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PT1:3: Pathology II > Urinary Pathologies > Flashcards

Urinary Pathologies Flashcards

1
Q

Lower UTI

A

bladder

urethra

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2
Q

cystitis

A

bladder infection

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3
Q

Upper UTI

A

kidney

glomeruli

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4
Q

pyelonephritis

A

kidney infection, of renal pelvis and interstitium

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5
Q

Who commonly gets UTI’s

A
  • 8x more likely in women

- more common in elderly (inactivity/mobility)

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6
Q

In elderly, UTI’s may cause:

A

confusion

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7
Q

Factors that increase the risk of UTI

A
  1. age
  2. gender
  3. incontinence leading to cauterization
  4. sexual activity
  5. diabetes
  6. pregnancy
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8
Q

S/S of UTI:

A

dysuria
increased freq and urgency
hematuria (blood)

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9
Q

UTI’s may mimic?

A

musculoskeletal problem, back pain near costovertebral angle (flank) tenderness

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10
Q

Risk factors of a kidney infection?

A
  1. ascending UTI or reflux of urine (neurogenic bladder)

2. kidney stones causing blockage

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11
Q

what causes a neurogenic bladder?

A

stroke, paraplegia

-lower sphincter closes, bladder contracts and urine goes up to kidney instead of out

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12
Q

Clinical manifestations of pyelonephritis (increased WBC):

A
  • same as UTI
  • fever
  • chills
  • hematuria
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13
Q

Red Flags of pyelonephritis:

A
  • back pain
  • costovertebral angle tenderness
  • may refer to shoulder
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14
Q

unreliable test for kidney infection?

A

murphy percussion test

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15
Q

most common neoplasm in renal

A

Renal Cell Carcinoma

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16
Q

S/S of Renal Cell Carcinoma

A
  • hematuria most common
  • often silent symptoms at initial stages
  • abdominal/flank pain develops later
  • palpable abdominal mass
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17
Q

Renal Cell Carcinoma usually metazoic to

A

lungs
liver
lymph
bones

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18
Q

most common inherited kidney disease

A

Polycystic Disease

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19
Q

accumulation of fluid in the kidneys causing a cyst to form

A

polycystic disease

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20
Q

polycystic disease may be caused by:

A

obstruction or weak basement membrane

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21
Q

what is the most common symptom of polycystic disease?

A
  • Flank pain

- others: palpable, enlarged kidneys, hematuria, hypertension

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22
Q

polycystic patients are at risk for

A

UTIs

hypertension

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23
Q

third most common urinary tract disorder

A

kidney stones

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24
Q

calcium deposits

A

kidney stones

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25
Q
  • 4x greater in males
  • diet (grapefruit juice increases risk, coffee decreases_
  • obesity
  • climate (warmer)
  • 50% reoccurance
A

risk factors for kidney stones

26
Q

Clinical manifestations of kidney stones: (red flags)

A
  1. acute, excruciating flank & upper, outer abdominal pain
  2. dull back pain progressing to worst pain ever
  3. Cost. vet. angle. tenderness
  4. may radiate into lower abdomen, bladder, and perineal area
27
Q

other clinical manifestations of kidney stones:

A
  1. nausea and vomiting
  2. increased freq. and urgency
  3. hematuria
  4. asymptomatic
28
Q

difference between musculoskeletal pain and renal/urethra pain?

A

musculoskeletal pain usually altered by position

29
Q
  • gradual loss of nephrons over a period of time
  • decreased glomerular filtration and reabsorption
  • decreased endocrine function of kidneys
A

Chronic Renal Failure and End Stage Renal Disease

30
Q

how many nephrons must be lost in order to show S/S of Chronic Renal Failure

A

-50%

31
Q

Risk Factors for Chronic Kidney Disesase

A

-Hypertension
-Diabetes
NSAIDS
Age
Smoking
Heredity

32
Q

How does hypertension affect the kidneys?

A

-damages glomerulus arterioles, decreasing GFR and increasing protein filtration

33
Q

System Changes with CKD

A
  • Hematologic
  • Cardiovascular issues
  • neuromuscular
  • Skeletal
  • neurologic
  • gastrointestinal
  • physical performance
  • Integumentary
34
Q

Hematologic changes with CKD?

A

-anemia due to decreased RBC production

35
Q

Cardiovascular issues with CKD?

A
  • hypertension (due to increased renin)

- increased Na+ and increased fluid volume

36
Q

Neuromuscular changes with CKD?

A
  • muscle cramping
  • weakness
  • myopathy
  • sensory loss
  • tremors
37
Q

Skeletal changes with CKD?

A
  • demineralization of bone due to loss of calcium in urine

- PTH is released and takes calcium from bones which could lead to osteoporosis

38
Q

Neurological Changes with CKD?

A

-increased remix alters nervous system function, memory loss, irritability, impaired judgement, seizers, coma at end stage

39
Q

GI changes with CKD?

A
  • anorexia
  • nausea
  • vomiting
40
Q

Physical performance changes with CKD?

A

-impaired early in the course of the disease, not always

41
Q

Integumentary changes with CKD?

A
  • pallor
  • bruising
  • skin pigmentation
42
Q

Chronic Renal Disease concerns for physical therapy?

A
  • decreased RBCs leads to anemia and fatigue, weakness, dyspnea
  • osteoporosis due to poor calcium regulation
  • renal osteodystrophy because of Ca ++ loss, leading to bone pain
  • memory loss, coma, decreased alertness
43
Q

How can having chronic renal disease affect PT’s?

A

pt. may have:
- decreased alertness
- poor concentration and memory
- difficulty following instructions (transfers, exercises, mechanics)
- fatigue and weakness meaning more rest
- potential osteoporosis
- interventions to prevent fractures

44
Q

treatment for CKD?

A
  • dialysis (hemodialysis in the clinic and peritoneal)

- transplant

45
Q

What is the number one cause of mortality in CKD?

A

CVD

46
Q

three reasons why heart rate monitoring does not work well for measuring exercise intensity in those with CRD?

A
  1. medications
  2. abnormal heart rate due to disease
  3. fluid status may alter HR
47
Q

what causes a spastic bladder?

A

UMNL, stroke, spinal cord lesion

48
Q

describe a spastic bladder?

A
  • increased detrusor muscle tone and activity
  • decreased urine volume
  • increased freq. and urgency
  • involuntary voiding
  • incoordination of detrusor and sphincter muscles leading to decreased flow and reflux
49
Q

what causes a flaccid bladder?

A

LMNL, below sacral level
Spina bifida
diabetes

50
Q

describe a flaccid bladder?

A
  • detrusor muscle inactivity and loss of sensation of bladder fullness
  • causes bladder to overfill leading to overflow and incontinence
51
Q

How can you treat a neurogenic bladder?

A
  • catherization (intermittent or permanent)
  • bladder retraining, EMG biofeedback
  • control fluid intake
  • surgery
52
Q

4 types urinary incontinence?

A
  1. Functional
  2. Stress
  3. Urge
  4. Overflow
53
Q
  • normal urine control

- have difficulty reaching toilet in time due to muscle or joint dysfunction

A

Functional Incontinence

54
Q
  • loss of urine during activities that increase intra-abdominal pressure such as couching, lifting, or laughing
  • pelvic floor weakness
A

Stress Incontinence

55
Q

Sudden, unexpected urge to urinate and the uncontrolled loss of urin

  • overactive bladder
  • UMNL
A

Urge incontinence

56
Q

Frequent dribbling or leaking or ride from bladder that is full but unable to empty

  • blocked or flaccid bladder
  • LMNL
A

Overflow Incontinence

57
Q

What type of incontinence is common after pregnancy?

A

Stress

58
Q

Risk factors for urinary incontinence

A
  • women
  • pelvic floor weakness w/aging and pregnancy
  • neurological disorders
  • UTI
  • medications
  • prostatectomy or prostatic hyperplasia
59
Q

caused by uncontrolled bladder contractions increasing freq. and urgency of voiding
-often by UMNL and uncoordinated actions of the detrusor and sphincter muscles

A

Urge Pathogenesis or urge incontinence

60
Q

What types of incontinence have PT been beneficial for?

A

stress and urge incontinence but using biofeedback and pelvic floor exercises

PT1:3: Pathology II (3 decks)

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