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CHI 335 > Lecture 9 Genitourinary > Flashcards

Lecture 9 Genitourinary Flashcards

1
Q

Give me 4 organs of urinary system.

A
  1. Kidneys
  2. Ureters
  3. Urinary Bladder
  4. Urethra

Nephrons are the function units of the kidney.

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2
Q

Give me 3 indication of urine inspection.

A
  1. Colour
  2. Clarity
  3. Odour
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3
Q

Give me 7 urine investigation.

A
  1. Measuring GFR
    (GFR = indication of renal function)
  2. Urinalysis
  3. Concomitant blood test
  4. Imaging
  5. Endoscopy
  6. Renal biopsy
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4
Q

Give me 3 urine analysis.

A
  1. Macroscopic (Color and Clarity)
  2. Biochemical (pH, protein, glucose, ketones, nitrite, leukocyte)
  3. Microscopic (crystals, casts, squamous cells, WBC, RBC, bacteria )
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5
Q

Dipstick test.

A

Refer to the lecture

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6
Q

What is Acute tubular necrosis (ATN) (急性腎小管壞死)

A

Death of a significant number if tubule epithelial cells –> alters reabsorption and secretion –> leads to kidney impairment –> acute renal failure

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7
Q

Give me 4 Potential risk of ATN.

A
  1. renal ischemia
  2. Toxic chemical damage
  3. Immune attack
  4. Sepsis
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8
Q

What is Acute Renal Failure (ARF) ?

A

Sudden loss of kidney function

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9
Q

Give me 3 causes of acute renal failure (ARF).

A
  1. Pre-renal causes
  2. Intrarenal causes
  3. Postrenal causes
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10
Q

What is Pre-renal ARF?

A

Associate with alterations in renal blood flow.
1. Renal blood supply/ flow decrease / disruption –> tubular necrosis –> ARF
2. Occur in up stream of kidney
3. cause of kidney low perfusion

3.1 Trauma or major surgery
3.2 Heart disease with decrease cardiac output
3.3 Hypotension of any causes
3.4 Stenosis of renal arteries
3.5 Occlusion of small blood vessels with the kidney

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11
Q

What is Intrarenal ARF?

A

Associate with damage to kidney

Affect nephrons themselves as a result of diseases.

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12
Q

Give me 4 diseases of Intrarenal ARF.

A
  1. Glomerular disease
  2. Medullary disease
  3. Immune hypersensityivity disorder
  4. Toxic chemicals
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13
Q

Give me 3 common cause of Post-renal ARF.

A
  1. Nephrolithiasis
  2. Benign prostatic hyperplasia
  3. Tumor
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14
Q

Give me 3 manifestations of ARF.

A
  1. Oliguria/ Anuria: Sudden drop or a complete cessation of urine production
  2. Anzotaemia: Raise level of nitrogenous waste compounds and creatine in the blood
    3.Ureamia
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15
Q

Give me 6 general Sign and symptom of ARF.

A
  1. HTN
  2. Oedema
  3. Hyperkalaemia
  4. Malaise
  5. Anorexia, weight loss
  6. Pruritus
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16
Q

Give me 2 long standing disease affecting the kidney.

A
  1. Chronic glomerular disease
  2. Chronic medullary disease
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17
Q

Give me 3 chronic renal failure associate with.

A
  1. DM
  2. Hypertension
  3. Polycystic kidney disease
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18
Q

What is Chronic renal failure?

A
  1. End-stage renal disease.
  2. From long-term progressive and permanent loss of nephrons.
  3. More than 80% loss of nephron function
  4. No possibility of nephron recovery
  5. Regular dialysis or kidney transplant
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19
Q

What is Glomerulonephritis (GN)?

A
  1. Inflammation of glomeruli
  2. Glomerular injury
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20
Q

How to classified Glomerulonephritis based on histopathological appearances?

A

Renal biopsy

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21
Q

Give me 4 S&S of Nephritic Syndrome (腎炎綜合徵)

A
  1. Haematuria
  2. Oliguria, oedema
  3. Azotaemia
  4. Hypertension
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22
Q

Give me 4 S&S of Nephrotic Syndrome. (腎病症候群).)

A
  1. Massive proteinuria
  2. Hypoalbuminaemia
  3. Oedema
  4. Hyperlipidaemia
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23
Q

What is IgA nephropathy?

A
  1. Most common type of GN
  2. Most common in 2nd and 3rd decade and males.
  3. Frequently preceded by an URTI or GI infection.
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24
Q

Give me 2 signs and symptoms of IgA nephropathy.

A
  1. Haematuria is main and earliest sign.
  2. HTN
  3. Proteinuria is a late feature
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25
Q

Give me possible management of IgA nephropathy.

A
  1. No specific treatment
  2. Control blood pressure to prevent or decelerate progressive renal disease.
  3. High dose corticosteroid
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26
Q

What is Post-streptococcal GN?

A
  1. Most common type of post- infection GN.
  2. Most common in children
  3. Follows a streptococcal infection (Sore throat, skin infection, otitis media)
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27
Q

Give me 5 management of Post- Streptococcal GN.

A
  1. Fluid and salt restriction
  2. Antihypertensives
  3. Diuretics
  4. Dialysis if necessary
  5. Corticosteroid may help
28
Q

What is Urinary Tract Infection?

A

Use to describe acute urethritis or prostatitis or cystitis or pyelonephritis.

29
Q
  1. Usually slight or no systemic symptoms.
  2. Common in female
  3. Dysuria
  4. Frequency and urgency
  5. Suprapubic pain during and after voiding (urining)
  6. Cloudy urine may have an unpleasent odour(Smell)
  7. Microscopic or visible haematuria
  8. Back pain and costovertebral angle tenderness

What is the disease

A

Urinary Tract Infection

30
Q

Give me couple of Urinary tract infection risk factor.

A
  1. Bladder outflow obstruction:
    benign prostatic enlargement
    Prostate cancer
    Urethral stricture
    Vesico-urecteric reflux
  2. Uterine Prolapse
  3. Neurological problems
    Multiple sclerosis
    Spinal bifida
    Diabetic neuropathy
  4. Foreign Bodies
    Urethral catheter or ureteric stent
    Urothiasis
  5. Loss of host defences
    Atrophic urethritis and vaginitis in post-menopausal women
    Diabetes mellitus
31
Q

Give me 4 investigation of UTI.

A
  1. Presence or absence of pyuria
  2. Presence or absence of nitrite
  3. Haematuria
  4. Urine culture and microscopy
32
Q

Give me 4 investigation of UTI.

A
  1. Presence or absence of pyuria
  2. Presence or absence of nitrite
  3. Haematuria
  4. Urine culture and microscopy
33
Q

Acute infection hat ascend from lower urinary tract or rarely spread haematogenously to the kidneys.
What is the disease?

A

Acute Pyelonephritis

34
Q

Give me 7 systemic symptoms of acute pyelonephritis.

A
  1. Loin pain
  2. Tenderness over the kidney
  3. Fever
  4. Rigors
  5. Vomiting
  6. Hypotension
  7. Guarding
35
Q

Give me 3 treatment of urinary tract infection.

A
  1. Antimicrobial agents
  2. Fluid intake at least 2 L/ day
  3. Asymptomatic bacteriuria must be treated (In pregnancy)
36
Q

Give me 5 checks for semen analysis.

A
  1. Volume
  2. Sperm number
  3. Sperm motility
  4. Sperm morphology
37
Q

Give me 5 pertinent investigation for reproductive system.

A
  1. Hormone level
  2. Semen analysis
  3. Prostate specific antigen
  4. Breast examination
  5. Cervical screening test
38
Q

A protein secreted by the epithelial cells if the prostate gland which could be traced in the blood.
What is it?

A

Prostate specific antigen.

39
Q

What is PSA <4 ng/ml mean?

A

Normal

40
Q

What is PSA 4-10 ng/ml mean?

A
  1. Benign hypertrophy or cancer
  2. Trauma to the prostate
  3. DRE and sex
41
Q

What is PSA> 10 ng/ml mean?

A

A prostatic biopsy will show cancer in over 50% of cases.

42
Q

Give me 5 breast examination.

A
  1. CBE
  2. BSE
  3. Screening mammography
  4. US
  5. FNABx
43
Q

Give me 5 examples of STI. (Reproductive system)

A
  1. Chlamydial infection
  2. Genital herpes
  3. Gnorrhoea
  4. Anogenital wart (HPV)
  5. Syphilis
44
Q

Most common STDs in the world.
Usually asymptomatic in both men (50%) and women (80%).
What is the disease?

A

Chlamydial infection

45
Q

Give me 5 diagnostic factors of Chlamydial infection.

A
  1. Asymptomatic (Vaginal/Penile swab, urine analysis, antigen)
  2. Dysuria
  3. Penile / vaginal discharge
  4. Lower abdominal/ pelvic pain
  5. Post-coital or intermenstrual bleeding
46
Q

Give me 4 management of Chlamydial infection.

A
  1. Eradicate infection and follow up on sexual contacts.
  2. Delay in treatment increase risk of infertility.
  3. Antibiotic therapy
  4. Treatment failures are uncommon
47
Q

Give me 5 complications of Chlamydial infection.

A
  1. Salpingitis
  2. Epididymo-orchitis
  3. Reactive arthritis
  4. Pelvic inflammatory disease
  5. Ophthalmia neoinatorum
48
Q

Herpes simplex virus: HSV-1 oral or HSV-2 genital
Transmission: vaginal , anal, oro-genital or oro-anal
Virus remains latent in the body
What is the disease?

A

Genital herpes

49
Q

Give me 2 prevention of genital herpes.

A
  1. Avoid sexual contact
  2. use condom
50
Q

Give me 6 diagnostic factors of genital herpes.

A
  1. Fever, malaise, headache
  2. Tingling/ Itching
  3. Painful genital/ Oral ulcers
  4. Inguinal lymphadenopathy
  5. Dysuria
  6. Meningitis/ encephalitis
51
Q

Give me 3 management of Genital herpes.

A
  1. Topical antivirals
  2. Antiviral therapy
  3. Reduce contact when lesion are present.
52
Q

Genotypes: HPV-6, HPV-11, HPV-16, HPV-18.
Last two have strong associated with genital carcinomas.
Skin to skin transmission.
Lesion size range from a few millimeters to several centimeters.
Lesion typically appear within weeks to months after exposure.
Rarely can be transmitted during oral sex.
What is the disease?

A

Anogenital warts — HPV

53
Q

Give me 4 prevention of Anogenital warts — HPV.

A
  1. Abstinence
  2. Barrier methods such as condom
  3. Vaccine
  4. Male circumcision may protect against HPV infection.
54
Q

Give me 3 management of Anogenital —HPV.

A
  1. No cure
  2. Resolve spontaneously
  3. Removal of visible warts
55
Q

Benign enlargement of the prostate gland.
Unknown aetiology.
Hyperplasia of the glandular and connective tissues.
Enlargement stretches, compress and distorts the urethra hence obstructing bladder outflow.
What is the disease?

A

BPH (良性前列腺增生)

56
Q

Give me a stronger risk factor of BPH.

A

Age which older than 50 years old.

57
Q

Give me some weak risk factor of BPH.

A
  1. FHx
  2. Non asian face
  3. Smoking
  4. Male pattern baldness
  5. Metabolic syndrome
58
Q

Give me 2 common diagnostic factors of BPH.

A
  1. Storage symptom
  2. Voiding symptom
59
Q

Give me 1 uncommon diagnostic factors of BPH.

A

Fever with dysuria

60
Q

Give me 2 test of BPH.

A
  1. Urinalysis
  2. PSA
61
Q

Give me 4 diagnosis of BPH.

A
  1. Age and clinical presentation
  2. Digital rectal exam
  3. PSA
  4. MRI/US
62
Q

Give me 3 management of BPH.

A
  1. Mild to moderate symptoms
    1.1 watchful waiting
    1.2 medication
  2. Acute urinary retention
  3. Surgery
63
Q

Presence of endometrial tissue outside the urine cavity.
Tissue embedded on the serosal aspect of organs.
Common in age 20-45 and in nulliparous women.
Cyclical engorgement and inflammation.
What is the disease?

A

Endometriosis (子宮內膜異位症)

64
Q

Give me 8 S&S of endometriosis.

A
  1. Asymptomatic ⭐️
  2. Pain (Lower abdominal, pelvic, low back pain) ⭐️
  3. Heavy or irregular bleeding and dysmenorrhea
  4. Dyspareunia (性交困難)
  5. Dyschezia (排便障礙)
  6. Bloating, nausea and vomiting
  7. Pain on micturition and/or urinary frequency ⭐️
  8. Pain during exercise ⭐️
65
Q

Menstruating woman <25
Has multiple sex partners.
Not use protection.
Living in an area of high prevalence of STIs.
What is the disease?

A

Pelvic inflammatory disease.

66
Q

Give me 5 toxic symptom of PID.

A
  1. Fever, nausea, vomiting
  2. Severe pelvic pain
  3. lower abdominal pain
  4. Abnormal vaginal discharge
  5. Unanticipated vaginal bleeding, often postcoital (性交後)

CHI 335 (8 decks)

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