Renal 3 rod Flashcards
What are 3 examples of urinary tract diseases?
- Urinary tract infection
- Urinary tract obstruction (renal stones, tumours, prostatic hypertrophy)
- Urinary tract malignancy
Which gender is more prone to UTI’s?
Females
Which microorganisms usually causes UTI’s?
E.coli (85%)
If a patient is immunosuppressed organisms other than E.coli can cause UTI’s. Give examples of these? (4 points)
- Staph, fungi, virus and TB possible
Urine is bacteriostatic to peritoneal organisms, what does bacteriostatic mean ?
- A substance that prevents the multiplying of bacteria without destroying them
What is cystitis?
- Bladder inflammation
What are 2 predisposing factors of a UTI?
- Poor bladder emptying
- Low urinary flow rates
Is urine usually sterile?
Yes, detecting ANY bacteria implies infection (30% may be asymptomatic)
Is contamination of urine through the skin possible?
Yes
What are examples of things that are indicative of a urine infection? (2 points)
- White cells in urine
- Blood in urine (microscopy only)
What is the ideal way to collect a urine sample?
Collect MID-stream urine sample (MSSU)
What is supra-pubic urine sampling?
- 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
If urine is infected, what can this cause? (3 points)
- Cystitis (can spread upwards to kidney)
- Renal infection
- Prostate infection
Urethritis can occur in isolation. What microorganism can cause this?
Gonococcal
What is the process of normal peeing? (2 points)
- Full bladder
- Empty bladder
What is the process or urine reflux?
When contract bladder the pressure also forces urine back up to the kidney
What are common symptoms of a UTI? (5 points)
- Dysuria
- Urinary frequency
- Cloudy urine
- Offensive smelling urine
- Supra-pubic pain
What is dysuria?
Pain on passing urine
What causes cloudy urine?
If have cells and protein in it
How could you diagnose a UTI? (2 points)
- MSSU only (less contamination)
- Microscopy, culture and sensitivity
How can you treat a UTI? (3 points)
- Increase fluid intake
- Frequent micturition
- Occasional antibiotics required
What is micturition?
The action of urinating
What are 2 examples of antibiotics that can be used to treat UTI’s?
- Trimethoprim
- Amoxycillin
What are 4 examples of things that can cause a urinary tract obstruction?
- Renal calculi (stones)
- Prostatic disease (hypertrophy, malignancy)
- Urinary tract strictures
- External compression
What are 3 examples of prostate disease? (3 points)
- Prostatitis
- Benign prostatic hypertrophy
- Prostate cancer
What is prostatitis?
Inflammation of the prostate
- sudden narrowing of the urinary passage
What is benign prostatic hypertrophy?
Hyperplasia of the prostate
How long does it take for prostatitis to occur?
Can take hours or days
How long does it take for benign prostatic hypertrophy to occur?
- Usually comes over years
Is benign prostatic hypertrophy linked to prostatic cancer?
- No
What type of tumour is prostatic cancer?
An adenocarcinoma
How common is benign prostatic hypertrophy?
- Pretty common
- 80% of men over age of 80 have it
- 100% of men will get it if they live long enough
What are common signs of a urinary outflow obstruction? (6 points)
- Slow stream
- Hesitancy
- Frequency
- Urgency
- Nocturia
- Incomplete voiding
What is nocturia?
Peeing during the night - often
What are the treatment options for benign prostatic hypertrophy? (2 points)
Initially drug based:
- alpha-blocking drugs
Surgery - prostatectomy
- TURP = transurethral prostatectomy
- Open prostatectomy
At what age do people tend to start developing prostatic malignancies?
After age 45
What % of men have symptomatic prostatic malignancy?
10% of men
What is PSA useful for?
Monitoring activity in those known to have the disease (prostatic malignancy)
Why is the PSA test not always a diagnostic test for prostatic malignancies?
- Can often be normal when do have cancer and can be high when you don’t
What are the treatment options for prostatic malignancy? (3 points)
Surgery - radical prostatectomy
Radiotherapy
Hormone treatment:
- Anti-androgens & LHRH analogues
- Block hormone-dependent tumour growth
Prostatic malignancy can cause widespread bone metastasis. What is this?
Cancer that starts in one area and then spreads to a bone
Prostatic malignancy can cause osteosclerosis. What is this?
Abnormal hardening of bone
What percentage of the population develop renal calculi?
5%
- in the liver or bladder
Are renal calculi painful?
Yes, EXTREMELY
What are the 2 different types of renal calculi?
- Calcium and oxalate (radiopaque)
- Uric acid (not radiopaque)
You would treat renal calculi with LITHOTRYPSY. What is this?
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
