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Urology > Presentation of Diseases of the Kidney and Urinary Tract > Flashcards

Presentation of Diseases of the Kidney and Urinary Tract Flashcards

1
Q

What is the most important muscle of the bladder?

A

Detrusor muscle

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2
Q

What is the innervation of the bladder?

A

Both sympathetic and parasympathetic

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3
Q

What innervation causes contraction of the bladder?

A

Parasymp.

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4
Q

Describe the bladder outflow tract

A 
Bladder neck 
Prostate 
External urethral sphincter 
Urethra
Urethral meatus 
Foreskin
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5
Q

What is typical presentation of renal disease?

A 
Pain 
Pyrexia 
Haematuria 
Proteinuria 
Pyruria  
Mass on palpation 
Renal failure
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6
Q

What is defined as oliguria?

A

Urine output <0.5ml/kg/hour

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7
Q

What is defined as anuria?

A

No urine output

<100ml in 24 hours

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8
Q

What is defined as polyuria?

A

Urine output >3L/24 hrs

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9
Q

What is defined as nocturia/

A

Waking up at night >1 to pee

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10
Q

What is defined as nocturnal polyuria?

A

Nocturnal urine output is >1/3 of total urine output for 24 hrs

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11
Q

Describe the RIFLE staging criteria for AKI?

A

.Risk - Increase in serum creatinine level (1.5x) or decrease in GFR by 25%, or UO <0.5 mL/kg/h for 6 hours

  1. Injury - Increase in serum creatinine level (2.0x) or decrease in GFR by 50%, or UO <0.5 mL/kg/h for 12 hours
  2. Failure - Increase in serum creatinine level (3.0x), or decrease in GFR by 75%, UO <0.3 mL/kg/h for 24 hours, or anuria for 12 hours
  3. Loss - Persistent ARF or complete loss of kidney function >4 weeks
  4. End-stage kidney disease - complete loss of kidney function >3 months
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12
Q

What can chronic renal failure presentation be

A 
Asymptomatic 
Tiredness
Anaemia 
Oedema 
Hypertension 
Bone pain (due to renal bone disease)
Pruritis 
Nausea/vomiting 
Dysponea 
Neuropathy
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13
Q

What ureteritis?

A

Infection of the ureters

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14
Q

When can iatrogenic ureteric disease occur?

A

Can be inadvertently cut or tie during hysterectomy or colon resection

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15
Q

What can obstruct the ureters intra-luminal?

A

Stone, blood clot

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16
Q

What can obstruct the ureters intra-mural?

A

Stricture- (from scar tissue)

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17
Q

What can obstruct the ureters extra-luminal?

A

Pelvic mass

Pregnancy

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18
Q

What are common presentations of ureteric disease?

A 
Pain 
Pyrexia 
Haematuria 
Palpable mass
Renal failure
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19
Q

What is cystitis?

A

Infection of the bladder

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20
Q

What are examples of inflammatroy bladder disease?

A

interstitial cystitis,

colonic diverticulitis

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21
Q

What is an example of a cancer of the baladder?

A

Squamous cell carcinoma

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22
Q

What causes overactive badder syndrome?

A

Idiopathic

Unknown

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23
Q

Give an example of a degenerative bladder disease?

A

Chronic urinary retention

24
Q

Give an example of a neurological bladder disease?

A

Neurogenic bladder dysfunction

25
Q

Give an example of neoplastic diseases affecting the ureters?

A

TCC of ureter
TCC of bladder obstructing VUJ
Prostate cancer

26
Q

Give example of hereditary diseases that affect the ureters?

A

PUJ obstruction

VUJ reflux

27
Q

Give example of inflammatory diseases of the kidneys?

A

Glomerulonephritis

Tubulointerstitial nephritis

28
Q

Give an example of an iatrogenic disease of the kidneys?

A

Nephrotoxicity

29
Q

Which drugs are known to be nephrotoxic?

A

ACE inhi

Gentamicin

30
Q

What type of neoplasia is commonly found in the kidney?

A

Clear cell carcinoma

31
Q

Give an example of vascular diseases of the kidneys?

A

Atherosclerosis
Hypertension
DM

32
Q

Give an example of a hereditary disease that affects the kidneys?

A

Polycystic kidney disease

33
Q

What is the common presentation of bladder diseases/

A

Pain (suprapubic)
Pyrexia
Haematuria
Storage (frequency, nocturia, urgency, urge incontinence)
Voiding (poor flow, intermittency, terminal dribbling)
Incontinence ( stress, urge, mixed, neurogenic)
Recurrent UTIs
Chronic urinary retention
Vesico-vaginal fistula

34
Q

What are the 2 stages of the micturition cycle?

A

Storage or filling phase

Voiding phase

35
Q

What controls the relaxation of the internal urethral sphincter?

A

Autonomic - sympathetic supply

36
Q

What controls the relaxation of the external urethral sphincter?

A

Somatic

Voluntary

37
Q

Give an example of infection or inflammatory diseases of the bladder outlfow tract?

A

Prostatitis

38
Q

Give an example of a neoplasia of the bladder outflow tract?

A

Prostate cancer

Penile cancer

39
Q

Give an example of a obstructive bladder outflow tract?

A

Primary bladder neck obstruction
Benign prostatic enlargement
Urethral stricture
Phimosis

40
Q

How do bladder outflow tract disease present?

A 
Pain 
Pyrexia 
Haematuria 
Voiding 
Stress urinary incontinence 
Recurrent UTIs
Acute urinary retention 
Chronic urinary retention
41
Q

What is acute urinary retention?

A

Painful inability to void with a palpable and percussible bladder

42
Q

What is the main risk factor of acute urinary retention?

A

Benign prostatic obstruction

43
Q

What is the immediate treatment for acute urinary retention?

A

Catheterisation

44
Q

What is chronic urinary retention?

A

Painless, palpable and percussible bladder after voiding

45
Q

What is the main aetiological factor of chronic urinary retention?

A

Detrusor underactivity

46
Q

What are UTIs?

A

Infections affecting the urinary tract

47
Q

How do you diagnose UTIs?

A

Microbiological evidence and symptoms

48
Q

What microbiological evidence must be present for UTI diagnosis?

A

bacterial count of 10 to power of 5
for MSSU specimen
with more than 2 species of micr-organisms

49
Q

What is commonly an uncomplicated UTI presentation?

A

Young sexually active females only with clear relation to sexual activity

50
Q

What are investigations for UTI?

A

MSSU
Lower tract: flow studies, residual bladder scan, cystoscopy
Upper tract: USS kidneys, IVU/CT urogram

51
Q

What is the treatment for UTIs?

A

Appropriate AB therapy

Treat complications and cause

52
Q

What are some complications of UTI?

A 
Infective (sepsis)
Renal failure 
Bladder malignancy 
Acute urinary retention 
Frank haematuria 
Bladder or renal stones
53
Q

What is the most common cause of chronic urinary retention?

A

Bladder outlet obstruction

54
Q

What are potential complications of chronic urinary retention?

A

UTI
Post-decompression haematuria
Electrolyte abnormalities

55
Q

What is the common presentation of UTI?

A 
Fever
Loin/flank pain 
Tenderness
Urinary frequency
Urinary urgency 
Dysuria

Urology (13 decks)

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