utrasound waves to
pulverize stone

108
Q

What surgery to do for stones if pt have kid measure

A

Nerphectomy-

109
Q

Diet and meds per stone

1.calcium intake 3 meds 3

A
  1. no restrict CA unless high, rest protein, acid diet avoid cal/alumn hydroxide anatacid, amphogel
    Med- Cellulose sodium phosphate- redc absn,
    hydracholorothiazide- thiazide diutcs,
    lithostat,
110
Q

uric acid stone mngt

dos donts 2 meds

A

avoid- hi in purine , limit ptn- no alch, fasting crash diet
do- alkaline diet
med allopurinol- rdc kevel
sodium bicard-icr ph

111
Q

purine foods 5

A

shellshish anchovies, asparegus, mushroom, organ meats

112
Q

oxalate foods 7

A

spinish strabrry rhubarb chocalte tea penut wheat brain

113
Q

cystine2 and struvite 1t mngt

A

cystine low proetin alkalin diet

struviate- antibiotc for bact

114
Q

Alkaline diet4

Acid diet5

A

milk vegt rhurab most fruits

cranberry, prunes/plum eggs bread meat

115
Q 
Urethra stricture
2 import
3 causes 
ss3 
1 pc
mgntt 2
A

narrowing urethra;- congtnt or accrq
cause - injury, gon. urethretis, born w it
ss- overflow incontin strainin, decreased force urine
PC- hydronephrosis
mgnt - dilation, surgical removal

116
Q

hydronephritis
causes 5
ss4
mngt 3

A

urine traps in pxml to bladder
casuse- stone tumor, scar tiss,urteral str BPH
ss- may none, flank pain, infected UTI ss, may have hematuria
mngt- antibc remove obtr, may urinary diversion

117
Q

Bladder cancer risk factor 3 main 6 others

A

(Caucasian, men, over 55,)
smoke chemical like ink leather paint, chronic UTI, high PH, high CHO intake, Pelvic radiation therapy, mestasis from prosate, colon, rectum

118
Q

Bladder cancer
ss
3 test

A

painless hematuria

diagn test UA IVP Cysto

119
Q

Management of bladder cancer

5

A

radiation BGC med- inject chemo-retain gluid 2 hrs then void
local resection or tatal cystectomoy c diversion

120
Q

urinary diversion types

A

cutaneous and continent

121
Q

urinary diversion pre op 5 intvnt

A

clean bowel, low res diet, antibiotic fluid

may neeed hyperlimentation TPN mark stoma location

122
Q

ileal conduct
3 impot
PC 5

A

ureters attact to intestin- pouch for urine- watertight if leaks mucous encourage fluid
PC-infection dishenc, urin leakage small bowel obst,
stoma gangrene- not ntomal see stool in drainage

123
Q

Assess diversion mangtnt

6

A 
check appliance early am
avoid moist soap 
avd food strn odor- apra eggs cheese
liquid odorizer- white vineger ascorbic acid PO
change when 1/3 full
124
Q

uretersigmostomy
3 pts for
4 impltn

A

implant ureters in sigm colon- pelvic rdts small bowel disease or resection
some bowel inc may occur q 2 hr- likelu watery and some degree noctia
anal pictr- contol of void defect
may have cather in rectum- irrigate but dont force

125
Q

Continent Ileal urinary resev (Indiana pouch ) 5

kock pouch 2

A

most common content diversion ileam and cecum form reser. Ureters anastomased- narrow part of the ileam and ter terniem ileum to sq tissure
cath inserted to drain
kock pouch-nipple on valve prevnt leakage, in males opuch connect to end urethra for more normal voiding

126
Q

post op Indiana puch

5 -how look, teaching

A 
stoma- beefy red moist 
UOP- less than 30cc hr
watch for dehydration obstruction 
body image 
teach pt how to drain c cath
127
Q

Indiana pouch 5 PC

1 intvnt

A

Atelectasis
skin irrit- bleed, infect,
Perotonitis
Stoma ischema pink- dark color- vascular compr
Stoma restraction and separtion
Ascorbic acid to keep urine ph below 6.5- alkaline inscr around stoma

128
Q

Benign Prostate hyperplasia
6 risk factors
7 ss

A

most men over 50 some enlrg
90% men 85yrs old
risk- smoking etoh HTN CV disease DM, incr age

ss- urinary elimination problem, straining dribbling, UTI , nocturia decre force urine chronic retn (azotemia and renal fail)

129
Q

diagn test BPH 6 ,2 spec

A

dital exam UA CBC- clotting facr
Urodynamics
PSA- antigen normal 4 can be slight elec BPH abd prostatis

130
Q

Compication of BHP 4

A

hydroureter, hydroneph, pylephrutis renal failure

131
Q

Medical treatment BHP 7 surgical

A

waiting- no obstn or comps ok
balloon dialation- sht term
suprapubic cath
transurethra; needle abliation- destroy tiss
microwat therapy
TRansurethr lase resect- less bleeed TUIP
TUIP- electric laser incisn to decrease rest to urine flow

132
Q

Meds for BHP 3

A

Aplha block- terazosin, doxazosin, tamsulosin -obstn

antiandrogen- dustasteride, finasteride- block DHT -
erectile dysfunct gynecomasty and flushing
Saw palmetto herb

133
Q 
Turps trans. resect, proatste 
preop-2
post-3
meds2 and se 
teach 5
A

take inner part or entire gland
preop- 3 way foley and pain from bladder spasm
post- irigattion 36-48hrs decr bleeding clots- rate for pink urine NS 50cc for clots assess for clots,
meds probanthine-antichol- se palptn blurred vision no glucoma, antispamotics for bladder. Bella and opium cause tachy, confus, consti,
teach-bladder exercise, stool softner, fluid clear, only mD for cath, mintor bleding 2 weeks

134
Q

Prostate Cancer
risk factors 4
clinical mainfest

A

most prevelent in AA males men p 40 ecam yearly
familu, diet hi fat, chemical exhst fumes, fertilizer chems increase with age

usually none early then obstruct later, painfull eject blood in urine if bladder, may mestasis to boone or lymph nods

135
Q

diagnt test 4 prostate cancer

A

tissue prostectomy
PSa- norm less 4
PAP PAA notmal 2.5-3.7 mestaistx effetv
DRE- advnced lesion stony-hard and fox

136
Q

prostate cancer

medical managemt 5

A
  1. surgery standard- laparoscomy radical prost
  2. radiation- found early- ext(teletherapy 6-7 wks daily) interna(brachyther)-seed implant- avoid pregn and 2 mo old- strain urine for seed use condom 2wks implant
  3. Hormone tx- control not cure mnthy inj LEUPROLIDE prevent progge-
  4. orchiectomy-testes
  5. take estrogen
137
Q 
epidymitis 
3 impt things 
pc-3
manifest-5 
mangment 6 , no to 2 
meds-3
A

infection from protate or UTI usually unilateral, may take 4 weeks normal, remove if reoccurance or no resp treatemt
PC- orchitis, abcess, sterility
manifest severe pain and tenderness dysur, freq, fevr, WBC 20-30k
mang- 24hrs onset spermatic cord anethsia, BR 3-5 ,days elevate scrotum (ice), later heat sitz bath. no straining or sex, lifting until undercontrol
MEds- analgesics, antipyretic antibiotic

138
Q

prostatis

4 manifest

A

can be acute chronic viral or bactr

manifest buring, nocturia pain in peri and rectal pain ejaculation and fever

139
Q

acute chronic s/s prostatitis

A

acute- sudden fever low back urinary symp

chronic major cause reoccurant UTI, fever and temp uncommon

140
Q

managemtn protatitis
3 meds
3 home

A 
antibiotic- sufla drugs 30 days - months 
vira- NSAIDs 
analgesics 
do not force fluids-med
avd- codee chocolate alcohol spices
f/u 6mo -12
141
Q

erectile dysfunct
9 causes
test- 1

A

age 40=70 causes- anxty fatique
diseases- occlusive vasc disease, endocrine dis, chronic renail failure GU condit hematol, neuro, trauma etoh meds drug abuse

test- noctural penile tumescence- organic or psycologcal isssue - healthy men paralled Rapid eye move

142
Q

Pharmalogical erectile dysfunction
(PDE-5) time
se-3
contrainct7

A

phosphodiesterase (PDE-5)- sildenafil,vardenafil, tadafil- take one hour beforelast 60=120 min
se- headache flushing dyspepsia
contr- nitration uncontroled BP CAD MI (6mo)cardiac dysm kid or liver dysfn

143
Q

Erectile dysfn
VAsoactives
time
meds PC

A

alprostadi papaverine phentolamin
inj directlu into penic
PC- priapism- persist erectn abnm
inhect 20 min before last 20 minutes

144
Q

Erectile dyfn

urethra; suppositiry

A

used 2 day
COntra- pregnt women
inset 10 minute sbefore inte last 1 hr

145
Q

SUrgical erectile dyfn

3 PC

A

penile implants- inflama rod prosethesis

PC infection erosion persistant painn

146
Q

Phimosis
what is it
tx

A

foreskin cannot be restacted from poor hygience

use steriod cream

147
Q

Paraphimosis
what is it
PC 2
Tx

A

foreskin not reurned over glas once restracted
causes venous conge edema enlargemtn of glan
PC arterial occlusion necrosis
tx pressing firmly 5 mins to reduce edema and size then move skin

148
Q

Nephrotic syndrome management 4 food meds3

A

Diuretic(sometme) ace inhibitors steroid

Tx hyperlipidemia mod- protein and CHO

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