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Year 3 - Uro > Urinary retention > Flashcards

Urinary retention Flashcards

1
Q

What the main categories of urinary retention?

A

Prerenal
Renal
Postrenal

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2
Q

Give some pre-renal causes of urinary retention

A

Hypovolemia
Low BP
HF
Reduced local perfusion of the kidneys

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3
Q

What are the renal causes of urinary retention?

A 
Acute tubular necrosis (e.g. ischaemia, nephrotoxic drugs)
Glomerulonephritis
Interstitial nephritis
Vascular causes
Infectious causes
Multiple myeloma
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4
Q

What is glomerulonephritis

A

Damage to glomeruli after infection, vascular causes or autoimmune causes

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5
Q

Drugs that cause interstitial nephritis

A

NSAIDS

antibiotics

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6
Q

Give examples of vascular causes of renal disease

A

Malignant hypertension
DIC
TTP
HUS

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7
Q

Give infectious causes of renal disease

A

Malaria

Legionairre’s diseaes

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8
Q

What is multiple myeloma?

A

Proliferation of plasma cells

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9
Q

What is the mnemonic for multiple myeloma?

A

Calcium is high
Renal impairement
Anaemia
Bone pain

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10
Q

What is nephrotic syndrome?

A

Proteinuria >????
Low serum albumin
Oedema

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11
Q

What is nephritic syndrome

A

Blood in urine
HTN
Haematuria

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12
Q

How do you classify vasculitis?

A

Large vessel
Medium vessel
Small vessel

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13
Q

What is HUS and what do these cause?

A

Haemolysis -> MAHA and thrombocytopenia causing jaundice and conjunctival pallor
Urinary problems -> oliguria
Shits -> abdo pain and bloody diarrhoea

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14
Q

What is TTP

A

Basically all of HUS plus the following:
Temperature
Fever
Fluctuating CNS signs

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15
Q

What is dysfunctional in TTP?

A

ADAMS13 protein dysnfuction

normally cleaves vWF

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16
Q

What do you need to diagnose DIC?

A

Evidence of bleeding at three unrelated sites

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17
Q

What is associated with DIC?

A

MAHA
Sepsis signs
Bleeding and clots

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18
Q

What post renal causes classifications

A

Ureter
Bladder
Urethra

19
Q

Post renal causes of urinary retention is due to

A

obstruction of urinary flow

20
Q

Ureter causes

A

Abdo/pelvic pain

Bilateral calculi

21
Q

Bladder causes

A

Drugs e.g. anticholinergic drugs
Bladder stones
Tumour

22
Q

What are the three types of tumours in the bladder?

A

Transitional cell - most common
Squamous cell
Adenocarcinoma

23
Q

Urethra causes

A

BPH
Blocked catheter
Prostate cancer
Infection (HSV) - > painful urination means patients don’t urinate

24
Q

Which ethnicity is prostate cancer common in?

A

Afro Caribbeans

25
Q

Hx questions

A

When did it start?
Has this happened before?
Sudden or gradual?
Intermittent or continuous?

26
Q

If the symptoms are gradual, what does it suggest?

A

Gradual - prerenal

27
Q

If the symptoms are intermittent, what does it suggest?

A

Intermittent - malaria

28
Q

What other questions would you screen for if you’re thinking HF?

A

HF - orthopnoea, fatigue, weight loss, pink/frothy sputum

29
Q

What other questions would you screen for if you’re thinking glomerulonephritis?

A

Haematuria, oedema, polyuria/oliguria

30
Q

What other questions would you screen for if you’re thinking vasculitis?

A

Vasculitis - anoything e.g. fever, malaise, weight loss, rash, ulcers, arthraliga, abdo pain, cough, sob

31
Q

What other questions would you screen for if you’re thinking DIC?

A

Petechiae, epistaxis, mucousal bleeding, hypotension, tachycardia

32
Q

What other questions would you screen for if you’re thinking malaria?

A

High fever, sweating, rigors, vomiting, jaundice, hepatomegaly, anaemia, consciousness, fits

33
Q

What other questions would you screen for if you’re thinking HUS?

A

Jaundice
Conjuntival pallor
ABDO PAIN
bloody diahorea

34
Q

What other questions would you screen for if you’re thinking TTP?

A

Jaundice
Conjuntival pallor
ABDO PAIN
bloody diahorea

+ fever
fluctuating CNS symp

35
Q

What other questions would you screen for if you’re thinking multiple myeloma?

A

Bone pain
Lethargy
Aneamia

36
Q

What other questions would you screen for if you’re thinking BPH?

A 
Poor flow
Hesitancy
Incomplete voiding
Painful urination
UTI
37
Q

What other questions would you screen for if you’re thinking prostate cancer?

A

Pain with ejaculation
Painless macroscopic haematuria
more pain depending on

38
Q

What other questions would you screen for if you’re thinking paraneoplastic syndrome?

A

Constipation
Crampy abdo pain
High calcium

39
Q

What are the relevant pre-existing conditions?

A 
HF
Malignancy
Cirrhosis
Hepatitis
CKD
PVD
DM
Pancreatitis 
Recent trauma
Recent infections
Blocked catheter
Schistosomiasis
Abnormal androgens (causing bladder hyperplasia)
40
Q

Schistosomiasis increases your risk of?

A

Squamous cell carcinoma

41
Q

Relevant drugs

A 
Antibiotics - gentamycin
Streptomycin
ACEi
Contrast agents
NSAIDs
Anticholinergics
Sympathomimetics
42
Q

Why is occupation relevant?

A

Cadmium - (e.g. smelting metals, manufacturing, making batteries) increases risk of prostate cancer
Aromatic amines increase risk of bladder cancer e.g. in

43
Q

What increases the risk of

A

Low fibre diet

Year 3 - Uro (8 decks)

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