Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Urinary System > Stones and Infections of the Urinary System > Flashcards

Stones and Infections of the Urinary System Flashcards

1
Q

State possible causes of obstruction in the ureter.

A
  1. Calculi
  2. Ca
  3. Retroperitoneal fibrosis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

State possible causes of obstruction in the bladder.

A

Neuropathic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

State possible causes of obstruction in bladder neck.

A

Hypertrophy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

State possible causes of urinary tract obstruction related to the prostate.

A

BPH

Ca

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

State possible causes of obstruction in the urethra.

A

Stricture

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Outline the host factors responsible for urinary tract infections.

A
  1. Shorter urethra: females > males
  2. Ureteric reflux: Ascending infection to the bladder especially in children
  3. Obstruction: tumour, stones, enlarged prostate, pregnancy
  4. Neuropathic: incomplete emptying, residual urine
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

State organisms that are commonly implicated in urinary tract infections.

A
  1. Coliforms (commonest): e.g. E. coli, Klebsiella, enterobacter - gram negative pink rods
  2. Proteus spp
  3. Coagulase negative staph - biofilm production
  4. Enterococci
  5. Pseudomonas
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

State the signs and symptoms of cystitis.

A
  1. Frequency
  2. Dysuria
  3. Urgency
  4. May have low grade fever
  5. Pain or burning sensation in urethra while passing urine
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

State the signs and symptoms of pyelonephritis.

A
  1. Fever
  2. Loin pain
  3. May have dysuria and frequency
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is an uncomplicated infection?

A

Defined as infection by a usual organism in an individual with a normal urinary tract and normal urinary function

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is a complicated infection?

A

When 1 or more factors are present that predispose the patient to recurrent/persistent infections or treatment failure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

State examples of UTIs that would be considered complicated.

A
  1. Abnormal urinary tract: indwelling catheters, Vesicoureteric reflux
  2. Virulent organisms, e.g Staph aureus
  3. Impaired host defences: poorly controlled diabetes, immunosuppression
  4. Impaired renal function
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

State the types of urine specimens that can be collected.

A
  1. Mid stream urine samples: cleansing not required in women
  2. Clean catch in children: no antiseptic
  3. Supra-pubic aspiration
  4. Catheter sample
  5. Transportation: 4 degrees celcius +/- boric acid (preservative in powder or crystal form which prevents organisms multiplying excessively and changing the original picture)
  6. Collection bag: 20% false positives
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Indicate what substances can be tested for in the urine in near patient testing (screening) with a dipstick.

A
  1. Leukocyte esterase- enzyme produced by leukocytes, indicates presence of leukocytes in urine - pyuria
  2. Nitrites: some bacteria produce enzymes reducing nitrates to nitrites
  3. Proteinuria
  4. Haematuria: inflammation, damage to epithelium and release of red blood cells
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is negative predictive value?

A

How helpful a test is in excluding infection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

State some risk factors for bladder stones.

A
  1. Increased oxalate consumption
  2. Low protein diet
  3. Chronic diarrhoea and dehydration
  4. Vitamins A, B1 and B6 deficiency
  5. Magnesium deficiency
17
Q

What is a lithotomy?

A

Surgical removal of a calculus from the bladder, kidney or urinary tract

18
Q

Why was it difficult to perform lithotomies suprapubically in ancient times?

A
  • Before the time of anaesthesia

- Rectus muscles go into spasm

19
Q

What are the complications associated with a lithotomy?

A
  1. Infection
  2. Haemorrhage
  3. Fistulae
  4. Urinary incontinence
  5. Erectile dysfunction
  6. Mortality rate up to 50%
20
Q

State some causes for bladder stones seen in modern times.

A
  1. Bladder outflow obstruction: neuropathic bladder, urethral stricture, prostate obstruction
  2. Foreign body: catheters, non-absorbable sutures
  3. Many are passed down from the upper urinary tract
21
Q

State the symptoms of bladder stones.

A

Bladder outflow obstruction:

  1. Anuria: difficulty passing urine
  2. Painful bladder distension
22
Q

What can renal stones be made of?

A

Calcium stones (99%)

  1. Calcium phosphate (apatite) usually with calcium oxalate - 65%
  2. Calcium phosphate alone - 15%
  3. Uric acid - 3-5%
  4. Struvite stones - “infection stones” (10-15%)

Other types (1-2%):

  1. Cysteine stones: seen in rare genetic disorder cystinuria
  2. Drug stones: e.g. indinavir (HIV treatment), triamterene (diuretic), sulphadiazine (sulphonamide antibiotic)
  3. Ammonium acid urate stones
23
Q

What are struvite stones? Which gender are they more commonly seen in?

A
  1. Infection stones
  2. Urease stones
  3. Triple phosphate stones: magnesium ammonium phosphate hexahydrate
  4. Seen with infection by bacteria which have urease

Females

24
Q

How can urine become supersaturated with minerals?

A
  1. Decrease in water content
  2. Increase in mineral content
  3. Decrease in solubility of solute in urine (change in urinary pH)
25
Q

Which stones are more likely to form in acidic pH?

A
  1. Calcium oxalate

2. Uric acid stones

26
Q

Which stones are more likely to form in alkaline pH?

A

Calcium phosphate stones

27
Q

What is the consequence of renal tubular acidosis?

A
  1. Alkaline urine

2. Decreased urinary citrate excretion

28
Q

How do the majority of calcium oxalate stones form?

A

Majority grow as stalactites attached to exposed interstitial deposits of calcium phosphate, “Randall’s plaque”, on the tips of renal papilla
- Consists of a core of calcium phosphate surrounded by calcium oxalate

29
Q

State additional causative factors for kidney stones.

A
  1. Congenital/genetic: primary metabolic disturbances (e.g. cystinuria, polycystic kidney disease)
  2. Drugs
  3. Urinary stasis: low urine flow, infection, obstruction
  4. Idiopathic
30
Q

What are the causes of hypercalciuria without hypercalcaemia?

A
  1. Impaired renal tubular absorption of calcium

2. Hyperabsorption of calcium from gut

31
Q

What are the causes of hyperoxaluria?

A
  1. Hereditary

2. Secondary to intestinal overabsorption by patients with enteric disease

32
Q

Where are calcium sensing receptors present?

A
  1. Kidney
  2. Brain
  3. Parathyroid glands
33
Q

How does calcitonin decrease serum calcium?

A
  1. Inhibiting osteoclastic resorption of bone

2. Increasing excretion of calcium and phosphate

Urinary System (5 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions