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Differential Dx > Urogenital Screening > Flashcards

Urogenital Screening Flashcards

1
Q

The urinary tract consists of _______, ________, _______, and ________.

A

kidneys, ureters, bladder, urethra

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2
Q

The primary function of the urogenital system is….

A

acid base balance, electrolyte balance, control of BP w/ renin, form RBC’s, activation of vitamin D and calcium balance

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3
Q

the ______ are located in the posterior upper abdominal cavity in space behind the peritoneum

A

kidneys

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4
Q

_______ of urinary excretion is based on learned inhibition of reflex pathways from the walls of the bladder. Release of urine from the bladder occurs under voluntary control of the ________

A

Voluntary Control

Urethral Sphincter

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5
Q

Constitutional Symptoms of Genitourinary disease

A

fever, chills, fatigue, malaise, anorexia, weight loss

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6
Q

MS Symptoms of Genitourinary disease

A

unilateral costovertebral tenderness, LBP, flank pain, inner thigh pain, leg pain, ipsilateral shoulder pain

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7
Q

Genitourinary symptoms specific to Women

A

abnormal vaginal bleeding, painful menstruation, changes in menstrual pattern, pelvic masses or lesion, vaginal itching or discharge, pain during intercourse

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8
Q

Genitourinary symptoms specific to Men

A

Difficulty starting/continuing stream or urine, discharge from penis, penile lesion, testicular/penis pain, scrotal enlargement, swelling/mass in groin, sexual dysfunction

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9
Q

Common Urinary Problems

A

Dysuria, nocturia, feeling that you aren’t completely empty, hematuria, dribbling at end of urination, increased frequency, hesitancy, proteinuria

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10
Q

kidneys and ureters are innervated by ________

A

sympathetic and parasympathetic fibers

  • renal vasoconstriction and increased renin release are associated w/ sympathetic stimulation. Lower parts cause more pain by stretching or puncture
  • when stimulated, common for visceral pain fibers to stimulate concurrent stimulation of cutaneous fibers.
  • consistent w/ T10-L1 dermatomes
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11
Q

Ureteral pain is felt in the ____ and _____ area

A

groin and genital areas

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12
Q

Renal pain is typically felt in the ___________ and _________

A

posterior subcostal and costovertebral region

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13
Q

whenever the renal capsule is punctured, a dull pain can also be felt. ________ of renal tissue caused by blockage of blood flow to kidneys results in ______ or ________.

A

Ischemia.

constant dull or constant dull pain

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14
Q

Pseudorenal pain may occur secondary to _______ or _______ to the costal nerves caused by ________ of the costovertebral or costotransverse joints

A
  • radiculitis or irritation
  • mechanical derangements

-most common sites are T10-T12. onset is usually acute w/ some type of trauma. It can be altered by body position. Radiculitis may mimic ureteral colic or renal pain.

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15
Q

Bladder innervation occurs through syhmpathetic, parasympathetic, sensory nerves at levels _______

A
  • sympathetic - T9 or higher

- parasympathetic - S2-S4 and provides coordination for voiding

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16
Q

Urethral innervation occurs at levels ________

A

S2-S4 and also occurs through pudendal nerve

-bladder and urethral pain is felt above the pubis or low in the abdomen

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17
Q

Predisposing factors to renal and urinary tract problems include……

A
  • age over 60
  • diabetes or HTN
  • kidney disease, MI, CVA
  • kidney stones, urinary tract infection
  • African, Hispanic, Pacific Island, Native American
  • Exposure to chemicals
  • Low birth weight
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18
Q

Upper UTI include ______ and lower UTI include ______

A
  • kidney or ureteral infection
  • cystitis or urethritis

-upper is considered more serious

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19
Q

Routes of entry of bacteria into urinary tract can be ______

A

-ascending, bloodborne, or lymphatic

20
Q

Lower UTI is more common in ______

A

women - is because of short female urethra

21
Q

Inflammation w/ infection of the bladder is ______. Inflammation w/o infection is _________. Inflammation and infection is _________

A
  • cystitis
  • interstitial cystitis
  • urethritis

All 3 appear similarly. All known as painful bladder syndrome. It consists of recurring pelvic pain, associated w/ urinary frequency and urgency

22
Q

Obstructions occurring w/in the urinary tract is _______ and obstructions occurring from disease outside the urinary tract is ________

A
  • primary urinary obstruction
  • secondary urinary obstruction

-both result in backup or collection of urine eventually causing severe dilation of the renal collecting system and renal failure

23
Q

Pain, hyperesthesia of dermatomes, N/V, palpable flank mass, hematuria, fever, chills, urge to urinate, abdominal muscle spasms, renal impairment indicators all indicate ________

A

obstruction of upper urinary tract

  • pain can be acute, spasmodic, radiating, on flank, or lumbar depending on severity or location
  • most common symptom is sudden, sharp, severe pain
  • uretral colic occurs if the stone becomes trapped in ureter
24
Q

Common conditions of obstruction of lower urinary tract include…..

A

bladder tumors, prostatic enlargement, BPH, or malignant cancer
-may cause difficulty emptying

25
Q

______ is a relatively common inflammation of the prostate

A

Prostatitis

  • Type 1-Type 3
  • exacerbated by sexual activity, voided complaints, urgency, frequency, nocturia, slow stream
  • differs from BPH in that there is discomfort before, during, or after voiding
  • Can’t be cured - but can be managed
26
Q

fever, chills, LBP, inner thigh/perineal pain, testicular pain, frequency/urgency, nocturia, dysuria, weak stream, unable to fully empty, sexual dysfunction, malaise, arthralgia, myalgia suggest _________

A

Prostatitis

27
Q

Palpable bladder above symphysis pubis, urinary issues (hesitancy, small voiding, dribbling, frequency, nocturia), lower abdominal discomfort, LBP, suprapubic/pelvic pain, difficult erection, blood in urine/semen suggest ______

A

Obstruction of lower urinary tract (BPH or Prostatic cancer)

28
Q

Prostate cancer risk

A
  • increased by age 50
  • prostate-specific antigen rises in men who have prostatic changes
  • early prostate cancer often does not cause symptoms
  • stages 1-4
29
Q

______ refers to involuntary leakage of urine

A

Incontinence

  • is not a disease but rather a symptom
  • stress incontinence - occurs when the support for the bladder or urethra is weak or damaged
  • urge incontinence - overactive bladder
  • overflow incontinence - bladder cannot empty completely
  • functional incontinence - describes how bladder is normal but mind/body not working together
30
Q

frequency of UI is significantly higher in _______

A

athletes w/ eating disorders

  • chemotherapy, radiation, surgery, medications all can cause issues as well
  • it is not part of the normal aging process
31
Q

Cervical spinal manipulation in those w/ urinary incontinence is _______

A

contraindicated

32
Q

_______ occurs when kidneys can no longer maintain homeostatic balances w/in body that are necessary for life

A

kidney failure
-it can be acute renal failure or chronic renal failure (irreversible)
diabetic nephropathy is the primary cause of ESRD

33
Q

advanced age, diabetes mellitus, HTN, chronic urinary tract obstruction, kidney transplantation all are risk factors for ______

A

End stage renal disease (ESRD)

34
Q

Unilateral costovertebral tenderness, flank pain, ipsilateral shoulder pain, fever, chills, skin hypersensitivity, hematuria, pyuria, bacteriuria, HTN, decreased urine output, anorexia, dyspnea, mild HA, proteinuria, anemia suggest ___________

A

Renal Impairment

35
Q

Chronic kidney disease characteristics

A
  • often autonomic dysfunction and sensorimotor peripheral neuropathies
  • impaired fluid and waste excretion and altered renal regulation creating pH issues, RBC issues, and calcium-phosphorus issues
36
Q

Treatment options for kidney disease

A

dialysis, dietary changes, medications to regulate blood pressure and assist in lost metabolic functions

37
Q

______ is the 4th most common cancer in men and the 10th for women. Risk factors include:

A

Bladder cancer

  • age over 40
  • tobacco use
  • occupation exposing to carcinogens
  • infections
  • treatment w/ cyclophosphamide or arsenic
  • white race
38
Q

blood in urine, pain during urination, urinary urgency all suggest _______

A

bladder cancer

39
Q

blood in urine, painful urination, urinary urgency, flank pain, lump/mass in abdomen, weight loss, fever, general fatigue suggest _______

A

renal cancer

40
Q

Risk factors for renal cancer include …..

A
  • smoking
  • obesity
  • HTN
  • long-term dialysis
  • Von Hippel-Lindau syndrome
  • occupation exposing to chemicals
  • men more likely
41
Q

lump/enlargement in testicle, significant loss in size, heavy feeling scrotum or lower abdomen, dull ache in lower abdomen, sudden fluid accumulation in scrotum, pain in scrotum, enlarged breast, infertility, LBP suggest _________

A

Testicular Cancer

  • most common ages 15-35
  • higher risk if they had undescended testicle
  • family history
  • often is asymptomatic
  • staged 1-3
42
Q

______ is the name for commonly used method of determining various properties of urine

A

urinalysis (UA)

  • used to assess renal function
  • BUN or RBC’s
43
Q

Immediate Physician Referrals

A
  • blood in urine
  • C-spine pain and urinary incontinence
  • bowel/bladder incontinence and/or saddle anesthesia secondary to cauda equina lesion
44
Q

General Physician Referrals

A
  • any systemic S/S
  • back or shoulder pain w/ abnormal urinary constituents
  • Positive Murphy’s percussion
45
Q

Cues to Renal/Urologic Origin

A
  • men >45 years
  • blood in urine
  • changed urinary pattern
  • presence of constitutional symptoms
  • pain unchanged by altering body position; side bending to involved side and pressure at that level is “more comfortable”
  • true renal pain seldom affected by movements of spine
  • SLR is negative
  • back pain at level of kidneys is woman w/ previous breast or uterine cancer
  • assessment of pseudorenal pain is negative

Differential Dx (12 decks)

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