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gigu & men’s health > GU System Quiz > Flashcards

GU System Quiz Flashcards

1
Q

Pain Referral Patterns: Kidney

A

• Ipsi costovertebral angle
• T-L or L-S area
• Possible diffuse upper abdominal pain

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2
Q

Pain Referral Patterns: Ureters

A

• Upper: flank
• Mid: lateral to umbilicus
• Lower: groin and genitalia

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3
Q

Pain Referral Patterns: Bladder

A

-Over suprapubic region

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4
Q

Dysuria

A

• Defined as painful or uncomfortable urination
– Typically a sharp, burning sensation
– May cause painful ache over bladder or perineum

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5
Q

Dysuria is extremely common in _________

A

• Extremely common in women, but can occur in men also & at any age

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6
Q

Dysuria: Most Common Causes

A

– Cystitis
– Urethritis due to STD

• Other causes: interstitial cystitis, prostatitis, epididymo-orchitis, cervicitis, atrophic vaginitis, tumors

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7
Q

Dysuria: Red Flags

A

– Fever, flank pain, recurrent episodes, known urinary tract abnormality, male

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8
Q

Dysuria: Diagnosis

A

– No single uniform approach to testing
– Urinalysis (WBC’s), STD testing
– Sometimes will give antibiotics without testing in young, otherwise healthy person

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9
Q

Dysuria: Treatment

A

– Directed at underlying cause-antibiotics, STD

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10
Q

Dysuria: Key Points

A

– Not always caused by bladder infection.
– Consider STDs and cancer

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11
Q

Dysuria: Potential DDx’s

A

Cystitis, Urethritis, Interstitial cystitis, Tumor

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12
Q

Hematuria

A

• Red blood cells in urine
– May be visible (urine is red, bloody, cola colored)
– May not visible (may be microscopic)

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13
Q

Reddish color is not always due to RBCs

A

– Hemoglobin/myoglobin in urine, food, drugs

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14
Q

Hematuria: Can originate from (5)

A

– kidneys, ureters, bladder, urethra, prostate

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15
Q

Hematuria: Most common causes

A

– UTI
– Prostatitis
– Urinary calculi (in adults)

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16
Q

_______ can cause transient hematuria

A

Vigorous exercise

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17
Q

In patients over 50, hematuria may indicate:

A

Cancer or prostate disease

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18
Q

Hematuria: Potential DDx

A

-Infection
-Calculi
-Glomerular disease
-Polycystic kidney disease
-Genitourinary cancer
-Trauma
-Prostatic Hyperplasia
-Prostatitis

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19
Q

Polyuria is defined as urine output of ____/day

A

> 3L

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20
Q

Urinary Frequency

A

Need to urinate many times during the day or night but in normal or less-than-normal volumes.

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21
Q

Polyuria: Common Causes

A

– Taking diuretics (in adults)
– Uncontrolled diabetes mellitus

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22
Q

Polyuria: Red Flags

A

– Abrupt onset, night sweats, cough, weight loss (especially if there is a history of smoking)

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23
Q

Urinary Frequency: Common Causes

A

– UTI
– Urinary tract calculi
– Urinary incontinence
– BPH

Also: Caffeine intake

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24
Q

Urinary Frequency: Red Flags

A

– Lower extremity weakness or signs of spinal cord damage
– Fever and back pain

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25
Q

Acute Kidney Injury (AKI): Acute Renal Failure

A

• Described as the rapid decrease in renal function over days
(Reduced blood flow to kidney allows creatinine and urea build up, leading to fluid/electrolyte disorders)

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26
Q

AKI: Complications

A

Fluid build up in lungs, chest pain, kidney damage, death

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27
Q

Acute Kidney Injury: Initial Symptoms & Signs

A

-Weight gain & peripheral edema

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28
Q

AKI: Later symptoms & signs

A

-Oligouria
-Anorexia
-Nausea, vomiting
-Back pain
-Confusion, anxious, restless
-Diarrhea
-Fatigue, lethargy
-Hypertension
-Weakness

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29
Q

AKI: Diagnostics

A

-Increased uria & creatinine (takes 24 hours for creatinine to increase)

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30
Q

AKI: Treatment

A

-Immediate Care (Can be serious-lead to coma, death)

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31
Q

Kidney (Renal) Trauma

A

-Kidney is injured by outside force: Penetrating/Blunt Trauma

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32
Q

Kidney (Renal) Trauma: Possible other symptoms

A

– Hematuria
– Diffuse abdominal tenderness
– Flank contusion
– Lower rib fractures
– Skin wound

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33
Q

Kidney (Renal) Trauma: Exam

A

– Look for any signs of trauma, contusion or redness

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34
Q

Kidney (Renal) Trauma: Lab Test

A

– Hematuria, low hematocrit

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35
Q

Kidney (Renal) Trauma: Treatment

A

– Depends on injury & situation
– May need surgery
– Most blunt trauma is low grade: Treatment is bed rest until gross hematuria resolved)

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36
Q

Chronic Kidney Disease

A

• Defined as long-standing, progressive deterioration of renal function

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37
Q

Chronic Kidney Disease: Risk Factors

A

– Analgesic use
– Hypertension
– Smoking
– Obesity
– African-American or Native American
– Older age
– Family history of kidney disease

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38
Q

Chronic Kidney Disease: Most common causes

A

• Diabetic nephropathy
• Hypertension
• Glomerulonephritis

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39
Q

Chronic Kidney Disease: Additional Causes

A

• Polycystic kidney disease
• Vesicoureteral reflux
• BPH

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40
Q

Chronic Kidney Disease: Possible Symptoms

A

(Typically asymptomatic or few symptoms)
• Anorexia
• Nausea, vomiting
• Nocturia
• Fatigue
• Pruritus
• Edema of feet/ ankles
• Urinary issues
• Muscle twitches and cramps

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41
Q

Chronic Kidney Disease: Complications

A

• Pulmonary edema, hyperkalemia, heart issues
• Central nervous system: difficulty concentration, personality change

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42
Q

Glomerular Disease

A

• Reduces kidneys ability to filter
• Red blood cells and protein may be excreted into the urine while toxins may be retained

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43
Q

Glomerular Disease: Basic Types

A

Nephrititic & Nephrotic

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44
Q

Glomerular Disease: Complications

A

• Hypertension, kidney failure

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45
Q

Nephritic Syndrome (glomerulonephritis)

A

• Bacterial or viral infection causes diffuse inflammation and damages the glomeruli

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46
Q

Nephritic Syndrome ( Glomerulonephritis): Epidemiology

A

– Most common in children (60% ages 2-12, 10% >40)
– Predominately males

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47
Q

Nephritic Syndrome (Glomerulonephritis): Causes

A

– Previous infections such as strep
– Other causes: lupus, polyarteritis nodosa, etc.

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48
Q

Nephritic Syndrome: Signs/Symptoms

A

▪ Hematuria
▪ Mild proteinuria (less than 3 g/ 24 hours)
▪ Edema
▪ Hypertension
▪ Oliguria

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49
Q

Nephritic Syndrome: Acute vs. Chronic Cases

A

-Acute: Abrupt onset of hematuria with mild proteinuria
-Chronic: May develop silently over months to years

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50
Q

Nephrotic Syndrome:

A

• Syndrome in which too much protein is releases in urine

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51
Q

Nephrotic Syndrome: MC secondary cause

A

Diabetes

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52
Q

Nephrotic Syndrome: Key Features

A

Massive proteinuria (and no hematuria)
-How we differentiate from nephritis

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53
Q

Nephrotic Syndrome: Signs/Symptoms

A

– Edema (most obvious clinical manifestation)
– Massive proteinuria (at least 3.5 g protein/ 24 hours)
– Hypoalbuminemia (<3 g/dl)
– Hyperlipidemia/hyperlipiduria

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54
Q

Nephritic vs. Nephrosis: Pathogenesis

A

-Nephritic Syndrome: Inflammation of Glomeruli
-Nephrosis Syndrome: Abnormal glomerular permeablility

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55
Q

Nephritic vs. Nephrotic: Causes

A

-Nephritic: Many causes; MC post-strep infection
-Nephrotic: Many causes; 2nd MC Diabetes

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56
Q

Nephritis vs. Nephrosis: Lab Findings

A

-Nephritic: Hematuria & proteinuria (mild)
-Nephrosis: No blood & proteinuria (>3.5g/24 hours)

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57
Q

Nephritic vs. Nephrosis: Clinical Findings

A

-Nephritic: Edema, Hypertension, Oliguria
-Nephrotic: Edema, Hypoalbuminia, Hyperlipidemia

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58
Q

Nepthritis vs. Nephrosis: Inflammation

A

-Nephritis: Inflammation
-Nephrosis: Non-Inflammatory

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59
Q

Nephritis vs. Nephrosis: Hematuria

A

-Nephritis: Hematuria
-Nephrosis: No Hematuria

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60
Q

Nephritis vs. Nephrosis: Proteinuria

A

-Nephritis: Proteinuria: <3.5g/day
-Nephrosis: Proteinuria: >3.5g/day

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61
Q

Polycystic Kidney Disease

A

• Genetic disorder: cluster of cysts develop in kidney
– Causes kidney to enlarge
– Reduces function

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62
Q

Cysts in PKD are:

A

Non-cancerous

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63
Q

PKD: Predominant age of diagnosis

A

Usually diagnosed by 45
(Equal to both genders)

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64
Q

PKD: Complications

A

• Hypertension
• Recurrent UTI or pyelonephritis
• Kidney stones

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65
Q

PKD: Signs & Symptoms

A

-Flank, low back & abdominal pain
-Dysuria
-Hematuria
-Nocturia
-Polyuria
-Hypertension (might notice 1st)
-Hepatomegaly

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66
Q

PKD: Exam

A

• Possible increased size of abdomen
• Palpable kidneys

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67
Q

PKD: Treatment

A

-Supportive Care
-Possible kidney transplant

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68
Q

Nephrolithiasis

A

• Hard deposits that form in kidney

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69
Q

Kidney stones are ___ composed of calcium

A

85%

70
Q

Nephrolithiasis: Epidemiology

A

Predominately male

71
Q

Nephrolithiasis: Risk Factors

A

• Family history
• Dehydration
• Diet: high protein, salt, sugar
• Obesity
• Medications & supplements: Vitamin C, antacids

72
Q

Nephrolithiasis: Other conditions

A

• Gastric by pass surgery
• IBD
• Chronic diarrhea

73
Q

Nephrolithiasis: Other kidney conditions are known risk factors

A

– Repeated UTIs
– Polycystic kidney disease
– Previous history of stone

74
Q

Nephrolithiasis: Alternate Names

A

– Urinary calculi
– Renal calculi
– Renal lithiasis
– Urolithiasis

75
Q

Nephrolithiasis: Symptoms

A

• Sudden onset
• Colicky & agonizing flank pain
• Nausea, possible vomiting
• Hematuria
• Chills & fever

76
Q

Nephrolithiasis: Discomfort

A

• May not be able to lie down
• Constantly shift positions

77
Q

Nepholithiasis: Exam

A

• Tachycardia
• Abdominal tender w/ deep palpation
• Costovertebral angle tenderness
(+Murphy’s kidney punch)

78
Q

Nephrolithiasis: Labs/Diagnostics

A

• Urinalysis
• Kidney ultrasound

79
Q

Nephrolithiasis: Treatment

A

• If stone larger than 6 mm, may need intervention
– Pain medication, increased hydration, surgery

• 85% of time: pass stone with urination within 72
hours

80
Q

Nephrolithiasis: Prevention

A

-Drink enough water
-Avoid large doses vitamin C
-Low oxalate diet

81
Q

Low Oxalate Diet

A

– If stones made from calcium oxalate: limiting the amount of dietary oxalate may prevent stones
– Limit oxalate to 40-50 mg day
– High oxalate foods include spinach, beets, blackberries, etc.

82
Q

Obstructive Uropathy

A
83
Q

Obstructive Uropathy

A

Functional or anatomic obstruction of urinary flow

84
Q

Obstructive Uropathy: Causes by age

A

-Young: Anatomic abnormalities
-Adults: Calculi (kidney stones)
-Older men: BPH and prostate cancer

85
Q

Obstructive Uropathy: Consequences

A

Urine accumulates proximal to obstruction, causing distention which can cause pain

86
Q

Obstructive Uropathy: Lower urinary tract symptoms

A

-Frequency, nocturia, incontinence, dysuria, hesitancy weak stream or straining to void

87
Q

Obstructive Uropathy: Upper Urinary Tract Symptoms

A

Asymptomatic
-If caused by stone, can have renal colic (sudde, severe, flank pain that may radiate to groin)

88
Q

Obstructive Uropathy: Vitals

A

-Hypertension
-Fever

89
Q

Hydronephrosis

A

-Accumulation of urine in the kidney causes it to dilate; Usually due to an obstruction

90
Q

Hydronephrosis: Most common cause in Adults

A

Nephrolithiasis (kidney stones)

91
Q

Hydronephrosis: Other causes

A

-Acquired: prostate hyperplasia, cancer, neurogenic bladder

92
Q

Hydronephrosis: Risk Factors

A

-Kidney stones
-Prostate hypertrophy/cancer
-Diabetes mellitus
-Analgesic abuse

93
Q

Hydronephrosis: Upper Obstruction

A

Flank pain

94
Q

Hydronephrosis: Lower Obstruction

A

May radiate to ipsilateral testicle/labia

95
Q

Hydronephrosis other symptoms

A

Changes in urination, thirst, edema

96
Q

Hydronephrosis: Exam

A

-Costovertebral angle tender
- (+ Murphy’s kidney punch)
-If severe, kidney may be palpable (also bladder)
-If caused by lower obstruction: Suprapubic area tender

97
Q

Urethritis

A

Lower urinary tract infection in urethra

98
Q

Cystitis

A

Lower urinary tract infection in bladder

99
Q

Pyelonephritis

A

Upper urinary tract infection in kidney

100
Q

Prostatitis

A

Infection in prostate

101
Q

UTI: Epidemiology (Adults 20-50 yoa)

A

-Far more common in female

102
Q

UTI: MC Types in Female

A

Cystitis or pyelonephritis

103
Q

UTI: MC types in Male

A

Urethritis or prostatitis

104
Q

UTI: MC Cause

A

MC Cause: Bacteria

105
Q

Urethritis: MC Cause

A

STI: Gonorrhea, chlamydia

106
Q

Urthethritis

A

Infection of the urethra

107
Q

Urethritis: Complications

A

-Can cause urethral scarring & stricture
-May spread into bladder
-May spread into gender organs

108
Q

Urethritis: Signs & Symptoms

A

-Dysuria
-Discharge (penile, vaginal)
-Itching/tenderness
-Edema, inflammation

109
Q

Urthethritis: Female symptoms

A

Vaginitis, cystitis, cervicitis

110
Q

Urethritis: Risk Factors

A

-Multiple partners
-STI history
-Unprotected intercourse

111
Q

Urethritis: Labs

A

Perform STI testing

112
Q

Cystitis

A

Inflammation of bladder mucosa due to infection or irritation

113
Q

Cystitis is more common in

A

Women

114
Q

Cystitis: Causes

A

Acute infection (E. coli 90% of time)

115
Q

Cystitis: Risk factors/causes

A

-Sexual activity, pregnancy, incomplete bladder emptying
-Previous UTI, STI (chlamydia)
-Catherization

116
Q

Cystitis: Symptoms & Signs

A

-Burning or pain during urination
-Urgency, frequency
-Sense of incomplete bladder emptying
-Blood in urine
-Offensive odor
-Nocturia
-Lower abdominal or back pain, tenderness or cramping

117
Q

Cystitis: Lab

A

Urinalysis

118
Q

Cystitis in Men

A

-Uncommon <50 yoa
-Usually result of ascending infection from urethra or prostate

119
Q

Cystitis in Men: Risk Factors

A

-Catherization, Urethral strictures

120
Q

Cystitis in Men: If Fever

A

Concomitant pyelonephritis or prostatitis

121
Q

Pyelonephritis

A

Acute, diffuse infection of kidneys or one or both kidneys

122
Q

Pyelonephritis: Epidemiology

A

More common in females

123
Q

Pyelonephritis: Risk Factors

A

-Frequent bladder infections
-Anything causing obstruction
-DM
-Other: Neurogenic bladder, vesicoureteral reflux

124
Q

Pyelonephritis: Symptoms shared w/ Cystitis

A

-Dysuria
-Urinary Frequency
-Hematuria

125
Q

Pyelonephritis: Unique symptoms

A

-Location of Pain: Flank Px, colicky abdominal pain
-High fever

126
Q

Pyelonephritis: Exam

A

-Murphy’s kidney punch: Positive on affected side
-Kidney may be palpable and tender if enlarged

127
Q

Pyelonephritis: Diagnostic Procedures

A

-Urinalysis, urine culture
-CT, US

128
Q

Interstitial Cystitis

A

-Non-infectious bladder inflammation

129
Q

Intersititial cystitis is more common in:

A

Women (90%)

130
Q

Intersitial Cystitis: Triggers

A

-Excess caffeine
-Tobacco, alcohol
-Food w/ high potassium, spicy
-Seasonal allergies, menstruation, stress, sexual intercourse

131
Q

Interstitial cystitis may be initially

A

Asymptomatic

132
Q

Interstitial Cystitis: Sx/SI

A

(Similar to UTI)
-Dysuria
-Increased frequency
-Urgency
-Pressure in bladder/pelvis
-Nocturia
-Pelvic floor dysfunction/tension
-Pain w/ intercourse
-General discomfort

133
Q

Interstitial Cystitis: Differentials

A

UTI, overactive bladder, urethritis, urethral syndrome, prostatitis

134
Q

Interstitial Cystitis: Labs

A

Normal unless another condition is involved

135
Q

Neurogenic Bladder

A

-Bladder dysfunction caused by neurologic damage

136
Q

Neurogenic Bladder: Many causes

A

CNS, PNS, Other

137
Q

Neurogenic Bladder: Different Types

A

-Flaccid Bladder: Contractions absent
-Spastic Bladder: Involuntary contractions
-Mixed patterns: Both

138
Q

Neurogenic Bladder: Symptoms

A

-Flaccid: Overflow incontinence
-Spastic: Frequency, nocturia, urgency, leakage

139
Q

Neurogenic Bladder: Common complications

A

-Recurrent infections
-Vesicoureteral reflux

140
Q

Loss of bladder control

A

Urinary incontinence

141
Q

Urinary incontinency is more common in

A

Elderly and women

142
Q

Urinary incontinence: Risk factors (5)

A

-Diabetes, MS, obesity
-BPH, Multi-parity

143
Q

Urinary Incontinence: Types

A

-Stress
-Urge
-Overflow
-Functional
-Mixed

144
Q

Urinary Incontinence: Stress

A

-Caused by coughing, sneezing, laughing, exercising, or lifting something heavy

145
Q

Urinary Incontinence: Urge

A

-Sudden, intense urge followed by involuntary loss
-Causes: Infection or Conditions (DM or neurologic)

146
Q

Urinary Incontinence: Overflow

A

Dribbling as bladder doesn’t empty completely

147
Q

Urinary Incontinence: Overflow

A

Dribbling as bladder doesn’t empty completely

148
Q

Urinary Incontinence: Functional

A

-Physical or mental impairment impedes getting to the toilet on time

149
Q

Incontinence: Causes

A

-Obstruction such as BPH
-DM
-Pelvic floor weakness
-Infection
-Stones
-Tumor

150
Q

Enuresis

A

Involuntary loss of urine
-Involuntary voiding of urine > 2x/month during the day or night

151
Q

Enuresis is more common in:

A

Male Children (3:1)

152
Q

Enuresis: Primary classification

A

Children: Never were dry/were not potty trained

153
Q

Enuresis: Secondary Classification

A

-Begins after 6 months of dryness

154
Q

Enuresis: Secondary Classification (Causes)

A

-ADD
-Stress
-Anxiety
-Pinworm
-Food Allergies

155
Q

Retrograde flow of urine from bladder into ureters or kidneys

A

Vesicoureteral Reflux

156
Q

Vesicoureteral Reflux: Epidemiology

A

More common in infants and young children

157
Q

Vesicoureteral Reflux: MC Causes

A

Congenital defect at ureterovesical junction

158
Q

Vesicoureteral Reflux: Symptoms

A

-Dysuria, urgency, frequent urination, hematuria, abdominal pain

159
Q

Bladder Injury: Signs/Symptoms

A

-Suprapubic pain, urinary retention, hematuria (90%), muscle rigiditiy over lower abdomen

160
Q

Most common renal cancer (90-95%)

A

Renal Cell Carcinoma

161
Q

Renal Cell Carcinoma affects people between:

A

50-70 yoa

162
Q

Renal Cell Carcinoma: Symptoms

A

-Appear late when the tumor is large & metastatic
-Hematuria, flank pain, palpable mass, fever

163
Q

Most common type of bladder, ureter, urethra cancer

A

Transitional Cell Carcinoma

164
Q

Transitional Cell Carcinoma: Causes

A

Certain drugs, radiation, mutation, cigarette smoke

165
Q

Wilms’ Tumor/Neuroblastoma manifests in _____

A

Children <5 yoa

166
Q

Wilms’ Tumor/Neuroblastoma: Cause

A

Possible genetic abnormalities

167
Q

Wilms’ Tumor: Symptoms

A

Painless, palpable abdominal mass

168
Q

Wilms’ Tumor: Prognosis

A

Good, but may recur within 2 years

169
Q

UTI vs. Interstitial Cystitis

A

UTI: Hematuria may be present, WBC in urine
Interstitial Cystitis: Normal labs, Dx by exclusion

170
Q

Abdominal and Posterior Flank Area: Exam Findings

A

-Bruit: Renal artery stenosis
-Murphy’s Kidney Punch: Pyelonephrtitis
-Palpable Kidneys: Masses potentially

171
Q

Abdominal and Posterior Flank Area: Exam Findings

A

-Bruit: Renal artery stenosis
-Murphy’s Kidney Punch: Pyelonephrtitis
-Palpable Kidneys: Masses potentially

gigu & men’s health (6 decks)

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