Midterm 1

Question 1

Urinary Urgency

Answer 1

A sudden compelling urge to urinate, accompanied by bladder pn.
Classic symptom of UTI
**urgency without bladder pn may point to an UMNL

Question 2

Urinary Frequency

Answer 2

Increased incidence of the urge to void. Usually resulting from decreased bladder capacity, frequency is cardinal sign of UTI

Question 3

Dysuria

Answer 3

Painful or difficult urination. Often accompanied by urinary frequency, urgency, or hesitancy.
Usually reflects lower UT irritation or inflammation.
Pn just before voiding = bladder irritation or distention
Pn at the start of urination = bladder outlet irritation
Pn at the end = may signal bladder spasms

Question 4

Oliguria

Answer 4

Cardinal sign of renal and UT disorders.
Urinary output less than 400 ml per 24 hours
Causes:
Prerenal - decreased renal blood flow *reversible
Intrarenal - Intrinsic renal damage * more persistent
Postrenal - UT obstruction * reversible

Question 5

Anuria

Answer 5

Urine output less than 75 ml daily

Indicates either UT obstruction or acute renal failure

Question 6

Polyuria

Answer 6

Daily excretion and production of more than 2500 ml or urine.
Most commonly results from diuretics
Can reflect CNS dysfunction that diminishes or suppresses secretion of ADH which regulates fluid balance

Question 7

Hematuria

Answer 7

Abnormal presence of blood in the urine. Strict definition = 3 or more RBC per high power microscopic field in the urine.
Initial hematuria = uretheral pathology
Terminal hematuria = pathology of bladder neck, posterior urethra or prostate.
Total hematuria = bleeding throughout = pathology above bladder neck.

Question 8

Urine Cloudiness

Answer 8

Cloudy, murky, or turbid urine reflects the presence of bacteria, mucus , leukocytes, erythrocytes, epithelial cells, fat or phosphates (in alkaline urine)

Question 9

Flank Pain

Answer 9

Area extending from ribs to the ilium = leading indicator of renal and Upper urinary tract disease or trauma.
Aggravated by costovertebral angle percussion.

Question 10

Costovertebral Angle Tenderness

Answer 10

Indicates sudden distention of the renal capsule, almost always elicits dull, constant flank pain the CVA just lateral to the sacrospinalis muscle below the 12th rib. Pain typically travels anteriorly into the subcostal region.

Question 11

Urinary Hesitancy

Answer 11

Difficulty starting a urinary stream

Question 12

Urethral Discharge

Answer 12

Excretion from the urinary meatus that may be purulent, mucoid, or thin; sanguineous or clear; and scant or profuse. Usually develops suddenly most commonly in men with prostatic infection.

Question 13

Urinary Incontinence

Answer 13

Uncontrollable passage of urine, results from bladder abnormalities or neurological disorders.
May be transient or permanent, may involve large volumes of urine, or scant dribbling.

Question 14

Stress incontinence

Answer 14

Intermittent leakage, resulting from a sudden physical strain, such as a cough, sneeze, or quick movement

Question 15

Overflow incontinence

Answer 15

A dribble resulting from urinary retention, which fills the bladder and prevents it from contracting with sufficient force to expel a urinary stream

Question 16

Urge Incontinence

Answer 16

Refers to the inability to suppress a sudden urge to urinate.

Question 17

Total incontintence

Answer 17

Continuous leakage resulting from the bladder’s inability to retain any urine.

Question 18

Bladder distention

Answer 18

The abnormal enlargement of the bladder results from an inability to excrete urine, causing its accumulation. Distention can result from mechanical and anatomic obstructions, neuromuscular disorders and drugs.
Typically occurs gradually which usually remains asymptomatic until stretching of the bladder produces discomfort.

Question 19

Nocturia

Answer 19

Excessive urination at night - may result from disruption of the normal diurnal pattern of urine concentration or from overstimulation of the nerves and muscles that control urination.

Question 20

Enuresis

Answer 20

Usually, refers to nighttime urinary incontinence in a girl over age 5 or boy over age 6.
Primary = child who has never achieved bladder control
Secondary = child who achieved bladder control for at least 3 months but has lost it.

Question 21

Uremic frost

Answer 21

A fine white powder believe to be rate crystals, that covers the skin, is a characteristic sign of end-stage renal failure, or uraemia. Urea and other waste substances that can’t be excreted by the kidneys in urine are excreted in sweat, and remain as powedery deposits on the skin when the sweat evaporates.

Question 22

Ammonia Breath Odour

Answer 22

Described as ruinous or fishy breath - typically occurs in end-stage chronic renal failure. Reflects the long-term metabolic disturbances and biochemical abnormalities associated with uraemia and end-stage chronic renal failure.