Urinary System and Male Genital Tract Flashcards
What are the risk factors of UTIs?
Female Sex Pregnancy Diabetes Obstructions eg. stones/catheters
What are the 4 types of UTI?
Urethritis (urethra)
Cystitis (bladder)
Prostatitis (prostate)
Pyelonephritis (kidney)
What is the most common causative organism of UTIs?
E.coli, staphylococcus, proteus, klebsiella
What are the symptoms of cystitis?
Frequency Dysuria Urgency Haematuria Suprapubic pain
What are the symptoms of pyelonephritis (kidney)?
High fever
Rigors
Vomiting
Loin pain
What are the symptoms of prostatitis?
Flu like
Few urinary
Swollen tender prostate
How do you manage UTIs?
Fluid Urination Antibiotics (trimethoprim) Imaging Admission
What do the kidneys maintain?
Water, electrolyte and acid-base homeostasis
What do the kidneys excrete?
Toxic metabolic waste products e.g. urea and creatine
What hormonal functions are the kidneys involved in?
Renin (BP)
Erythroprotein (RBCs in bone marrow and produce vit D)
What does a nephron consist of?
Glomerulus and renal tube
What in filtered in the glomerulus?
Small molecules from the blood
What are the 2 types of renal failure?
Acute & chronic
What are the 2 clinical features of acute renal failure?
Low urine volume (
What are the 3 stages of acute renal failure?
Pre renal
Renal
Post renal
What are the causes of pre renal acute renal failure?
Hyperperfusion
Sepsis
What are the causes of renal acute renal failure?
ATN damage to tubules due to ischaemia or nephrotoxins
What are the causes of post renal acute renal failure?
Renal tract obstruction e.g stones
How can you manage acute renal failure?
Find & treat cause
Treat exacerbating factors
Stop nephrotoxic drugs
May need renal replacement therapy
Chronic renal failure is classified into 5 stages depending on what?
Glomerular filtration rate (GFR)
What is Glomerular filtration rate (GFR)?
The volume of fluid filtered from the glomerular capillaries into the bowman’s capsule per unit time
At what stage of chronic renal failure do symptoms usually occur?
Stage 4
What are the 5 common causes of renal failure?
Glomerulonephritis Diabetes Reno vascular disease Hypertension Polycystic disease
What is Glomerulonephritis?
Group of disorders where there is damage to the glomerular filtration apparatus
What can Glomerulonephritis cause?
Leak of protein or blood into the urine
What are stones?
Crystal aggregates that form in the collecting ducts of the kidneys and can deposit anywhere in the renal tract
What are the risk factors of stones?
Dehydration
Dietary factors
Drugs e.g. loop diuretics, antacids, corticosteroids, aspirin
Renal tract abnormalites
Recurrent UTIs
Metabolic abnormalities e.g. hyperthyroidism, cancer
Kidney stones cause pain where?
Loin
Ureteric stones cause what?
Renal colic
Bladder and urethral stones cause pain when?
During interrupted micturition (urination)
If stones are asymptomatic, how are they found?
Accidentally on X-ray or blood on dipstick
What scans are used to view stones?
CT
KUB xray
What is the most common type of renal cancer?
Renal cell carcinoma
What are the risk factors of renal cell carcinoma?
Smoking
Obesity
Hypertension
Asbestos
What are the presentations of renal cell carcinoma?
Haematuria
Loin pain
Abdominal mass
Para neoplastic syndromes
What treatment is available for renal cancer?
Radical nephrectomy +/ chemotherapy
What is the most common benign bladder condition?
Cystitis
What is the most common malignant bladder condition?
Transitional cell carcinomas
What are the presentations of transitional cell carcinomas?
Painless haematuria
Frequency, urgency, dysuria
What tests can be done to identify transitional cell carcinomas?
Urine for cytology
Cystoscopy and biopsy
How can small lesions at early stage transitional cell carcinoma be treated?
Diathermy on cystoscopy
How can later stages of transitional cell carcinomas be treated?
Radical cystectomy or palliative chemo/radiotherapy
What is benign prostatic hyperplasia?
Increase in number of cells resulting in the formation of nodules
What are the symptoms of benign prostatic hyperplasia?
Increased frequency
Hesitancy
Nocturia
Terminal dribbling
What treatments are advised if benign prostatic hyperplasia is small and non symptomatic?
Reduce fluid intake Reduce alcohol and caffeine Scheduled voiding Alpha blockers Transurethral Resection of the prostate
What are the risk factors of prostate cancer?
Age Race Family history Hormone levels Diet
What are the symptoms of prostate cancer?
Nocturia, hesitancy, poor stream, terminal dribbling, hard irregular prostate
How is prostate cancer diagnosed?
Raised prostate specific antigen (PSA)
Biopsy
How can local prostate cancer be treated?
Radical prostatectomy
How can more advanced prostate cancer be treated?
Hormal therapy
Radiotherapy
What is testicular torsion?
Sudden onset of pain in 1 testis
What are the symptoms of testicular torsion?
Pain in abdomen
Nausea
Testis hot, swollen, tender
High and transverse testis
How can testicular torsion be tested for?
USS with doppler
May need exploratory surgery
What surgery is used to treat testicular torsion?
Bilateral fixation (orchidopexy) if viable Orchidectomy if abnormal
What are the risk factors of testicular tumours?
Undescended testis
Infant hernia
Infertility
How do testicular tumours present themselves?
Painless testicular lump often noted after trauma or infection
What is the most common germ cell tumour?
Seminoma
How are testicular tumours treated?
Orchidectomy & a combination of radiotherapy and chemotherapy
