Renal and Urological

Question 1

Renal Failure

Answer 1

Acute: sudden loss of kidney function with resulting elevation in serum urea and creatinine

Chronic: progressive loss of kidney function leading to end stage failure

• Etiology Chronic
  
  • prolonged acute UTI
  • infection,
  • diabetes
  • SLE
  • uncontrolled hypertension
• May lead to multisystem abnormalities and failure

Question 2

Stress Incontinence

Answer 2

sudden release of urine due to:

• increased intra-abdominal pressure
• weakness and laxity of pelvic floor ms, sphincter weakness
  
  • postpardum incontinence
  • menopause
  • damage to PUDENDAL nerve

Question 3

Urge Incontience

Answer 3

bladder begins contracting and urine is leaked after sensation of bladder fullness is percieved; an inability to delay voiding to reach toilet secondary to:

• detrusor muscle instability or hyperreflexia (stroke)
• sensory instability: hypersensitive bladder

Question 4

Overflow Incontinence

Answer 4

bladder continuously leaks secondary to urinary retention (over distended) or incomplete emptying:

• anatomical obstruction (prostate enlargement)
• acontractile bladder (SCI or diabetes)
• neurogenic bladder (MS, suprasacral spinal lesions)

Question 5

Functional Incontinence

Answer 5

leakage associated with inability or unwillingness to toilet due to:

• impaired cognitition; depression (alzheimers)
• impaired physical function (stroke)
• environmental barriers

Question 6

Incontinence Management

Answer 6

• dietary
• medical
• bladder training
• Physical therapy
  
  • pelvic floor (PUBOCOCCYGEUS)
    
    • kegel - type 1 - 10 sec on/off, type 2 = quick contraction to stop urine flow. 10-80 reps per day.
    • functional e-stim
    • biofeedback
    • progressive strength
    • kegels in everyday life
  • behavioral training
  • functional mobility
  • environment modification
  • maintain skin condition
  • psychological support