Urologic disorders Flashcards
Acute polynephritis
subpubic, R/LLQ tenderness, burning w/ urination, CVA tenderness, concentrated urine, TNTC bacteria, WBC casts, left shift, pyuria, hematuria, possible blood culture positive
Acute polynephritis treatment
first line: cipro 500 mg BID 7-10 days, could also use bactrim, macrolid+pyridium, do sensitivity test
Complicating factors of acute polynephritis
pregnancy, age, high WBC, positivie culture, hydronephrosis
Cystitis
bladder infection, common in women, dysuria, abd pain, nausea, irrative voiding, bacturia might not show up if entercoccus
Treatment of cystitis
bactrim, Cipro, macrobid, pyridium
Acute prostatitis
fever, irrative voiding, perineal/ subpubic pain, severe tenderness on rectal exam, leucocytosis, pyuria, bacteriuria, hematuria, ecoli and pseudomonas most common, could also be STD
Acute prostatitis treatment
if high fever/ in severe pain, admit to hospital and give ampicillin and gentamycin until organism identified, if afebril, Levaquin 500 mg daily 4 wks, doxycycline may also be used, do not cath, suprapubic tube required to drain
Orchitis
25% due to mumps, fever tachycardia, testicular swelling and tenderness is unilateral, pyuria, bacteriuria, pos cultures
Treatment of Orchitis
if mumps- ice and analgesic, if bacteria- Cipro 500 mg BIDx12 days
Epididymitis
retrograde infection through vas deferens, heaviness/dull/ache in scrotum, pain in scrotum, inguinal area and into flank on affected side, epididymis markedly swollen and tender to palpation, scrotal mass, phrehn’s sign
Treatment of epididymitis
Ceftriaxone 250 mg IM, plus doxycyclin 100 mg bidx10 days, cipro 500 mg bidx14 days, ejaculation
UTI preventative measures
urinate after sex, drink plenty of water, urinate often, dec caffiene, protected sex, wipe front to back
Glomerulonephritis
damage to glomeruli by protein being deposited into glomerular membranes, 60% are 2-12yo, can be focal involves
Focal causes
benign hematuria, henoch-schonlein, purpura, mild postinfections GN, Adults: IgA nephropathy, hereditary nephritis, IgA nephropathy, hereditary nephritis, SLE
Diffuse causes
postinfections GN, membranoproliferative GN; Adults: SLE membranoproliferative GN, rapidly progressive GN, postinfectious GN, vasculitis
GN symptoms
blood in urine or tea colored urine, dec or no urine output, swelling of face and eyes in morning and of feet and ankles in pm, HTN common, dec complement, abnormal RBCs
GN treatment
steroids and immunosuppressive therapy, abx if due to PSGN, dietary management (dec Na and fluid), dialysis, ACEI, treat other medical conditions
Nephrotic syndrome
excretion of 3.5g of protein per 1.73m in 24hr, manifests- hypoalbuminemia, lipiduria, hypercholesterolemia, edema, predisposing factors- thrombosis
Causes of nephrotic syndrome
primary renal disease, secondary disease-drugs
Nephrotic syndrome
malaise, bloating, anorexia, facial edema/puffy eyelids, dec urination, scrotal swelling, dyspnea, wt gain, ascites, edema, HTN, orthostatic hypoTN, retinal sheen, skin striae, foamy urine, proteinuria, hyperlipidemia
Nephrotic syndrome treatment
dependent on cause and complications, usually use ACEI and diuretics, otherwise treatment of cause
Acute tubular necrosis
AKI due to tubular damage, approx 85% of intrinsic AKI, caused by ischemia or nephrotoxin, P and K elevated, UA- brown, granular casts
Nephrotoxins
Exogenous: aminoglycosides, amphotericin B, Vanco, IV acyclovir, cephalosporins, contrast; Endogenous: heme containing products, uric acid, paraproteins, myoglobinuria, bence jones protein
Renal cell carcinoma
most common type of renal malignancy, more common in men, >55, black, unknown cause, linked to smoking, gross or microscopic hematuria, pain or abd mass, normocytic anemia, ESR inc
