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NPTE > Reproductive, renal and urological systems > Flashcards

Reproductive, renal and urological systems Flashcards

1
Q

What is a rectal fissure?

A

Tear or ulceration in the lining of the anal canal

contributing factors: large, hard stools

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2
Q

What is another name for hemorrhoids?

A

piles

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3
Q

What are the female sex hormones?

A

estrogen and progesterone

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4
Q

What controls the release of estrogen and progesterone?

A

ovaries

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5
Q

What controls the release of testosterone/androgens?

A

testes

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6
Q

What controls the release of 1,25-dihydroxy-vitamin D?

A

kidneys

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7
Q

What controls the release of insulin?

A

pancreatic islet cells

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8
Q

What controls the release of glucagon?

A

pancreatic islet cells

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9
Q

What controls the release of somatostatin?

A

pancreatic islet cells

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10
Q

What controls the release of the parathyroid hormone (PTH)?

A

parathyroid glands

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11
Q

What controls the release of triiothyronine?

A

thyroid

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12
Q

What controls the release of thyroxine?

A

thyroid

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13
Q

What controls the release of epinephrine and norephinephrine?

A

adrenal medulla

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14
Q

What controls the release of aldosterone (mineral corticosteroids)?

A

adrenal cortex

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15
Q

What controls the release of glucocorticoids (cortisol)?

A

adrenal cortex

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16
Q

What controls the release of adrenal androgens (dehydroepiandrosterone [DHEA])?

A

adrenal cortex

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17
Q

What controls the release of androstenedione?

A

adrenal cortex

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18
Q

What releases thyrotropin-releasing hormone (TRH)?

A

hypothalamus

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19
Q

What releases gonadotropin-releasing hormone (GnRH)?

A

hypothalamus

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20
Q

What releases growth hormone-releasing hormone (GHRH)?

A

hypothalamus

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21
Q

What releases corticotropin-releasing hormone (CRH)?

A

hypothalamus

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22
Q

What releases dopamine?

A

hypothalamus

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23
Q

What does thyrotropin-releasing hormone (TRH) do?

A
  • Stimulates the anterior pituitary gland to release thyroid-stimulating hormone (TSH) and prolactin
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24
Q

What does the gonadotropin-releasing hormone (GnRH) do?

A

Stimulates the anterior pituitary gland to release follicle-stimulating hormone (FSH) and luteinizing hormone (LH) once puberty occurs

Maintains male and female physiology

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25
Q

What does the growth hormone-releasing hormone (GHRH) do?

A

Stimulates the anterior pituitary to release growth hormone (GH)

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26
Q

What does corticotropin-releasing hormone (CRH) do?

A

stimulates the anterior pituitary to release adrenocorticotropic hormone (ACTH) in response to physical and emotional stress

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27
Q

What does somatostatin do?

A

Inhibits the release of growth hormone (GH) and thyroid stimulating hormone (TSH).

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28
Q

What does dopamine do?

A
  • inhibits the release of prolactin from the anterior pituitary
  • modulates motor control centers
  • activates the reward centers of the brain
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29
Q

What does prolactin do?

A
  • promotes lactation
  • regulates reproduction, metabolism, and the immune system
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30
Q

What is another name of vasopressin?

A

Anti-diuretic hormone (ADH)

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31
Q

What does vasopressin (ADH) do?

A

facilitates the reabsorption of water (regulates water levels and influence blood bolume and pressure)

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32
Q

What does oxytocin do?

A
  • stimulates contractions of the uterus at birth
  • stimulates release of milk
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33
Q

What does orexin and ghrelin do?

A

increase appetite

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34
Q

What does leptin do?

A

decreases appetite

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35
Q

What does the parathyroid hormone (PTH) do?

A

Controls the level of calcium within the blood and calcium absorption within the kidneys and small intestine

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36
Q

What does thyroid-stimulating hormone (TSH) do?

A

regulates metabolism, growth, HR, and body temperature

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37
Q

What does cortisol do?

A

Stress hormone (fight v. flight response)

excessive levels causes the following:
- suppression of functions that are not necessary at that time for the response
- burst of energy and strength

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38
Q

What effect does estrogen have on the rate of bone reabsorption?

A

decreases the rate

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39
Q

What effect does estrogen have on the thyroid?

A

increases production of thyroid

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40
Q

What effect does estrogen have on high-density lipoproteins?

A

increase

protective effect against heart disease

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41
Q

What is the average weight gain for pregnancy?

A

20-30 pounds

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42
Q

What hormone causes ligamentous laxity?

A

relaxin

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43
Q

What type of incontinence do 80% of pregnancies experience?

A

stress incontinence

Increased pressure on bladder leads to increased urination, increased incidence of reflux, and UTIs

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44
Q

What is diastasis recti abdominis?

A

Separation of the rectus abdominis from the linea alba (> 2 cm is significant)

associated with loss of abdominal wall support and increased back pain

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45
Q

What protocol is put into effect when diastasis recti abdominis is present?

A

No abdominal muscle exercises until the separation is <2 cm

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46
Q

What are the primary causes of pelvic muscle weakness?

A
  1. overstretching during pregnancy
  2. further loss of elasticity and muscle tone later in life (can cause prolapse)
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47
Q

What is cystocele?

A

Herniation of the bladder into the vagina

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48
Q

What is rectocele?

A

Herniation of the rectum into the vagina

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49
Q

What is uterine prolapse?

A

herniation of the uterus into the vagina

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50
Q

What are the s/s of pelvic floor disorders?

A
  1. pain
  2. urinary incontinence
  3. pain with sex
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51
Q

Where is pain located in the presence of pelvic floor disorders?

A
  1. perivaginal
  2. perirectal
  3. lower abdomen

can radiate down posterior thigh

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52
Q

What are contraindications to perform pelvic floor exercises?

A
  1. recent surgery
  2. urinary catheter
  3. excessive pelvic pain
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53
Q

Where is pain located with SIJ dysfunction?

A
  1. posterior pelvic pain
  2. pain in the buttocks that may radiate to the posterior thigh or knee
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54
Q

What aggravates SIJ dysfunction?

.

A

Prolonged sitting, standing, and walking

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55
Q

What type of exercises may aggravate SIJ dysfunction pain?

A

single limb WB

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56
Q

What must you avoid if you have varicose veins?

A

crossing the legs

only elevate the legs and use compression socks

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57
Q

What is preeclampsia?

A

Acute HTN after the 24th wk of gestation that can be mild or severe

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58
Q

What are the s/s of preeclampsia?

A
  • HTN
  • edema
  • sudden excessive weight gain
  • HA
  • visual disturbance
  • hyperreflexia
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59
Q

What can be used for C-section post-operative pain around the incision site?

A

TENS

parallel to the incision

60
Q

What exercise precautions are present with pregnancy in regard to heavy lifting?

A

No heavy lifting until 4-6 weeks after birth

61
Q

Diagnosis

Ectopic growth and function of endometrial tissue outside of the uterus

A

endometriosis

62
Q

(true/false) With endometriosis, the ectopic tissue can respond to hormones but cannot shed with the uterine tissue during menstruation

A

true

63
Q

What can endometrial tissue lead to?

A
  1. cysts
  2. rupture
  3. peritonitis
  4. adhesions
  5. obstruction
64
Q

s/s

  • pain
  • dysmenorrhea (moderate to severe pain during menstruation)
  • dyspareunia (abnormal pain with sex)
  • infertility
  • back pain
A

endometriosis

65
Q

What is the most common cancer in female reproductive organs?

A

endometrial carcinoma (uterine cancer)

66
Q

What causes endometrial carcinoma?

A
  1. imbalance of estrogen and progesterone
  2. ovarian tumor
  3. hormone therapy used for breast cancer
  4. no hx of pregnancy
  5. older age
  6. obesity
67
Q

Diagnosis s/s

  • pelvic pain
  • bleeding between periods
  • vaginal bleeding after menopause onset
  • central LBP
  • posterior thigh pain and/or abdominal pain
A

endometrial carcinoma

68
Q

What is pelvic inflammatory disease (PID)?

A

inflammation of the upper reproductive tract involving the uterus, fallopian tubes, or ovaries

69
Q

diagnosis s/s

  • lower abdominal pain that starts after the menstrual cycle
  • purulent cervical discharge
  • painful cervix
  • fever and elevated WBCs
  • increased ESR
A

PID

70
Q

What are possible complications caused by PID?

A
  • pelvic adhesions
  • infertility
  • ectopic pregnancy
  • chronic pain
  • abscess
71
Q

What hormone initiates spermatogenesis?

A

follicle stimulating hormone (FSH)

71
Q

What hormone regulates testosterone production?

A

luteinizing hormone (LH)

72
Q

What are the s/s of testicular cancer?

A
  • lump/enlargement in the testicle
  • aching in the groin or abdomen
  • breast enlargement
  • LBP that may radiate to the groin
73
Q

What is prostatitis?

A

inflammation and infection of the prostate

74
Q

What can cause acute bacterial prostatitis?

A

catheterization and multiple sexual partners

75
Q

Where can prostatitis pain refer to?

A

the low back and the sacral/genital/rectal regions

76
Q

What are the s/s of acute prostatitis?

A
  • increased frequency and urgency
  • fever and chills
  • arthralgia
  • myalgia
  • pain
  • urethral discharge
  • malaise
  • nocturia
  • dysuria
77
Q

Chronic bacterial prostatitis is associated with what?

A

recurrent UTI

s/s
- urinary frequency and urgency
- myalgia
- arthralgia
- pain in low back and/or perineal region

78
Q

diagnosis s/s

  • produces pain in the penis, testicles, and scrotum
  • pain with ejaculation
  • LBP and/or inner thigh pain
  • decreased libido
  • impotence
  • urinary symptoms
A

nonbacterial inflammatory prostatitis

79
Q

What can arise from prostatitis?

A

obstruction of urinary flow due to the prostate circling the urethra

80
Q

What is benign prostatic hyperplasia (BPH)?

A

Enlargement of the prostate gland

81
Q

What is BPH in relation to?

A
  • age (normally by age 60-80 y/o)
  • obesity
  • DM
  • heart disease
82
Q

Diagnosis s/s

  • frequent urination
  • nocturia
  • difficulty with urination initiation
  • inability to empty the bladder (high risk of UTI)
  • oversized prostate
  • bladder stones
A

benign prostatic hyperplasia (BPH)

83
Q

Where does prostate cancer metastasize to?

A

bone

often to the spine

Risk factors:
- men > 80 y/o
- family Hx
- obesity

84
Q

What are the symptoms of prostate cancer?

A

Late stage:
- frequent urination
- nocturia
- difficulty with urination initiation
- inability to empty the bladder (high risk of UTI)
- bladder stones
- blood in urine/semen
- bone and night pain
- weight loss
- Erectile dysfunction

usually no s/s in early stages

85
Q

Prostate-specific antigen labs are normally (decreased/increased) in the presence of prostate cancer.

A

elevated

86
Q

In what levels of the spine are the kidneys found?

A

T12-L2

multilobbular (contains > 1 million nephrons)

87
Q

What does the glomerulus do?

A

filters blood in the kidney

88
Q

definition

structure that extends from the renal pelvis to the bladder

A

ureter

89
Q

How does the ureter move urine?

A

via peristaltic action

90
Q

What is the glomerular filtration rate (GFR)? What is it regulated by?

A

a. amount of filtrate that is formed each minute as the blood moves through the glomeruli, serving as an important gauge of renal function

b. regulated by arterial BP and renal blood flow

91
Q

How is GFR obtained?

A

creatinine levels in blood and urine samples

92
Q

What is normal creatinine clearance?

A

115-125 mL/min

93
Q

What is BUN?

A

Blood urea nitrogen is the amount of urea produced in the liver as a byproduct of protein metabolism that is eliminated by the kidneys

94
Q

BUN levels are (decreased/increased) with increased protein intake, GI bleeding, and dehydration

A

increased

95
Q

BUN-creatinine ratio is abnormal with ___ disease.

A

liver disease

96
Q

What is the average pH of urine?

A

6

Range: 4.6-8.0

97
Q

What is the normal level of serum potassium?

A

3.5-5.5

97
Q

What heart condition can hypokalemia lead to?

A

supraventricular and ventricular arrythmias

some result in death

98
Q

What are the symptoms of hyperkalemia?

A

Normally asymptomatic unless there is a very high level - observe for muscle weakness

99
Q

What is the normal serum level for sodium?

A

135-146 mEq/L

100
Q

What s/s can be observed with hyponatremia?

A
  • confusion
  • decreased alertness
  • convulsions
  • increased ICP
  • decreased coordination
  • anorexia
  • fatigue
101
Q

What s/s can be observed with hypernatremia?

A
  • pitting edema
  • excessive weight gain
  • dyspnea
  • HTN
  • tachycardia
  • agitation/restlessness
  • convulsions
102
Q

What is the normal serum level of calcium?

A

8.4-10.4 mg/dL

103
Q

What are the possible s/s of hypocalcemia?

A
  • cramps
  • tetany
  • spasms
  • paresthesia
  • anxiety/irritability
  • convulsions
  • arrhythmias
  • hypotension
104
Q

What s/s can be seen with hypercalcemia?

A
  • fatigue
  • depression
  • confusion
  • N/V
  • increased urination
  • arrhythmia
105
Q

What is the normal serum level of magnesium?

A

1.8-2.4 mg/dL

106
Q

What s/s can be observed with hypomagnesemia?

A
  • confusion
  • hyperirritability
  • cramps in LEs
107
Q

What s/s can be present with hypermagnesemia?

A
  • hyporeflexia
  • weakness
  • drowsiness
  • confusion
  • bradycardia
  • hypotension
108
Q

(true/false) metabolic alkalosis and acidosis can lead to death.

A

true

109
Q

(true/false) Respiratory alkalosis can lead to disorientation, stupor, and/or death.

A

FALSE (respiratory acidosis)

110
Q

definition

CO2 retention with impaired alveolar ventilation

A

respiratory acidosis

111
Q

definition

diminished CO2 with alveolar hyperventilation

A

respiratory alkalosis

112
Q

Cystitis and urethritis are (lower/upper) UTIs

A

lower UTI

113
Q

definition

inflammation of the bladder

A

cystitis

114
Q

definition

inflammation of the ureter

A

urethritis

115
Q

(true/false) Lower UTI (cystitis or urethritis) are normally secondary to ascending UTIs

A

true

116
Q

(true/false) Lower UTIs can involve the kidneys and ureters

A

true

117
Q

Pyelonephritis is a (lower/upper) UTI.

A

upper UTI

118
Q

definition

inflammation and infection of one or both kidneys

A

pyelonephritis

119
Q

diagnosis s/s

  • fever and chills
  • malaise
  • back pain over kidneys
  • Murphy’s sign
  • frequent urination
  • burning urination
  • N/V
A

pyelonephritis

120
Q

What is murphy’s sign?

A

tenderness over the costrovertebral angle

121
Q

Are upper or lower UTIs more serious?

A

upper

122
Q

What are the 4 types of renal cystic disease?

A
  1. polycystic
  2. medullary sponge
  3. acquired
  4. simple
123
Q

diagnosis s/s

  • pain
  • hematuria secondary to rupture
  • HTN
  • fever
A

renal cystic disease

Simple cysts are commonly asymptomatic

124
Q

What is another name for renal calculi?

A

kidney stones

125
Q

diagnosis s/s

  • pain radiating to the lower abdomen, bladder, and/or perineal region
  • N/V
  • cool/clammy skin
  • pain is aggravated by stretching the urine collecting system
A

kidney stones

126
Q

What is extracorporeal shock wave lithotripsy (ESWL) used for?

A

breaking up kidney stones

127
Q

diagnosis

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

A

acute renal failure

128
Q

diagnosis

progressive loss of kidney function leading to ESRD

A

chronic kidney disease

129
Q

What can cause chronic renal failure?

A
  • prolonged acute urinary tract obstruction and infection
  • DM
  • SLE
  • uncontrolled HTN
130
Q

diagnosis

end-stage toxic condition resulting from renal insufficiency and retention of nitrogenous waste in the blood

A

uremia

131
Q

What causes dialysis dementia?

A

prolonged dialysis treatments over years

132
Q

What are the signs of dialysis disequilibrium?

A
  • N/V
  • drowsiness
  • HA
  • seizures
133
Q

What is dialysis disequilibrium a result of?

A

beginning dialysis

134
Q

What are the risk factors for renal cancer?

A
  • smoking
  • HTN
  • male african-americans
  • family history
  • advanced kidney disease
135
Q

diagnosis s/s

  • flank pain
  • hematuria
  • fatigue
  • unexplained weight loss
A

renal cancer

136
Q

What are the risk factors for developing bladder cancer?

A
  • > 55 y/o
  • decreased fluid intake
  • male
  • previous radiation/chemo
  • family history
137
Q

What causes stress incontinence?

A
  • increased intra-abdominal pressure
  • weakness of pelvic floor and sphincter
138
Q

diagnosis

sudden release of urine

A

stress incontinence

139
Q

diagnosis

bladder begins contracting and leaks uring after the sensation of bladder fullness is perceived

inability to delay voiding before reaching a toilet

A

urge incontinence

140
Q

What are the causes of urge incontinence?

A
  • detrusor muscle instability or hyperreflexia
  • sensory instability: hypersensitive bladder
141
Q

diagnosis

bladder continuously leaks secondary to urinary retention (overdistended bladder)

A

overflow incontinence

142
Q

What are causes of overflow incontinence?

A
  • obstruction
  • acontractile bladder
  • neurogenic bladder
143
Q

diagnosis

urine leakage associated with the inability or unwillingness to toilet due to impaired cognition, physical functioning, and/or environmental errors

A

functional incontinence

144
Q

What medications may aggravate incontinence?

A
  • anticholinergics
  • diuretics
  • psychotropic drugs

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