Renal 3 rod

Question 1

What are 3 examples of urinary tract diseases?

Answer 1

• Urinary tract infection
• Urinary tract obstruction (renal stones, tumours, prostatic hypertrophy)
• Urinary tract malignancy

Question 2

Which gender is more prone to UTI’s?

Answer 2

Females

Question 3

Which microorganisms usually causes UTI’s?

Answer 3

E.coli (85%)

Question 4

If a patient is immunosuppressed organisms other than E.coli can cause UTI’s. Give examples of these? (4 points)

Answer 4

• Staph, fungi, virus and TB possible

Question 5

Urine is bacteriostatic to peritoneal organisms, what does bacteriostatic mean ?

Answer 5

• A substance that prevents the multiplying of bacteria without destroying them

Question 6

What is cystitis?

Answer 6

• Bladder inflammation

Question 7

What are 2 predisposing factors of a UTI?

Answer 7

• Poor bladder emptying

- Low urinary flow rates

Question 8

Is urine usually sterile?

Answer 8

Yes, detecting ANY bacteria implies infection (30% may be asymptomatic)

Question 9

Is contamination of urine through the skin possible?

Answer 9

Yes

Question 10

What are examples of things that are indicative of a urine infection? (2 points)

Answer 10

• White cells in urine

- Blood in urine (microscopy only)

Question 11

What is the ideal way to collect a urine sample?

Answer 11

Collect MID-stream urine sample (MSSU)

Question 12

What is supra-pubic urine sampling?

Answer 12

• Can put catheter in through the tummy instead if the urethra
• If going to be in for any length of time then less likely to get infection

Question 13

If urine is infected, what can this cause? (3 points)

Answer 13

• Cystitis (can spread upwards to kidney)
• Renal infection
• Prostate infection

Question 14

Urethritis can occur in isolation. What microorganism can cause this?

Answer 14

Gonococcal

Question 15

What is the process of normal peeing? (2 points)

Answer 15

• Full bladder

- Empty bladder

Question 16

What is the process or urine reflux?

Answer 16

When contract bladder the pressure also forces urine back up to the kidney

Question 17

What are common symptoms of a UTI? (5 points)

Answer 17

• Dysuria
• Urinary frequency
• Cloudy urine
• Offensive smelling urine
• Supra-pubic pain

Question 18

What is dysuria?

Answer 18

Pain on passing urine

Question 19

What causes cloudy urine?

Answer 19

If have cells and protein in it

Question 20

How could you diagnose a UTI? (2 points)

Answer 20

• MSSU only (less contamination)

- Microscopy, culture and sensitivity

Question 21

How can you treat a UTI? (3 points)

Answer 21

• Increase fluid intake
• Frequent micturition
• Occasional antibiotics required

Question 22

What is micturition?

Answer 22

The action of urinating

Question 23

What are 2 examples of antibiotics that can be used to treat UTI’s?

Answer 23

• Trimethoprim

- Amoxycillin

Question 24

What are 4 examples of things that can cause a urinary tract obstruction?

Answer 24

• Renal calculi (stones)
• Prostatic disease (hypertrophy, malignancy)
• Urinary tract strictures
• External compression

Question 25

What are 3 examples of prostate disease? (3 points)

Answer 25

- Prostatitis - Benign prostatic hypertrophy - Prostate cancer

Question 26

What is prostatitis?

Answer 26

Inflammation of the prostate - sudden narrowing of the urinary passage

Question 27

What is benign prostatic hypertrophy?

Answer 27

Hyperplasia of the prostate 

Question 28

How long does it take for prostatitis to occur?

Answer 28

Can take hours or days 

Question 29

How long does it take for benign prostatic hypertrophy to occur?

Answer 29

- Usually comes over years 

Question 30

Is benign prostatic hypertrophy linked to prostatic cancer?

Answer 30

- No 

Question 31

What type of tumour is prostatic cancer?

Answer 31

An adenocarcinoma 

Question 32

How common is benign prostatic hypertrophy?

Answer 32

- Pretty common - 80% of men over age of 80 have it - 100% of men will get it if they live long enough

Question 33

What are common signs of a urinary outflow obstruction? (6 points)

Answer 33

- Slow stream - Hesitancy - Frequency - Urgency - Nocturia - Incomplete voiding

Question 34

What is nocturia?

Answer 34

Peeing during the night - often 

Question 35

What are the treatment options for benign prostatic hypertrophy? (2 points)

Answer 35

Initially drug based: - alpha-blocking drugs Surgery - prostatectomy - TURP = transurethral prostatectomy - Open prostatectomy

Question 36

At what age do people tend to start developing prostatic malignancies?

Answer 36

After age 45 

Question 37

What % of men have symptomatic prostatic malignancy?

Answer 37

10% of men 

Question 38

What is PSA useful for?

Answer 38

Monitoring activity in those known to have the disease (prostatic malignancy)

Question 39

Why is the PSA test not always a diagnostic test for prostatic malignancies?

Answer 39

- Can often be normal when do have cancer and can be high when you don't

Question 40

What are the treatment options for prostatic malignancy? (3 points)

Answer 40

Surgery - radical prostatectomy Radiotherapy Hormone treatment: - Anti-androgens & LHRH analogues - Block hormone-dependent tumour growth

Question 41

Prostatic malignancy can cause widespread bone metastasis. What is this?

Answer 41

Cancer that starts in one area and then spreads to a bone

Question 42

Prostatic malignancy can cause osteosclerosis. What is this?

Answer 42

Abnormal hardening of bone 

Question 43

What percentage of the population develop renal calculi?

Answer 43

5% - in the liver or bladder

Question 44

Are renal calculi painful?

Answer 44

Yes, EXTREMELY 

Question 45

What are the 2 different types of renal calculi?

Answer 45

- Calcium and oxalate (radiopaque) | - Uric acid (not radiopaque)

Question 46

You would treat renal calculi with LITHOTRYPSY. What is this?

Answer 46

A treatment, typically using ultrasound shock waves, by which a kidney stone can be broken down into small particles that can be passed out by the body