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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 postural changes occur with pregnancy?

A
  1. cervical lordosis
  2. thoracic kyphosis
  3. scapular PROT
  4. lumbar lordosis
  5. FWD head
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43
Q

Where does the COG move to when pregnant?

A

FWD and upward as the fetus develops

wider BOS

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44
Q

What hormone causes ligamentous laxity?

A

relaxin

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45
Q

What muscles become weak during pregnancy?

A
  1. abdominals
  2. pelvic floor
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46
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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47
Q

What changes occur to the respiratory system during pregnancy?

A
  • Thoracic cage widens
  • diaphrgm moves upward
  • possible DOE
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48
Q

What happens to the following during pregnancy?

  • blood volume
  • venous pressure in LEs
  • HR
  • CO
  • BP
A

blood volume and venous pressure: increased

HR and CO: increased

BP: decreased (due to venous distensibility)

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49
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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50
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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51
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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52
Q

What is cystocele?

A

Herniation of the bladder into the vagina

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53
Q

What is rectocele?

A

Herniation of the rectum into the vagina

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54
Q

What is uterine prolapse?

A

herniation of the uterus into the vagina

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55
Q

What are the s/s of pelvic floor disorders?

A
  1. pain
  2. urinary incontinence
  3. pain with sex
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56
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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57
Q

What are contraindications to perform pelvic floor exercises?

A
  1. recent surgery
  2. urinary catheter
  3. excessive pelvic pain
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58
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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59
Q

What aggravates SIJ dysfunction?

.

A

Prolonged sitting, standing, and walking

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60
Q

What type of exercises may aggravate SIJ dysfunction pain?

A

single limb WB

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61
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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62
Q

What is preeclampsia?

A

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

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63
Q

What are the s/s of preeclampsia?

A
  • HTN
  • edema
  • sudden excessive weight gain
  • HA
  • visual disturbance
  • hyperreflexia
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64
Q

When are C-sections indicated?

A
  1. pelvic disproportion
  2. failure of birth process to progress
  3. fetal and/or maternal distress
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65
Q

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

A

TENS

parallel to the incision

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66
Q

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

A

No heavy lifting until 4-6 weeks after birth

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67
Q

Diagnosis

Ectopic growth and function of endometrial tissue outside of the uterus

A

endometriosis

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68
Q

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

A

true

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69
Q

What can endometrial tissue lead to?

A
  1. cysts
  2. rupture
  3. peritonitis
  4. adhesions
  5. obstruction
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70
Q

What are the s/s of endometriosis?

A
  • pain
  • dysmenorrhea (moderate to severe pain during menstruation)
  • dyspareunia (abnormal pain with sex)
  • infertility
  • back pain
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71
Q

What is the most common cancer in female reproductive organs?

A

endometrial carcinoma (uterine cancer)

72
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
73
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

74
Q

What is pelvic inflammatory disease (PID)?

A

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

75
Q

What causes PID?

A

polymicrobial agent that ascends the endocervical canal

76
Q

diagnosis s/s

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

PID

77
Q

What are possible complications caused by PID?

A
  • pelvic adhesions
  • infertility
  • ectopic pregnancy
  • chronic pain
  • abscess
78
Q

What hormone initiates spermatogenesis?

A

follicle stimulating hormone (FSH)

78
Q

What hormone regulates testosterone production?

A

luteinizing hormone (LH)

79
Q

When is testicular cancer more likely to occur?

A

Ages 15-35

80
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
81
Q

What is prostatitis?

A

inflammation and infection of the prostate

82
Q

What can cause acute bacterial prostatitis?

A

catheterization and multiple sexual partners

83
Q

Where can prostatitis pain refer to?

A

the low back and the sacral/genital/rectal regions

84
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
85
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

86
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

87
Q

What can arise from prostatitis?

A

obstruction of urinary flow due to the prostate circling the urethra

88
Q

What is benign prostatic hyperplasia (BPH)?

A

Enlargement of the prostate gland

89
Q

What is BPH in relation to?

A
  • age (normally by age 60-80 y/o)
  • obesity
  • DM
  • heart disease
90
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)

91
Q

Where does prostate cancer metastasize to?

A

bone

often to the spine

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

92
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

93
Q

What tests are used for diagnosis of prostate cancer?

A
  • rectal exam
  • prostate-specific antigen
  • urine flow test
  • US
  • bone scan/MRI/PET/CT
94
Q

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

A

elevated

95
Q

In what levels of the spine are the kidneys found?

A

T12-L2

multilobbular (contains > 1 million nephrons)

96
Q

What does the nephron consist of?

A
  1. glomerulus
  2. nephron tubules

good substances are reabsorbed into the blood stream and waste is secreted into the tubules for elimination

97
Q

What does the glomerulus do?

A

filters blood in the kidney

98
Q

definition

structure that extends from the renal pelvis to the bladder

A

ureter

99
Q

How does the ureter move urine?

A

via peristaltic action

100
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

101
Q

How is GFR obtained?

A

creatinine levels in blood and urine samples

102
Q

What is normal creatinine clearance?

A

115-125 mL/min

103
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

104
Q

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

A

increased

105
Q

BUN-creatinine ratio is abnormal with ___ disease.

A

liver disease

106
Q

What is the average pH of urine?

A

6

Range: 4.6-8.0

107
Q

What are possible causes of edema?

A
  1. increased capillary pressure
  2. decreased osmotic pressure
  3. lymphatic flow obstruction
  4. increased capillary permeability
107
Q

How is homostasis of the urinary system regulated?

A

thirst mechanisms and renal function via ADH circulation

108
Q

What is the normal level of serum potassium?

A

3.5-5.5

109
Q

What are the causes of hypokalemia?

A
  • diarrhea
  • vomiting
  • metabolic acidosis or alkalosis
  • renal tubular disease
110
Q

What should you look out for in regard to possible hypokalemia?

A
  • weakness
  • ache
  • fatigue
  • abdominal distention
  • N/V
111
Q

What ECG changes are seen with hypokalemia?

A

P wave: increased

T wave: flat or inverted

ST depression

112
Q

What heart condition can hypokalemia lead to?

A

supraventricular and ventricular arrythmias

some result in death

113
Q

What are possible causes of hyperkalemia?

A
  • acute renal failure
  • kidney disease
  • metabolic acidosis
  • diaetic ketoacidosis
  • sickle cell anemia
  • SLE
114
Q

What are the symptoms of hyperkalemia?

A

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

115
Q

What ECG changes are seen with hyperkalemia?

A

T wave: tall

PR interval: prolonged

QRS duration: prolonged

arrhythmias

116
Q

What is the normal serum level for sodium?

A

135-146 mEq/L

117
Q

What are the causes of hyponatremia?

A

excess water associated with excess intake or excess ADH

118
Q

What s/s can be observed with hyponatremia?

A
  • confusion
  • decreased alertness
  • convulsions
  • increased ICP
  • decreased coordination
  • anorexia
  • fatigue
119
Q

What is the cause of hypernatremia?

A

Deficit in water intake

120
Q

What s/s can be observed with hypernatremia?

A
  • pitting edema
  • excessive weight gain
  • dyspnea
  • HTN
  • tachycardia
  • agitation/restlessness
  • convulsions
121
Q

What is the normal serum level of calcium?

A

8.4-10.4 mg/dL

122
Q

What are the causes of hypocalcemia?

A
  • reduced albumin
  • hyperphosphatemia
  • hypoparathyroidism
  • malabsorption of calcium and vitamin D
  • alkalosis
  • acute pancreatitis
123
Q

What are the possible s/s of hypocalcemia?

A
  • cramps
  • tetany
  • spasms
  • paresthesia
  • anxiety/irritability
  • convulsions
  • arrhythmias
  • hypotension
124
Q

What are the possible causes of hypercalcemia?

A
  • hyperparathyroidism
  • tumor
  • hyperthyroidism
  • vitamin A intoxication
125
Q

What s/s can be seen with hypercalcemia?

A
  • fatigue
  • depression
  • confusion
  • N/V
  • increased urination
  • arrhythmia
126
Q

What is the normal serum level of magnesium?

A

1.8-2.4 mg/dL

127
Q

What are possible causes of hypomagnesemia?

A
  • hemodialysis
  • transfusions
  • CKD
  • hepatic cirrhosis
  • chronic pancreatitis
  • hypoparathyroidism
  • malabsorption syndromes
  • severe burns
  • increased loss of body fluid
128
Q

What s/s can be observed with hypomagnesemia?

A
  • confusion
  • hyperirritability
  • cramps in LEs
129
Q

What can cause hypermagnesemia?

A
  • renal failure
  • diabetic acidosis
  • hypothyroidism
  • addison’s disease
  • dehydration
  • use of antacids
130
Q

What s/s can be present with hypermagnesemia?

A
  • hyporeflexia
  • weakness
  • drowsiness
  • confusion
  • bradycardia
  • hypotension
131
Q

What are possible s/s of metabolic acidosis?

A
  • weakness
  • compensatory hyperventilation
  • twitching
  • deep respirations
  • N/V/D
  • HA
  • dry skin
  • poor skin turgor
132
Q

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

A

true

133
Q

What are possible s/s of metabolic alkalosis?

A
  • compensatory hypoventilation
  • depressed respirations
  • dysrhythmias
  • prolonged vomiting
  • diarrhea
  • twitching
  • weakness
  • irritability/agitation
  • convulsions
  • coma
134
Q

What are possible causes of respiratory acidosis?

A
  • hypoventilation
  • drugs
  • chronic pulmonary disease
  • hypermetabolism (sepsis/burns)
135
Q

What possible s/s can be seen with respiratory acidosis?

A
  • dyspnea
  • hyperventilation
  • cyanosis
  • restlessness
  • HA
136
Q

What are possible causes of respiratory alkalosis?

A
  • hyperventilation
  • hypoxia
  • impaired lung expansion
  • CHF
  • pulmonary embolism
  • liver disease or CNS disease
  • stress
  • salicylate poisoning
137
Q

What s/s can possibly be present with respiratory alkalosis?

A
  • tachypnea
  • dizziness
  • anxiety
  • N/T
  • diaphoresis
  • cramps
  • twitching/tetany
  • weakness
  • arrythmias
  • convulsion
138
Q

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

A

FALSE (respiratory acidosis)

139
Q

definition

CO2 retention with impaired alveolar ventilation

A

respiratory acidosis

140
Q

definition

diminished CO2 with alveolar hyperventilation

A

respiratory alkalosis

141
Q

Cystitis and urethritis are (lower/upper) UTIs

A

lower UTI

142
Q

definition

inflammation of the bladder

A

cystitis

143
Q

definition

inflammation of the ureter

A

urethritis

144
Q

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

A

true

145
Q

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

A

true

146
Q

Pyelonephritis is a (lower/upper) UTI.

A

upper UTI

147
Q

definition

inflammation and infection of one or both kidneys

A

pyelonephritis

148
Q

diagnosis s/s

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

pyelonephritis

149
Q

What is murphy’s sign?

A

tenderness over the costrovertebral angle

150
Q

Are upper or lower UTIs more serious?

A

upper

151
Q

What are the 4 types of renal cystic disease?

A
  1. polycystic
  2. medullary sponge
  3. acquired
  4. simple
152
Q

diagnosis s/s

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

renal cystic disease

Simple cysts are commonly asymptomatic

153
Q

What forms kidney stones?

A
  1. calcium
  2. magnesium ammonium phosphate
  3. uric acid
  4. cysteine
154
Q

What is another name for renal calculi?

A

kidney stones

155
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

156
Q

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

A

breaking up kidney stones

157
Q

diagnosis

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

A

acute renal failure

158
Q

diagnosis

progressive loss of kidney function leading to ESRD

A

chronic kidney disease

159
Q

What can cause chronic renal failure?

A
  • prolonged acute urinary tract obstruction and infection
  • DM
  • SLE
  • uncontrolled HTN
160
Q

diagnosis

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

A

uremia

161
Q

What causes dialysis dementia?

A

prolonged dialysis treatments over years

162
Q

What are the signs of dialysis disequilibrium?

A
  • N/V
  • drowsiness
  • HA
  • seizures
163
Q

What is dialysis disequilibrium a result of?

A

beginning dialysis

164
Q

What are the risk factors for renal cancer?

A
  • smoking
  • HTN
  • male african-americans
  • family history
  • advanced kidney disease
165
Q

diagnosis s/s

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

renal cancer

166
Q

What are the risk factors for developing bladder cancer?

A
  • > 55 y/o
  • decreased fluid intake
  • male
  • previous radiation/chemo
  • family history
167
Q

What causes stress incontinence?

A
  • increased intra-abdominal pressure
  • weakness of pelvic floor and sphincter
168
Q

diagnosis

sudden release of urine

A

stress incontinence

169
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

170
Q

What are the causes of urge incontinence?

A
  • detrusor muscle instability or hyperreflexia
  • sensory instability: hypersensitive bladder
171
Q

diagnosis

bladder continuously leaks secondary to urinary retention (overdistended bladder)

A

overflow incontinence

172
Q

What are causes of overflow incontinence?

A
  • obstruction
  • acontractile bladder
  • neurogenic bladder
173
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

174
Q

What medications may aggravate incontinence?

A
  • anticholinergics
  • diuretics
  • psychotropic drugs

NPTE (22 decks)

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