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Pathology > Lecture 16 Urinary System & Male tract > Flashcards

Lecture 16 Urinary System & Male tract Flashcards

1
Q

Risk factors for UTI?

A

Urinary tract obstructions (stones/catheters), pregnancy, diabetes, sex, females.

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2
Q

Risk factors for UTI?

A

Urinary tract obstructions (stones/catheters), pregnancy, diabetes, sex, females.

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3
Q

Define UTI?

A

Presence of pure growth of >10^5 organisms in fresh urine

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4
Q

What is cystitis?

A

UTI in bladder

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5
Q

What is pyelonephritis?

A

UTI in kidney

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6
Q

What is the most common causative organisms?

A

E.coli (poo bacteria) 70% of community UTIs

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7
Q

What other organisms can cause UTIs?

A

Staphylococcus, proteus and klebsiella

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8
Q

What are the symptoms of pyelonephritis?

A

High fever, rigors, vomiting, loin pain and tenderness

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9
Q

What are the symptoms of prostatitis?

A

Few urinary symptoms, flu like, swollen tender prostate on PR

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10
Q

How are UTI managed?

A

Drink lots, urinate more, antibiotics (trimethoprim). US imaging in non-resolving UTIs, children, men and pyelonephritis.

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11
Q

What are the kidneys function?

A

maintenance of water, electrolyte and acid-base homeostasis. Excretes urea and creatinine

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12
Q

What hormones do the kidneys release?

A

Renin (BP control by controlling aldosterone), Erythropoietin - stimulates RBC and Vit D production

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13
Q

Define acute renal failure

A

deterioration in renal function, low urine volume (

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14
Q

Define Oliguria?

A

Abnormally small amounts of urine

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15
Q

What levels rise when someone has acute renal failure?

A

Plasma urea and creatinine levels

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16
Q

What causes “pre-renal” acute failure?

A

Hypoperfusion or sepsis

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17
Q

What causes “renal” caused acute failure

A

ATN (acute tubular necrosis) due to ischaemia or nephrotoxins

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18
Q

What causes “post-renal” acute failure?

A

Renal tract obstruction (stones/tumours)

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19
Q

Acute renal failure treatments?

A

Treat exacerbating factors (hypovolaemia/semsis). Stops nephrotoxic drugs (NSAIDs, ACE-1,…mycin). Haemofiltration/dialysis

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20
Q

GFR for chronic renal failure stage 1?

A

> 90

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21
Q

GFR for chronic renal failure stage 2?

A

60-89

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22
Q

GFR for chronic renal failure stage 3?

A

30-59

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23
Q

GFR for chronic renal failure stage 4?

A

15-29 SYMPTOMS SHOW

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24
Q

GFR for chronic renal failure stage 5?

A
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25
Q

What is the GFR?

A

Volume of fluid flitered from glomerular capillaries into the Bowman’s capsule/unit time

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26
Q

What can cause chronic renal failure?

A

Glomerulonephritis, diabetes, renovascular disease, hypertension, polycystic disease

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27
Q

What is glomerulonephritis?

A

disorders where there is damage to glomerular filtration apparatus

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28
Q

Signs of glomerulonephritis?

A

Protein or blood in urine. Immune complexes in one part of the nephron

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29
Q

What are stones?

A

Crystal aggregates (form in collecting ducts) that can be deposisted anywhere in renal tract

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30
Q

What is the % life time incidence of stones? Peak age and gender ratio?

A

15%, 20-40 years. Male:female 3:1

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31
Q

What are risk factors for stones?

A

Dehydration, dietary factors (^chocolates, tea and rhubard). Drugs (loop, antacids, steroids, aspirin), UTIs.

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32
Q

What pain do kidney stones cause?

A

loin

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33
Q

What do ureteric stones cause?

A

renal colic

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34
Q

Where do bladder and urethral stones cause pain?

A

Pain on micturition with interrupted flow.

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35
Q

When scanning for stones

A

80% visible on KUB-xray. 99% visible on CT scan

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36
Q

Stones

A

pass spontaneously within 48 hours, can take up to 30 days

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37
Q

Stones >5mm or causing obstruction

A

may need intervention

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38
Q

How common is renal cell carcinoma?

A

85% of all renal cancers

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39
Q

Who is renal cell carcinoma common to?

A

50-70 years old, 2:1 male predominance

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40
Q

What are the risk factors for renal cell carcinoma?

A

Smoking, obesity, hypertension, asbestos and hereditary conditions

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41
Q

Define polycythaemia

A

Abnormal ^ conc of haemoglobin in blood (^plasma volume or ^RBCs)

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42
Q

How to treat renal cell carcinoma?

A

Nephrectomy +/- chemo

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43
Q

What are the most common benign and malignant conditions in the bladder?

A

Cystitis and transitional cell carcinomas

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44
Q

What are the symptoms of transitional cell cancinoma (bladder)

A

Painless haematuria. Frequency urgency and dysuria.

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45
Q

What tests are done for bladder carcinomas?

A

Urine for cytology and cystoscopy and biopsy

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46
Q

How is early stage bladder carcinoma treated?

A

Diatheryl (high f electriacal currents -> stimulate circulation, reduce pain and destroy unhealthy cells. During cystoscopy

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47
Q

How are later stages of bladder carcinoma treated?

A

Radical cystectomy or palliative chemo/radio

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48
Q

What is the prostate?

A

Gland located at the base of bladder, (20gm). Helps in semen and spermatozoa secretion& maintenance

How well did you know this?
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49
Q

What are the age and incidence of benign prostatic hyperplasia given?

A 
40s = 20%
60s = 70%
80s = 90%
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50
Q

What can the prostate weigh with benign prostatic hyperplasia?

A

60-100gm

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51
Q

Signs and symptoms of benign prostatic hyperplasia?

A

Same as lower urinary tract obstruction: ^frequency, hesitancy, nocturia, terminal dribbling. ^ infection risk. Enlarged prostate.

52
Q

Treatments for benign prostatic hyperplasia?

A

Alpha-blockers. If small/non symptoms then conservative, reduce fluid (night), alcohol and caffeine.

53
Q

What are the risk factors for prostate cancer?

A

Age, race(black men more common, Asian less common), family history, hormone levels, diet (^risk with ^fat consumption)

54
Q

Signs and symptoms of prostate cancer?

A

May be asymptomatic. Nocturia, hesitancy, poor stream and terminal dribbling. Hard irregular prostate

55
Q

How is prostate cancer diagnosed?

A

Raised PSA (prostate specific antigen), (normal in 30% of cases), biopsy.

56
Q

Treatment for prostate cancer?

A

Depends on:age, stage and comorbidities. If many comorbidities watch and wait may be option. Hormone therapy and radiot in advanced changes.

57
Q

Signs and symptoms for testicular torsion?

A

Sudden pair in 1 testis, pain in abdomen, N/V. Hot swollen and tender. May be high.

58
Q

What age range is testicular torsion more common?

A

11-30 years old

59
Q

How is testicular torsion tested for?

A

USS, doppler but may need exploratory surgery

60
Q

Treatment for testicular torsion?

A

Urgent surgery, bilateral fixation (orchidopexy) if still poss, if abnormal then orchidectomy

61
Q

What is the most common malignancy in males aged 15-44?

A

Testicular tumours

62
Q

What are the risk factors for testicular tumours?

A

Undescended testis, infant hernia and infertility

63
Q

Signs of testicular tumours?

A

Painless testicular lump noted after trauma or infection (doesn’t cause it just found after this)

64
Q

Can have germ cell tumours, most common is?

A

Seminoma

65
Q

Define UTI?

A

Presence of pure growth of >10^5 organisms in fresh urine

66
Q

What is cystitis?

A

UTI in bladder

67
Q

What is pyelonephritis?

A

UTI in kidney

68
Q

What is the most common causative organisms?

A

E.coli (poo bacteria) 70% of community UTIs

69
Q

What other organisms can cause UTIs?

A

Staphylococcus, proteus and klebsiella

70
Q

What are the symptoms of pyelonephritis?

A

High fever, rigors, vomiting, loin pain and tenderness

71
Q

What are the symptoms of prostatitis?

A

Few urinary symptoms, flu like, swollen tender prostate on PR

72
Q

How are UTI managed?

A

Drink lots, urinate more, antibiotics (trimethoprim). US imaging in non-resolving UTIs, children, men and pyelonephritis.

73
Q

What are the kidneys function?

A

maintenance of water, electrolyte and acid-base homeostasis. Excretes urea and creatinine

74
Q

What hormones do the kidneys release?

A

Renin (BP control by controlling aldosterone), Erythropoietin - stimulates RBC and Vit D production

75
Q

Define acute renal failure

A

deterioration in renal function, low urine volume (

76
Q

Define Oliguria?

A

Abnormally small amounts of urine

77
Q

What levels rise when someone has acute renal failure?

A

Plasma urea and creatinine levels

78
Q

What causes “pre-renal” acute failure?

A

Hypoperfusion or sepsis

79
Q

What causes “renal” caused acute failure

A

ATN (acute tubular necrosis) due to ischaemia or nephrotoxins

80
Q

What causes “post-renal” acute failure?

A

Renal tract obstruction (stones/tumours)

81
Q

Acute renal failure treatments?

A

Treat exacerbating factors (hypovolaemia/semsis). Stops nephrotoxic drugs (NSAIDs, ACE-1,…mycin). Haemofiltration/dialysis

82
Q

GFR for chronic renal failure stage 1?

A

> 90

83
Q

GFR for chronic renal failure stage 2?

A

60-89

84
Q

GFR for chronic renal failure stage 3?

A

30-59

85
Q

GFR for chronic renal failure stage 4?

A

15-29 SYMPTOMS SHOW

86
Q

GFR for chronic renal failure stage 5?

A

Less than 15

87
Q

What is the GFR?

A

Volume of fluid flitered from glomerular capillaries into the Bowman’s capsule/unit time

88
Q

What can cause chronic renal failure?

A

Glomerulonephritis, diabetes, renovascular disease, hypertension, polycystic disease

89
Q

What is glomerulonephritis?

A

disorders where there is damage to glomerular filtration apparatus

90
Q

Signs of glomerulonephritis?

A

Protein or blood in urine. Immune complexes in one part of the nephron

91
Q

What are stones?

A

Crystal aggregates (form in collecting ducts) that can be deposisted anywhere in renal tract

92
Q

What is the % life time incidence of stones? Peak age and gender ratio?

A

15%, 20-40 years. Male:female 3:1

93
Q

What are risk factors for stones?

A

Dehydration, dietary factors (^chocolates, tea and rhubard). Drugs (loop, antacids, steroids, aspirin), UTIs.

94
Q

What pain do kidney stones cause?

A

loin

95
Q

What do ureteric stones cause?

A

renal colic

96
Q

Where do bladder and urethral stones cause pain?

A

Pain on micturition with interrupted flow.

97
Q

When scanning for stones

A

80% visible on KUB-xray. 99% visible on CT scan

98
Q

Stones

A

pass spontaneously within 48 hours, can take up to 30 days

99
Q

Stones >5mm or causing obstruction

A

may need intervention

100
Q

How common is renal cell carcinoma?

A

85% of all renal cancers

101
Q

Who is renal cell carcinoma common to?

A

50-70 years old, 2:1 male predominance

102
Q

What are the risk factors for renal cell carcinoma?

A

Smoking, obesity, hypertension, asbestos and hereditary conditions

103
Q

Define polycythaemia

A

Abnormal ^ conc of haemoglobin in blood (^plasma volume or ^RBCs)

104
Q

How to treat renal cell carcinoma?

A

Nephrectomy +/- chemo

105
Q

What are the most common benign and malignant conditions in the bladder?

A

Cystitis and transitional cell carcinomas

106
Q

What are the symptoms of transitional cell cancinoma (bladder)

A

Painless haematuria. Frequency urgency and dysuria.

107
Q

What tests are done for bladder carcinomas?

A

Urine for cytology and cystoscopy and biopsy

108
Q

How is early stage bladder carcinoma treated?

A

Diatheryl (high f electriacal currents -> stimulate circulation, reduce pain and destroy unhealthy cells. During cystoscopy

109
Q

How are later stages of bladder carcinoma treated?

A

Radical cystectomy or palliative chemo/radio

110
Q

What is the prostate?

A

Gland located at the base of bladder, (20gm). Helps in semen and spermatozoa secretion& maintenance

111
Q

What are the age and incidence of benign prostatic hyperplasia given?

A 
40s = 20%
60s = 70%
80s = 90%
112
Q

What can the prostate weigh with benign prostatic hyperplasia?

A

60-100gm

113
Q

Signs and symptoms of benign prostatic hyperplasia?

A

Same as lower urinary tract obstruction: ^frequency, hesitancy, nocturia, terminal dribbling. ^ infection risk. Enlarged prostate.

114
Q

Treatments for benign prostatic hyperplasia?

A

Alpha-blockers. If small/non symptoms then conservative, reduce fluid (night), alcohol and caffeine.

115
Q

What are the risk factors for prostate cancer?

A

Age, race(black men more common, Asian less common), family history, hormone levels, diet (^risk with ^fat consumption)

116
Q

Signs and symptoms of prostate cancer?

A

May be asymptomatic. Nocturia, hesitancy, poor stream and terminal dribbling. Hard irregular prostate

117
Q

How is prostate cancer diagnosed?

A

Raised PSA (prostate specific antigen), (normal in 30% of cases), biopsy.

118
Q

Treatment for prostate cancer?

A

Depends on:age, stage and comorbidities. If many comorbidities watch and wait may be option. Hormone therapy and radiot in advanced changes.

119
Q

Signs and symptoms for testicular torsion?

A

Sudden pair in 1 testis, pain in abdomen, N/V. Hot swollen and tender. May be high.

120
Q

What age range is testicular torsion more common?

A

11-30 years old

121
Q

How is testicular torsion tested for?

A

USS, doppler but may need exploratory surgery

122
Q

Treatment for testicular torsion?

A

Urgent surgery, bilateral fixation (orchidopexy) if still poss, if abnormal then orchidectomy

123
Q

What is the most common malignancy in males aged 15-44?

A

Testicular tumours

124
Q

What are the risk factors for testicular tumours?

A

Undescended testis, infant hernia and infertility

125
Q

Signs of testicular tumours?

A

Painless testicular lump noted after trauma or infection (doesn’t cause it just found after this)

126
Q

Can have germ cell tumours, most common is?

A

Seminoma

Pathology (25 decks)

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