Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Genitourinary > Phase II - GU > Flashcards

Phase II - GU Flashcards

1
Q

What might dysuria suggest?

A

Inflammation.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Give 3 causes of nocturnal polyuria.

A
  1. Habitual.
  2. Congestive cardiac failure.
  3. Sleep apnea.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Give a surgical treatment for BPE.

A

TURP.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What nerve fibres do cavernous nerves carry?

A

Parasympathetic: S2-4.
Sympathetic: T11-L2.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Describe the physiology of an erection.

A
  1. Parasympathetic stimulation.
  2. Arteriolar dilation.
  3. Smooth muscle relaxation.
  4. Testosterone.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What chemical compound is responsible for the smooth muscle relaxation that is required for an erection?

A

Nitric oxide (NO). It causes a fall in cytoplasmic calcium -> smooth muscle relaxation.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are the 2 main causes of erectile dysfunction?

A
  1. Organic e.g. vasculogenic, neurogenic, hormonal, anatomical.
  2. Psychogenic.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Give 3 characteristics of psychogenic erectile dysfunction.

A
  1. Sudden.
  2. Situational.
  3. Younger males affected.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Give 4 risk factors for erectile dysfunction.

A
  1. Obesity.
  2. Lack of exercise.
  3. Smoking.
  4. Diabetes mellitus.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is the non-pharmacological management of erectile dysfunction?

A
  1. Lose weight, stop smoking.

2. Education and counselling of patient and partner.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is the first line pharmacological management of erectile dysfunction?

A

Phosphodiesterase inhibitors e.g. viagra, cialis. They cause vasodilation and so increase arterial blood flow to the penis.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is the second line pharmacological management of erectile dysfunction?

A
  1. Intracavernous injections.

2. Vacuum devices.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is the third line pharmacological management of erectile dysfunction?

A

Penile prosthesis implantation.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is priapism?

A

Prolonged erection, lasting for >4 hours.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is a potential consequence of priapism?

A

Permanent ischaemic damage.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Give 5 functions of the kidney.

A
  1. Filters and excretes waste products from the blood.
  2. Regulates BP.
  3. Retains albumin.
  4. Reabsorption of Na, Cl, K, glucose, H2O, amino acids.
  5. Synthesises EPO.
  6. Converts 1-hydroxyvitaminD to 1,25-dihydroxyvitaminD.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Write an equation for GFR.

A

(Um X urine flow rate) / Pm.

  • Um = concentration of marker substance in urine.
  • Pm = concentration of marker substance in plasma.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What would you expect a typical GFR to be?

A

120ml/min.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Give an example of a marker substance used for estimating GFR.

A

Creatinine.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Estimating GFR: Give 3 essential features of a marker substance.

A
  1. Not metabolised.
  2. Freely filtered.
  3. Not reabsorbed/secreted.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Name a drug that can inhibit creatinine secretion. What is the affect of this on GFR?

A

Trimethoprim.

Serum creatinine rises and so kidney function (GFR) appears worse.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What is the affect on GFR of afferent arteriole vasoconstriction?

A

Decreased GFR.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What is the affect on GFR of efferent arteriole vasoconstriction?

A

Increased GFR.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Where in the nephron does the bulk of reabsorption occur?

A

At the proximal convoluted tubule.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What 7 things are reabsorbed at the PCT?

A
  1. Sodium.
  2. Chlorine.
  3. Potassium.
  4. Glucose.
  5. Water.
  6. Amino acids.
  7. Bicarbonate.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What is Fanconi syndrome?

A

Failure of the nephron to reabsorb essential ions. Sugar, amino acids and bicarbonate are therefore present in the urine.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Give 2 signs of Fanconi syndrome.

A
  1. Sugar in the urine.
  2. Acidotic due to bicarbonate in the urine.
  3. Rickets/osteomalacia.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Give 2 causes of Fanconi syndrome.

A
  1. Myeloma.

2. Cystinosis.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

What is the function of the counter current multiplication system?

A

It generates a hypertonic medullary interstitium for H2O reabsorption. Na+ moves out of the ascending limb which increases the medullary osmolality, H2O follows.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Which part of the loop of henle is permeable to H2O?

A

The descending limb is permeable to H2O.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Describe tubuloglomerular feedback.

A

Macula densa cells of the DCT lie between the AA and EA. They detect NaCl and use this as an indicator of GFR.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Macula densa cells detect a raised NaCl. What is the response?

A

AA constriction.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Macula densa cells detect a reduced NaCl. What is the response?

A

Renin secretion.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

What 2 cell types are found in the nephron collecting duct?

A

Principal and intercalated cells.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

What hormone is responsible for regulating sodium reabsorption?

A

Aldosterone.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Why might aldosterone secretion lead to hypokalaemia?

A

Aldosterone secretion leads to increased sodium reabsorption. Sodium reabsorption leads to increased potassium secretion and therefore hypokalaemia.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

What is the affect of NSAIDs on the afferent arteriole of glomeruli?

A

NSAIDs inhibit prostaglandins and so lead to AA vasoconstriction = reduced GFR.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

NSAIDs lead to a reduced GFR. Why?

A

NSAIDs inhibit prostaglandins and so lead to afferent arteriole vasoconstriction -> reduced GFR.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

What is the affect of ACEi on the efferent arteriole of glomeruli?

A

ACEi cause EA vasodilation = reduced GFR.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

Name 2 factors that govern renal potassium.

A
  1. Na+.

2. Aldosterone.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

What ion is responsible for volume control?

A

Sodium!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

Name 2 hormones that increase sodium reabsorption.

A
  1. Aldosterone.

2. Angiotensin 2.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

Name a hormone that decreases sodium reabsorption.

A

ANP.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

What is the function of EPO?

A

It stimulates the bone marrow -> RBC maturation.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

Give 2 functions of calcitriol.

A
  1. Increased calcium and phosphate absorption from the gut.

2. Suppression of PTH.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

What triggers PTH secretion?

A

Low serum calcium.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

Give 3 ways in which PTH increases serum calcium.

A
  1. Increased bone resorption.
  2. Increased reabsorption of calcium at the kidneys.
  3. Stimulates 1-hydroxylase -> 1,25-dihydroxyvitaminD -> increased calcium absorption from the intestine.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

Name 2 hormones secreted from the posterior pituitary gland.

A
  1. ADH.

2. Oxytocin.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

Describe the function of ADH.

A

ADH acts on the collecting ducts. It increases insertion of aquaporin 2 channels leading to H2O retention.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

Give 3 factors that stimulate renin release.

A
  1. Sympathetic stimulation.
  2. Decreased BP.
  3. Decreased Na detected by macula densa.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

Give 3 functions of ANP.

A
  1. Renal vasodilator.
  2. Inhibits aldosterone.
  3. Closes ENaC (decreased reabsorption of Na+).
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

Where on the nephron does aldosterone act?

A

On the collecting ducts.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

Describe aldosterone action.

A

Aldosterone acts on the collecting ducts. It increases ENaC and H+/K+ pumps. There is increased Na+ absorption and K+ secretion -> H20 retention -> increased BP.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

Define urinary tract infection.

A

Inflammatory response of the urothelium to bacterial invasion, usually associated with bacteriruria and pyuria.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

Name 2 groups of people that you would treat for bacteriuria?

A
  • Pregnant ladies.

- Children.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

What is septic shock?

A

Severe sepsis with persistent hypotension.

57
Q

Describe the pathophysiology of urosepsis.

A 
A symptomatic UTI combined with >1 of:
1. Microbial resistance.
2. Immunosuppression.
3. Pressure.
= UROSEPSIS!
58
Q

What can cause raised urinary tract pressure?

A
  1. Stone in lumen of UUT.
  2. Tumour in the wall.
  3. LUT outflow obstruction: BPH, tumour, stone.
  4. Bladder dysfunction.
59
Q

Give 4 causes of urinary tract colonisation.

A
  1. Diseases that require steroids or chemo e.g. diabetes, immunodeficiency.
  2. Stones or tumour in the lumen of the urinary tract.
  3. Poor bladder emptying.
  4. Catheterisation.
60
Q

Describe the treatment for sepsis.

A

The sepsis 6:

  1. Give high flow oxygen.
  2. Take blood cultures.
  3. Give IV abx.
  4. Give IV fluids.
  5. Check lactate.
  6. Monitor hourly urine output.

Also drainage to relieve pressure!

61
Q

Name the classification that helps differentiate between benign cystic lesions and cancerous cystic lesions.

A

The Bozniak classification.

62
Q

A patient presents with haematuria. A MSU sample is taken and a blood film is done. The RBC’s look dysmorphic. Where in the urinary tract is the problem likely to be?

A

Dysmoprhic RBC’s signify a glomerular origin.

If the RBC’s looked normal the problem is likely to be with the LUT.

63
Q

Give 5 causes of haematuria.

A
  1. Kidney tumour, trauma, stones, cysts.
  2. Ureteric stones or tumour.
  3. Bladder infection, stones or tumour.
  4. BPH or prostate cancer.
64
Q

What further investigations might you do in someone who presents with haematuria?

A
  1. Urinalysis.
  2. Urine cytology.
  3. Abdomen US.
  4. Abdomen CT.
  5. Cystoscopy.
65
Q

Describe the fluid distribution in the body.

A

ICF: 28L.
ECF: 14L
- Interstitial: 11L.
- Plasma: 3L.

Total body water: 42L.

66
Q

How much extra-vascular fluid is there in the body?

A

ICF + interstitial = 39L.

67
Q

How much intra-vascular fluid is there in the body?

A

Plasma: 3L.

68
Q

What happens to the heart rate in hypovolaemia?

A

Increases - tachycardia.

69
Q

What happens to the blood pressure in hypovolaemia?

A

Decreases - hypotension.

70
Q

What happens to the JVP in hypovolaemia?

A

JVP is low.

71
Q

What happens to tissue turgor in hypovolaemia?

A

Tissue turgor is reduced.

72
Q

What happens to urine output in hypovolaemia?

A

Urine output is reduced.

73
Q

What happens to weight in hypovolaemia?

A

Weight is reduced.

74
Q

Give 2 symptoms of hypovolaemia.

A

Thirst and dizziness.

75
Q

What happens to creatinine, haemoglobin and haematocrit levels in hypovolaemia?

A

They are raised.

76
Q

Name 5 groups of people who are at risk of hypovolaemia.

A
  1. Elderly.
  2. Those who have had an ileostomy.
  3. People with short bowel syndrome.
  4. Bowel obstruction.
  5. People taking diuretics.
77
Q

Name 5 groups of people who are at risk of hypervolaemia.

A
  1. Acute kidney injury patients.
  2. CKD patients.
  3. Heart failure patients.
  4. Liver failure patients.
78
Q

What happens to the heart rate in hypervolaemia?

A

HR is normal.

79
Q

What happens to blood pressure in hypervolaemia?

A

Blood pressure is high or normal.

80
Q

What happens to JVP in hypervolaemia?

A

JVP is high.

81
Q

What happens to tissue turgor in hypervolaemia?

A

Tissue turgor is normal.

82
Q

What happens to urine output in hypervolaemia?

A

Urine output is normal.

83
Q

What happens to weight in hypervolaemia?

A

Weight is increased.

84
Q

Give 2 symptoms of hypervolaemia.

A
  1. Shortness of breath.

2. Peripheral oedema.

85
Q

What happens to creatinine, haemoglobin and haematocrit levels in hypervolaemia?

A

They are reduced.

86
Q

Where might fluid accumulate in someone with hypervolaemia?

A
  • Pulmonary oedema.
  • Pleural effusion.
  • Ascites.
  • Bowel obstruction.
  • Intra-abdominal collection.
87
Q

Describe the management for hypovolaemia.

A
  1. Oral fluid.
  2. IV fluid if very ill.
  3. Treat reversible causes.
88
Q

Describe the management for hypervolaemia.

A
  1. Diuretics e.g. furosemide.
  2. Fluid restriction.
  3. Treat reversible causes.
89
Q

Name 3 isotonic solutions.

A
  1. 5% dextrose.
  2. 0.9% NaCl.
  3. Hartmann’s solution.
90
Q

What type of IV fluid moves from the intra-vascular to the extra-vascular space?

A

Crystalloid.

Small molecules pass through cell membranes and so move from the intra-vascular to extra-vascular space.

91
Q

Give an example of a colloid IV fluid.

A

Gelofusine.

92
Q

Give 3 potential causes of rising creatinine.

A
  1. Too aggressive with diuretics.
  2. Extravascular hypervolaemia but intravascular hypovolaemia.
  3. Progression of CKD.
93
Q

Describe the pathophysiology of congenital polycystic kidney disease.

A

Genetic mutation -> predisposition to cyst development -> cell proliferation and loss of planar polarity -> fluid secretion and cyst expansion.

94
Q

Describe the pathophysiology of acquired polycystic kidney disease.

A

Cysts develop over time.

Renal injury/ischaemia -> abnormal cell proliferation.

95
Q

What classification can be used to help differentiate between benign cystic lesions and cancerous lesions?

A

Bozniak classification.

96
Q

Give 4 congenital causes of renal cysts.

A
  1. ADPKD.
  2. ARPKD.
  3. VHL.
  4. OFD1 (oral-facial-digital syndrome 1).
97
Q

A mutation in what gene can cause ARPKD?

A

PKHD1.

98
Q

Give 4 features of acquired renal cystic disease.

A
  1. No genetic mutation.
  2. No family history.
  3. Normal kidney size.
  4. Risk factor for renal cell carcinoma.
99
Q

What is the access point in haemodialysis?

A

AV fistula.

100
Q

Why might someone having haemodialysis have a PFTE graft as opposed to an AV fistula?

A

If the patient has atherosclerotic veins or has had previous fistulas they may have a PFTE graft or a catheter tunnelled into the RA.

101
Q

Give examples of waste products that are removed from the blood in dialysis.

A
  1. Urea.
  2. Creatinine.
  3. Potassium.
  4. Phosphate.
102
Q

How many times a week and for how long does someone have hospital haemodialysis for?

A

3-5 hours, 3 times a week.

103
Q

How many times a week and for how long does someone have home haemodialysis for?

A

2-3 hours, 4-5 times a week.

104
Q

Why can someone on home haemodialysis take fewer tablets and have less dietary restrictions compared to someone on hospital haemodialysis?

A

Patients doing home haemodialysis dialyse more frequently and so can have less restriction on their diet.

105
Q

Give 5 potential complications of haemodialysis.

A
  1. Hypotension.
  2. Cramps.
  3. Nausea.
  4. Chest pain.
  5. Fever.
  6. Blocked or infected dialysis catheter.
106
Q

Give 3 groups of people who haemodialysis is good for.

A
  1. People who live alone/frail/elderly.
  2. People who fear operating machines.
  3. People who are unsuitable for PD e.g. previous abdominal surgery, abdominal hernia etc.
107
Q

What is the access point in peritoneal dialysis?

A

A peritoneal catheter is placed into the peritoneal cavity through a SC tunnel.

108
Q

How often does someone have to do CAPD?

A

30-40 minute exchanges, 3-5 times a day.

109
Q

How often does someone have to do APD?

A

One exchange overnight (8 hours).

110
Q

Give 4 potential complications of peritoneal dialysis.

A
  1. Infection e.g. peritonitis/catheter exit site infection.
  2. Peri-catheter leak.
  3. Abdominal wall herniation.
  4. Intestinal perforation.
111
Q

Give 3 groups of people who peritoneal dialysis is good for.

A
  1. Young people/those in full time work.
  2. People who want control/responsibility of their care.
  3. People with severe HF.
112
Q

Where in the abdomen does a transplanted kidney lie?

A

In the iliac fossa.

113
Q

Describe the criteria for selection of a living donor for kidney transplant.

A
  1. Blood relative.
  2. ABO blood group compatible.
  3. HLA identical.
  4. Excellent medical condition and normal renal function.
114
Q

Name 3 medical conditions that can exclude living kidney donation.

A
  1. Renal parenchymal disease.
  2. History of stones/frequent UTI/hypertension/DM.
  3. Recent malignancy.
115
Q

Describe the criteria for selection of a cadaver donor for kidney transplant.

A
  1. Irreversible brain damage.
  2. Normal renal function.
  3. No evidence of pre-existing renal disease or transmissible disease.
  4. ABO compatible and best HLA possible.
116
Q

What tests can be done to evaluate kidney function in a potential kidney donor?

A
  1. Serum creatinine.
  2. Creatinine clearance.
  3. Urinalysis.
  4. Urine culture.
  5. GFR.
117
Q

Give 5 contraindications for renal transplant.

A
  1. ABO incompatibility.
  2. Cytotoxic Ab’s against HLA antigens.
  3. Recent malignancy.
  4. Active infection.
  5. AIDS.
  6. Morbid obesity.
  7. Age > 70 y/o.
118
Q

Give 3 ways in which recipient and donor matching is assessed.

A
  1. HLA tissue typing (important to match DR antigens).
  2. Lymphocytotoxic cross matching; checks there are no preformed antibodies against HLA antigens.
  3. ABO blood group compatibility.
119
Q

Give 4 factors that can influence the longevity of renal allograft.

A
  1. Age.
  2. HLA matching.
  3. Ischaemia time.
  4. Number of acute rejection episodes.
  5. Ethnicity.
120
Q

What are the 2 major causes of allograft failure?

A
  1. Chronic rejection.

2. Death with functioning graft.

121
Q

What are the 2 major causes of death after kidney transplant?

A
  1. CV disease.

2. Infection.

122
Q

Name the 3 types of renal allograft rejection.

A
  1. Hyper-acute.
  2. Acute.
  3. Chronic.
123
Q

Describe hyper-acute renal allograft rejection.

A

Preformed antibodies against HLA antigens of donor organ.

124
Q

Why might someone have pre-formed antibodies against HLA antigens?

A

Can be a consequence of blood transfusion, pregnancy, prior transplant, auto-immune disease.

125
Q

What can cause immediate graft loss?

A

Fibrinoid necrosis.

126
Q

Describe acute renal allograft rejection.

A

Activated T lymphocytes. Occurs within the first 6 months but is often reversible e.g. with steroids.

127
Q

Describe chronic renal allograft rejection.

A

Slow and gradual decline in renal function, accompanied by proteinuria.

128
Q

What criteria can be used to diagnose allograft rejection?

A

Banff criteria.

129
Q

Give 3 consequences of chronic immunosuppression.

A
  1. Malignancy.
  2. Infection.
  3. SE’s of other drugs.
130
Q

Give 3 consequences of glomerulonephritis (glomerular disease).

A
  1. Leaky glomeruli -> haematuria and proteinuria.
  2. High BP.
  3. Deteriorating kidney function.
131
Q

Briefly describe the pathophysiology of glomerulonephritis (glomerular disease).

A

Immunologically mediated: immunoglobulin deposits and inflammatory cells.

132
Q

Name a loop diuretic.

A

Furosemide - acts on Na+/K+/2Cl- transporter (NKCC2).

133
Q

Give 3 potential side effects of furosemide.

A
  1. Hypokalaemia.
  2. Hypotension.
  3. Dehydration.
134
Q

What other drug might you prescribe with furosemide in someone with poorly controlled potassium?

A

A potassium sparing diuretic e.g. spironolactone. These work on RAAS (hormonal systems) as opposed to ion channels and should help control potassium levels in the blood.

135
Q

Name a potassium sparing diuretic.

A

Spironolactone.

136
Q

On which part of the nephron do thiazides act?

A

The distal tubule.

Act on NCC channels.

137
Q

A 50 y/o M presents with haematuria. On examination he has HTN, increased serum Cr and urea, proteinuria and bilateral palpable costo-vertebral angle masses. You take a family history and find out that his dad died of a sub-arachnoid haemorrhage. What is the most likely diagnosis?

A

ADPKD.

  • Normally people present around 50 y/o.
  • Raised creatinine and urea indicate a kidney problem.
  • The kidneys can be HUGE in ADPKD hence the palpable masses.
  • Intracranial haemorrhages are an extra-renal manifestation of ADPKD.
138
Q

What is the most common renal cancer in children?

A

Wilms tumour.

139
Q

What drug must you not give to someone with renal artery stenosis?

A

ACE inhibitors e.g. ramipril.

Genitourinary (17 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions