urinary Flashcards
What is nephrolithiasis?
Kidney stone disease, also known as renal calculi.
What does “calculus” refer to in nephrolithiasis?
The stone itself.
What does “lithiasis” mean in nephrolithiasis?
The formation of stones.
How can climate contribute to kidney stones?
Warm climates cause fluid loss, low urine volume, and increased urine solute concentration.
How can diet contribute to kidney stones?
Excess fruit juice/tea increases uric acid excretion; high protein and salt intake contribute.
What dietary factors increase urine concentration?
Low calcium intake and insufficient fluid intake.
How do genetic factors contribute to kidney stones?
Family history of stones, cystinuria, or renal tubular acidosis increases risk.
What lifestyle factors increase kidney stone risk?
Immobility, obesity, and a sedentary occupation.
What metabolic abnormalities contribute to kidney stones?
Increased urine pH, calcium, oxalate, or uric acid; or low citrate levels.
What prevents kidney stone recurrence?
Keeping urine dilute and free-flowing reduces recurrence risk.
How does urinary pH affect stone formation?
High pH reduces solubility of calcium and phosphate; low pH reduces solubility of uric acid and cystine.
What complications arise from infected stones?
Renal infection, hydronephrosis, and kidney function loss may occur.
What is a staghorn stone?
A large stone occupying a significant portion of the kidney, often caused by infection.
Where does pain occur if the stone is in the calyx or UPJ?
Pain is felt in the costovertebral flank area (renal colic).
Where does pain occur if the stone is in the UVJ?
Pain radiates to the abdomen, lower quadrant, or groin.
What pain is specific to men with kidney stones?
Testicular pain.
What pain is specific to women with kidney stones?
Labial pain.
What additional symptoms accompany kidney stones?
Nausea, vomiting, dysuria, fever, chills, and mild shock.
How is a kidney stone diagnosed?
Noncontrast CT scan or ultrasound; urinalysis to check for hematuria and crystalluria.
Why is stone retrieval and analysis important?
It helps diagnose the underlying problem contributing to stone formation.
What is laser lithotripsy?
A procedure using laser energy to break stones into smaller fragments for excretion.
What is ESWL (extracorporeal shock-wave lithotripsy)?
Uses shock waves to break up stones; performed under anesthesia.
What is ultrasonic lithotripsy?
Uses high-frequency sound waves to break stones into “sand”; requires anesthesia.
What is electrohydraulic lithotripsy?
Uses electrical shock waves to break up stones into fragments.
What is a cystoscopy?
A procedure to remove small stones located in the bladder.
What is cystolitholapaxy?
A procedure to break bladder stones using ultrasound, laser, or lithotrite, followed by irrigation.
What is a ureteroscopy?
A procedure to remove stones from the renal pelvis or upper urinary tract, with or without lithotripsy.
What is percutaneous nephrolithotomy?
A procedure involving kidney access via the back to fragment stones and irrigate the kidney.
What are the complications of nephrolithotomy?
Bleeding, infection, or injury.
What is a nephrolithotomy?
A surgical incision into the kidney to remove stones.
What is a pyelolithotomy?
A surgical incision into the renal pelvis to remove stones.
What is a ureterolithotomy?
A surgical incision into the ureter to remove stones.
What is a cystotomy?
A surgical procedure to remove bladder stones.
What are common interventions for kidney stones?
Increase hydration, manage pain and infection, and treat obstruction.
What diet changes help prevent kidney stones?
Low sodium diet and avoiding excessive animal protein and salt intake.
What is the most common cause of urinary tract infections (UTI)?
E. coli, accounting for 75% of cases.
What is pyelonephritis?
Inflammation of the renal parenchyma and collecting system caused by infection.
What are some anatomic risk factors for UTIs?
Abnormalities in the urinary tract, urinary retention, and foreign bodies like catheters.
What conditions can make someone more prone to UTIs?
Immunocompromised status, urinary stasis, and dehydration.
What functional disorders increase UTI risk?
Conditions like “nurse’s bladder” and issues caused by sexual activity or poor hygiene.
How does pregnancy affect UTI risk?
Pregnancy can increase the risk due to physiological changes like urinary retention.
What role does pH change play in UTI risk?
Any change in urinary pH can contribute to UTI development.
What are the lower urinary symptoms of a UTI?
Dysuria, hesitancy, intermittency, postvoid dribbling, urinary retention, and incomplete emptying.
What are storage symptoms of a UTI?
Incontinence, nocturia, nocturnal enuresis, urgency, and urinary frequency (more than every 2 hours).
What are common upper urinary symptoms of a UTI?
Fever, chills, and flank pain.
What tests are used to diagnose a UTI?
Urinalysis (clean-catch specimen), urine culture and sensitivity, imaging studies (CT, ultrasound, cystoscopy).
What is the first step in diagnosing recurrent UTIs?
Repeat urinalysis and urine culture and sensitivity testing.
When are imaging studies indicated for a UTI?
If the infection is recurrent or complicated, or if there is suspicion of anatomical abnormalities.
How are UTIs generally treated?
Antibiotics and increased fluid intake.
What is included in prevention education for UTIs?
Maintaining good hygiene, adequate fluid intake, and possibly using heat packs for discomfort.
How can patients with uncomplicated UTIs be supported?
Patient education on antibiotic use, prevention, and adequate hydration.
