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Anatomy and Phyisology > HLTH 2501: renal failure and male reproduction > Flashcards

HLTH 2501: renal failure and male reproduction Flashcards

1
Q

reasons why the kidneys may fail to function

A

reduced blood flow to the kidneys, inflammation, necrosis, and obstruction

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2
Q

what is the result of kidney failure

A

oliguria or anuria

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3
Q

oliguria

A

reduced urine output

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4
Q

anuria

A

no urine output

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5
Q

what is the treatment for kidney failure?

A

dialysis

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6
Q

causes of acute renal failure

A

glomerulonephritis, shock, heart failure, nephrotoxins, and mechanical obstructions

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7
Q

how does glomerulonephritis cause acute renal failure?

A

it reduces GFR

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8
Q

shock and heart failure leading to acute kidney failure

A

this results in tubule necrosis; shock from burns or injuries can also cause this by causing damaged RBCs or myoblin that break down in the circulation and damage the tubules

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9
Q

nephrotoxins

A

are drugs, chemicals, or toxins that cause tubule necrosis and obstruction of blood flow

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10
Q

drugs that may cause tubule damage

A

sulfa drugs, phenacetin, NSAIDS, acetaminophen, aspirin, and penicillin

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11
Q

what may cause obstructions in the kidneys?

A

calculi, blood clots, or tumors

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12
Q

serum levels of acute renal failure

A

blood tests will show elevated serum urea nitrogen, creatinine, hyperkalemia, and metabolic acidosis

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13
Q

chronic renal failure

A

is the gradual, irreversible destruction of the kidneys over a long period

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14
Q

what may chronic renal failure result from?

A

chronic kidney disease like congenital polycystic kidney disease or systemic disorders like diabetes or hypertension; nephrotoxins may also have an effect

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15
Q

why is chronic renal failure irreversible?

A

because of scar tissue

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16
Q

stages of chronic renal failure

A

begins with decreased renal reserve and GFR and high serum creatinine levels; then the second stage is renal insufficiency and a continued retention of nitrogen wastes, which is marked by excretion of large volumes of dilute urine; the final stage if end-stage renal failure and GFR is negligible, causing fluid, electrolytes and wastes to be retained in the body

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17
Q

3 stages of chronic renal failure simple

A

decreased reserve, renal insufficiency, and end-stage renal failure (uremia)

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18
Q

decreased reserve signs

A

is pretty much asymptomatic but there is decreased GFR and higher than normal creatinine levels

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19
Q

renal insufficiency signs

A

continued decreasing GFR, retention of nitrogenous wastes (urea and creatinine), large amounts of dilute urine, and elevated BP

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20
Q

early signs of chronic renal failure

A

increased urinary output (polyuria) and nocturia, general signs of anorexia, nausea, anemia, fatigue, and weight loss, bone marrow depression, and high BP

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21
Q

end-stage chronic renal failure signs

A

oliguria, dry-pruritic-hyperpigmented skin that bruises easily, abnormal limb sensations, decreased libido in men and menstrual irregularities in women, encephalopathy, CHG, arrhythmias, bone impact, urine-like breath, and systemic infections like pneumonia

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22
Q

why are systemic infections common with chronic renal failure?

A

due to poor tissue resistance caused by anemia, fluid retention and low protein levels

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23
Q

encephalopathy signs

A

lethargy, memory lapses, seizures, tremors

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24
Q

how is bone impacted in end-stage renal failure?

A

the failure of the kidney to activate vitamin D impacts calcium absorption and metabolism, leading to hypocalcemia and hyperphostehtamia with osteodystrophy, osteoporosis and tetany

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25
Q

osteodystrophy

A

is a deficit of bone development due to impaired calcium and phosphate metabolism

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26
Q

3 key indicators of chronic renal failure

A

anemia, acidosis, and azoemia

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27
Q

serum levels for end-stage chronic renal failure

A

low pH due to metabolic acidosis, azotemia, low hemoglobin, and hyponatremia, hyperkalaemia, hypocalcemia, and hyperphosphatemia

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28
Q

azotemia

A

refers to the presence of urea or other excess nitrogen wastes in the blood

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29
Q

goal of treatment for chronic renal failure

A

all body systems are affected so maintaining homeostasis of fluids, electrolytes, and acid-base balance is important

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30
Q

treatment for chronic renal failure

A

drugs to stimulate erythropoiesis and reduce phosphate levels, as well as for other disorders like hypertension; reducing fluid intake and transplants

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31
Q

risk for children with chronic renal failure

A

retarded growth and renal rickets

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32
Q

scrotum

A

a sac outside the abdominal cavity that houses the testes; consists of a layer of skin that is continuous with the skin or the perineal area, plus an inner muscle layer and fascia

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33
Q

spermatic cord

A

refers to a collection of vessels, nerves, and the ducts (vas deferens) surrounded by a fascia

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34
Q

testes function

A

produce sperm and the sex hormone testosterone

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35
Q

tunica vaginalis

A

is a double-walled membrane with a small amount of fluid between the layers and this encloses the testis and attached epididymis

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36
Q

why are the testes located outside the abdominal cavity?

A

to maintain an optimal temperature for sperm production, 1-2 degrees below normal body temperature

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37
Q

what happens to the testes when the external temperature drops?

A

the scrotal muscle draws them closer to the body; vise versa for increased temperature

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38
Q

spermatogenesis

A

is the production of spermatozoa and is a continuous process that takes about 60-70 days

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39
Q

steps of spermatogenesis

A

sperm goes from the seminiferous tubules, to the epididymis, then peristaltic movements assist the sperm to move into the ductus deferens then to the ampulla, where the now-motile sperm may be stored for several weeks until ejaculation occurs

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40
Q

epididymis

A

is where the sperm mature

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41
Q

vasectomy

A

is a method of birth control that involves cutting or obstructing the vas deferens to block the passage of sperm

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42
Q

seminal vesicles

A

are located behind the bladder and provide a secretion that includes fructose to nourish the sperm

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43
Q

prostate gland

A

surrounds the urethra at the base on the bladder and adds an alkaline fluid to provide an optimum pH of around 6 for fertilization

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44
Q

other name for the bulbourethral glands

A

cowper gland

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45
Q

bulbourethral glands

A

are situated near the base on the penis and secrete an alkaline mucus, which probably neutralizes any residual urine in the urethra

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46
Q

what does FSH do?

A

initiates spermatogenesis

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47
Q

what do LH do?

A

stimulates testosterone production by interstitial cells (Leydig cells) in the testes

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48
Q

what hormone is essential for the maturation of sperm?

A

testesterone

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49
Q

negative feedback for sperm production

A

testosterone provides continuous control of gonadotropin secretions

50
Q

functions of testerone

A

maturation of sperm, development of secondary sex characteristics such as hair, deeper voice, development of male external genitalia, and increases skeletal muscle mass

51
Q

epispadias

A

refers to an urethral opening on the dorsal (upper) surface of the penis, proximal to the glans

52
Q

exstrophy of the bladder

A

is a failure of the abdominal wall to form across the midline

53
Q

hypospadias

A

is an urethral opening on the ventral (under) surface of the penis

54
Q

chordee

A

ventral curvature of the penis

55
Q

peyronie’s disease

A

is a condition resulting from the development of fibrous scar tissue on the penis that causes a significant bend and/or pain; can result in painful sex and erectile dysfunction

56
Q

causes of peyronie’s disease

A

usually is due to injury but can also be CT disorders or hereditary

57
Q

treatment for peyronie’s disease

A

can be penile traction therapy or penile injections (uses collagenase, interferon, and verapamil); sometimes surgery is used

58
Q

cryptorchidism

A

aka maldescent of the testis and occurs when one or both of the testes fail to descend into the normal position in the scrotum during the latter part of pregnancy (they remain in the abdominal cavity or at some point in the inguinal canal)

59
Q

ectopic testis

A

when the testis assume an abnormal position outside the scrotum

60
Q

causes of cryptorchidism

A

hormonal abnormalities, a short spermatic cord, or a small inguinal ring

61
Q

complications of cryptorchidism

A

the seminiferous tubules can degenerate and spermatogenesis is impaired; there is also an increased risk of testicular cancer

62
Q

hydrocele

A

occurs when excessive fluid collects in the potential space between the layers of the tunica vaginalis

63
Q

how does hydrocele develop?

A

as a congenital defect in a newborn when peritoneal fluid accumulates in the scrotum due to fluid escaping when the processus vaginalis does not close off

64
Q

inguinal hernia

A

is common when the processus vaginalis remains open (hydrocele) and is a loop of intestine that passes through the abnormal opening

65
Q

what does an inguinal hernia result in?

A

intestinal obstruction

66
Q

acquired hydrocele

A

may result from scrotal injury, an infection, a tumor, or unknown causes; these are more common after middle age

67
Q

spermatocele

A

is a cyst containing fluid and sperm that develops between the testis and the epididymis outside the tunica vaginalis

68
Q

varicocele

A

is a dilated vein in the spermatic cord, usually on the left side; this frequently develops during puberty due to a lack on valves in the veins

69
Q

results of a varicocele

A

usually are painless but if extensive, is can be painful and tender and leads to infertility due to impaired blood flow to the testis

70
Q

torsion of the testis

A

occurs when the testis rotates on the spermatic cord, compressing the arteries and veins, causing ischemia to develop and for the scrotum to swell

71
Q

causes of torsion of the testes

A

puberty or trauma

72
Q

4 categories of prostatitis

A

1 is acute bacterial, 2 is chronic bacterial, 3 is nonbacterial, and 4 is asymptomatic inflammatory

73
Q

prostatitis

A

is an ascending infection or inflammation closely associated with UTIs

74
Q

acute bacterial prostatitis

A

causes a tender, swollen gland, typically soft and boggy on palpation

75
Q

nonbacterial prostatitis

A

is indicated by large number of WBCs in the urine and prostatic secretions, although the prostate gland in not enlarged

76
Q

chronic prostatitis

A

the prostate if slightly enlarged, irregular, and firm, because fibrosis is more extensive

77
Q

causative organisms of acute bacterial prostatitis

A

mostly E coli

78
Q

who does acute bacterial prostatitis occur in?

A

young men with UTIs caused by colon bacteria, in older men with benign prostatic hypertrophy, in STDs such as gonorrhea, through caterers, and from hematogenous spread

79
Q

causative organism of chronic prostatitis

A

repeated infection by E coli

80
Q

signs of acute and chronic prostatitis

A

dysuria, urinary frequency and urgency, fever and chills, low back pain or abdominal discomfort, prostate inflammation (may obstruct urinary flow), and systemic signs like fever, malaise, anorexia, and muscle aching

81
Q

nonbacterial prostatitis signs

A

similar to bacterial but with less marked systemic signs

82
Q

treatment for prostatitis

A

antibacterial drugs like ciprofloxacin and antiinflammatory drugs

83
Q

balanitis

A

is a fungal infection of the glans penis that can be transmitted during sex

84
Q

causative organism for balanitis

A

candida albicans

85
Q

balanitis signs

A

appears as penile vesicles that later develop into patches that cause burning and itching

86
Q

treatment for balanitis

A

topical antifungal agents like miconazole or tolnaftate

87
Q

epididymitis

A

is an inflammation of the epididymis, the coiled tube at the back of the testicle

88
Q

epididymo-orchitis

A

is an inflammation of both the epididymis and the testicle

89
Q

causative agent of epididymitis and orchitis before puberty

A

often in E coli

90
Q

causative agent of epididymitis and orchitis when sexuallary active

A

gonorrhea and/or chlamydia

91
Q

who is at risk for epididymitis and orchitis?

A

men with a medical history of UTIs or prostatitis, as well as those who have had bladder surgery or used a catheter

92
Q

benign prostatic hypertrophy

A

is common in older men and occurs when hyperplasia occurs of the prostatic tissue, with the formation of nodules surrounding the urethra, thus obstructing flow

93
Q

why does hyperplasia of the prostate occur?

A

due to an imbalance between estrogen and testosterone that is associated with aging

94
Q

diagnosis for benign prostatic hypertrophy

A

rectal examination

95
Q

complications of benign prostatic hypertrophy

A

obstruction can cause incomplete emptying leading to frequent infections, as well as a distended bladder, dilated ureters, hydronephrosis, and possible renal damage

96
Q

signs of benign prostatic hypertrophy

A

obstruction of urinary flow, hesitancy, dribbling, and decreased force of the urinary stream

97
Q

treatment for benign prostatic hypertrophy

A

drugs to reduce the androgenic effects and slow nodular growth like dutasteride, alpha-adrenergic blockers that relax the smooth muscle, and a combination of finasteride and doxazosin

98
Q

prostate cancer

A

is common in men over 50 and is the second leading cause of death from cancer in US men

99
Q

what are most prostate tumors?

A

adenocarcinomas that arise from tissue near the surface of the gland

100
Q

what prostate tumors are more aggressive?

A

those that are more undifferentiated or anaplastic tumors

101
Q

what does prostate cancer effect?

A

the regional tissues such as lymph nodes or the urethra and is may metastasize to bone

102
Q

causes of prostate cancer

A

many are inherited mutations in the HPC1 gene, but can also be high androgen levels, increased insulin-like growth factor, and recurrent prostatitis

103
Q

signs of prostate cancer

A

is a hard nodule on the periphery of the gland (often in the posterior lobe); small tumors don’t cause urinary obstruction but if large is may cause these signs

104
Q

two serum markers in prostate cancer

A

prostate-specific antigen and prostatic acid phosphate

105
Q

prostate-specific antigen

A

provides a useful screening tool for early screenings of cancer

106
Q

prostatic acid phosphatase

A

is elevated if the prostate tumor has metastasized

107
Q

three criteria for prostate cancer diagnosis

A

an elevated prostate-specific antigen, abnormality on a digital rectal exam, and biopsy results

108
Q

treatment for prostate cancer

A

surgery and radiation most often; if the tumor is androgen-sensitive, removal of the testes or anti testosterone drug therapy may be used

109
Q

procedure for removal of the testes

A

orchiectomy

110
Q

what are the majority of testes cancer

A

malignant and arise from germ cells

111
Q

who is often affected by testicular cancer?

A

men from the 15-35 age group; it is the most common solid tumor in young men

112
Q

teratoma

A

consists of a mixture of different germ cells combined with embryonal carcinoma (poorly differentiated cells) and may cause testicular cancer

113
Q

serum levels for testicular cancer

A

elevated human chorionic gonadotropin or alpha-fetoprotein

114
Q

what type of testicular cancer spreads early on?

A

choriocarcinoma

115
Q

where does testicular cancer often metastasize to?

A

the common iliac, the para aortic lymph nodes, the mediastinal and supraclavicular lymph nodes; later on it may spread to the lungs, liver, bone, and brain

116
Q

causes of testicular cancer

A

a change in chromosome 12, infection, trauma, or cryptorchidism

117
Q

signs of testicular cancer

A

hard, painless, unilateral masses, dull aching pain in the lower abdomen, hydrocele or epididymitis, or gynecomastia

118
Q

gynecomastia

A

enlarged breasts in testicular cancer due to hormones being secreted by the tumor

119
Q

diagnostic tests for testicular cancer

A

ultrasound, CT, lymphangiography and the presence of tumor markers

120
Q

treatment for testicular cancer

A

combination of surgery, radiation, and sometimes chemo

Anatomy and Phyisology (94 decks)

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