Medical Issues Genitourinary and Gynecological Pathology Flashcards
S/S with renal/reproductive pathology
hematuria changes in urinary habits nipple discharge hypertension anemia sexual dysfunction menstrual irregularities pain
heamturia
blood in the urine
pseudohematuria
-change in urine color as a result of something you ingest
exertional hematuria
-increase in RBCs that show up in the urine after heavy exertion
-ex. marathon, swimmers
if it occurs after trauma it’s a medical emergency
changes in urinary habits
dysuria nocturia unusual urgency ncontinence oliguria anuria
nipple discharge
serous
sanguineous
serosanguineous
can indicate breast cancer or benign breast conditions (gland infection or hormonal imbalances)
kidneys and BP
dual control of BP
resistance exercise vs. endurance exercise
-resistance
–increase in both systolic and diastolic
-endurance
–slight increase in systolic
anemia
kidney pathology may affect the production of erythropoietin (hormone that regulates RBC production)
decrease in erythropoietin leads to decrease in
sexual dysfunction
impotence
painful intercouse
hemospermia
bleeding during intercourse or loss of libido
menstrual irregularities
amenorrhea
-primary: don’t begin menstruating (16 y/o)
-secondary: stops menstruating (3 or less times a year or 3 consecutive months
oligomenorrhea
-3-6 cycles per year
dysmenorrhea
-disabling pain with menstruation
pain referral patterns
kidney -lower back or abdomen -typically due to infection or trauma bladder -over bladder -refer to lower back or thighs possibly ureter -groin
male-specific pain referral patterns
prostate gland -refers to lower back, scrotum, or perineum -diffuse but centralized area testicular disease -focal -testicles or lower abdomen
female-specific pain referral patterns
uterus -lower back ovaries and fallopian tubes -lower abdomen and sacrum breast -chest and ipsilateral shoulder
medical history and physical examination
family and personal history inspection - edema in extremities (advanced kidney pathology) palpation other things to consider -age of first period -cycle length -sexually active
urinalysis
purpose
- general evaluation of health
- metabolic disorders or systemic disease
- endocrine disorders
- diabetes
- pregnancy
- drug screening
- specific gravity
- pH
- protein
- ketones
- nitrates
- trauma to kidneys
urinalysis methods
best method -clean catch mid stream urine -needs to be tested within the hour -catheter can be used - comes with risks testing -dipstick method -microscopic
urinalysis abnormal results
cloudy
foul smelling
fruity - diabetes, starvation, and dehydration
urinalysis abnormalities cont.
blood casts -small fibrous pieces -protein buildup crystals protein sugars
renal pathology and pathogenesis
S/S
- kidney trauma
- -direct blow to middle/lower back
- -tenderness ribs 10-12
- -blood in urine (emergency referral)
- -treated with meds. not surgery
- bladder and urethral trauma
- -more common in crashes than sports (bladder)
- -pain in lower abdomen
- -traumatic impact to the urethra
renal pathology and pathogenesis treatment and referral
gross observable blood in urine after a blow to the back or abdomen requires immediate referral
changes in urine or frequency requires referral
UTI’s
bacterial infection more common in sexually active females S/S -dysuria -increased frequency -scanty flow -back pain red flags -gross hematuria -abnormal vaginal bleeding -fever
UTI Tx and referral
urinalysis and referral is often needed need to determine cause before treatment -bacterial -fungal -parasite -yeast medications also include analgesics and antipruretics (anti-itching) cranberry juice
urolithiasis (kidney stones)
forms due to excess salt, calcium or uric acid in the kidney filtrate
when stones get big enough to block urine flow pain begins
not usually any trauma
pain in abdomen, lower back radiating to anterior thigh
vomiting, pallor, tachycardia and signs of shock
small stones treated with medication and good hydration to pass
large stones-fragmented with light sound or shock
proper diet/hydration decreases chances
prostate disorders
produce symptoms due to chronic or acute inflammation (prostatitis)
likelihood increases with age
most commonly due to infection, but cancer and urogenital disease as well
symptoms - dysuria, increased volume or frequency or urination and nocturia
dull ache in low back/scrotum
prostate cancer
S/S -no reliable S/S in early prostate cancer fatigue weight loss hematuria urinary retention urinary incontinence back pain Tx and RTP guidelines -radiaton and hormone therapy -radiation to metastasized areas as needed -RTP during treatment is okay if they feel well enough and no significant side effects
testicular torsion
spermatic cord twists, compressing veins and arteries to the testicles
S/S
-nausea and vomiting
-abdominal pain
-scrotal swelling
-tender testicle
-elevated bilaterally
Tx
-manual detorsion is successful 30-70% of the time
-6 hours from the onset of pain treatment will result in 80-100% salvage
12+ hours 0% salvage
hydrocele
fluid collection along the scrotal sac or along spermatic cord 6% of adult men asymptomatic possible aching/fullness RTP is not limited if asymptomatic
varicoceles
valves in the veins fail veins stretch, get bigger or become swollen feels like a "bag of worms" dull ache and heaviness in scrotum no participation risks
testicular cancer
S/S
-nodule in testicle is palpable
-unilateral testicular swelling
-pain in testicle
-rare occasions - breast tenderness and heaviness and aching in the scrotum
Tx
-removal of testicle and spermatic cord (orchiectomy)
-chemo and/or radiation therapy
-RTP si based on symptoms during treatment and physician orders
-wearing a cup is mandatory to protect remaining testicle
athlete recommendation
get a yearly exam
endometriosis
when endometrial tissue grows outside of the uterus between ages of 30-40 S/S -dysmenorrhea -increased discharge volume with menstruation -dysparenunia -dysuria -pain with bowel movements -back pain -leading cause of infertility Tx -hormone and pain therapy (progesterone) -occasionally surgical intevention
pregnancy
S/S
- unceplained weight gain
- recurring vomiting and nausea
- abdominal pain
- frequent urination
- hypertension
- breast enlargement
pregnancy facts
25-30 pounds are added during pregnancy
heart rate increases up to 15 bpm
hormone relaxin is secreted throughout pregnancy and makes patient more susceptible to injury
NCAA recommendations for the pregnant athlete
avoid supine positions no heavy weight lifting discourage valsalva maneuver no activities that involve risk of falling avoid contact sports after the 14th week no hot tubs/whirlpools no scuba diving if previous medical condition (diabetes, hypertension, cervical defects)
ruptured ectopic pregnancy
when ovum attaches outside uterus, usually in fallopian tube
normal signs of pregnancy
once large enough, tube ruptures causing severe hemorrhaging
low back pain, low quadrant tenderness, vaginal bleeding, syncope, and shock
baby will due no matter what
surgery is to save the mother
female athlete triad
amenorrhea (any menstrual irregularity), disordered eating (overall energy availability), and osteoporosis
pelvic inflammatory disarders
infection of the cervix, uterus, or fallopian tubes chlamydia and gonorrhea are the most common culprits S/S -abdominal pain -high-grade fever -nausea -abnormal vaginal discharge complications -infertility -ectopic pregnancy -chronic pelvic pain treatment -antibiotics
ovarian cysts
fibrous cysts or fluid filled sacs can form within urogenital system
may cause unusual bleeding or interference with menstrual cycle and estrogen production
if rupture cause internal hemorrhaging, abdominal pain, peritenosis, shock, and sometimes death
pediatric concerns
primary amenorrhea
kidney trauma
-more frequent than spleen or liver injuries because they are more highly exposed
-trauma should be screened for S/S of renal damage
cryptorchidism - “undescended testes”
-most common congenital abnormality
-associated risk with inguinal hernia
