Urology Flashcards
What is an Ureteral pain
Acute obstruction
Back pain from the renal capsular distention combined with severe colicky pain that radiates from the costovertebra, and,e down toward the lower anterior abdominal quadrant
Upper ureter stone
Radiation in testicle
Mid ureter stone right
Radiation to the mc burneys point
Mid ureter stone in the left
Radiation to the left lower quadrant
Distal ureter stone causes
Lower urinary tract stones
Varicocele
Dull testicular pain increased after heavy excecise first symptom of an indirect inguinal
Continues incontinence
An ectopic ureter that enters urethra or female genitalia, tract
Stress incontinence
Sudden leakage of urine in coughing sneezing or excercise
Urgency incontinence
Loss of urine by a strong urge cyctitis
Paradoxical incontinence
Urine dribbles out in small amounts
Enuresis nocturna
Occurs during sleep up to 3 years old children
All children other than 5 years of and 1% at age 15
URINARY TRACT OBSTRUCTION
Mechanical or functional blockage that inhibits the outflow of urine
What is hydronephrosis
Dilation of the renal pelvis and calyces
Types of the Antenatal hydrobeohrosis
Transient hydroneohrosis 40~50%
UPJo
Vesicoureteral reflux
Megaureter
PUV
UTEROPELVIC JUNCTION OBSTRUCTION
The junction between the ureter and pelvic is narrowed with a palpable abdominal mass to hydroneohrosis in neonates or large amount of diursis in older children
IntiAl evaluation of UTO
CBC
BMP
URINALYSIS
Imaging of UTO
USG
MAG3
MAG 3 scintigraphy
Dosage
Timing of furosemide
Hydration fo the patient
Bladder empty
UVJO MEGAURETER
Dilation of the ureteral lumen
Distal ureterak diameter >7mm
Normal balder outlet
Post urethral valves
Membranous folds within the urethra obstruct the outflow of urine a developmental condition
Dilation of the ureteral lumen
Common complication of PUV
Vesicouretral reflux
Recurrent Uti
Bladder dysfunction
Diagnosis for PUV
> 24 th gestational week
Keyhole sign
Increased bladder thickness
Bilateral or unilateral HN
OLIGOHYDROAMNIOSIS
UTO COMMON ETIOLOGIES
Congenital anamolie. = PUV
YOUNG CHILDREN NEPHROLITIASIS
OLDER ADULTS prostatic enlargement BPH
Ureterocele
Cystic dilation of the distal ureter at the bladder level
1 year male
Recurrent uti
Bilateral HN
SERIAL US DEMONSATRTE INCREASED HN BILAT
Bacteiriuria
Bacteria in urine
Pyuria
Presence of WBCS in the urine
Infection and inflammation in the urothelium
Uncomplicated UTI
Normal urinary tract
Majority are women
Healthy patient
Acute pyelonephritis
Recurrent bacterial cystitis
Complicated uti
Men majority
Abnormal urine
Bacteria maybe have increased virulence
Golden standard for uti
Quantitative culture of urine
Acute pyleonephritis
Infection of the renal pelvis and paracnhyma bacterial infection of the bladder
Flank pain
Costovertebra, angle
Fever
Pyuria and bacteria
Symptoms of Acute cyctitis
Suprapubic oain
Dysuria
Frequency
Urgency
Acute cystitis
Infection the bladder
More common in women
Acute bacterial prostatitis
Inflammation of the prostate
Third most coo in men older then 50 yrs
Fever perineal pain
Myalgia
E. Coli is the most common cause
Urethritis
Urethral inflammation from infections
Dysuria
Urethra pruritus
Urethral discharge
Epididymitis
Sexually active men < 36 years
Inflammatory hydrocele and palpable swelling of the epididymis
Unilateral he is royal pain and tenderness
Most frequently seen benign renal lesion
Renal cysts
Renal cysts
Male
HT
Renal failure
70% asymtomatic
Most common cause of perirenal hemorrhage among renal masses 25%
Angiomyolipoma
Most frequent solid lesion
Renal cell carcinoma
RCC
90% renal malignancies
60-70 years of age
Comprises 2-3% of all cancers
RCC ETIOLOGY
Smoking
Obesity
Hypertension
What are the familia RCC SYNDROMES
Von hippel lindue
Hereditary papillary rcc
Familial leiomyomztosis
Birt Hogg dube
What’ is important for good prognosis
Fuhrman grading
Size Ashley and nucleiolar feature
Pathological subtypes RCC
Clear cell RCC 80%-90%
Papillary RCC 10-15%
Chromiphobe RCC 3%-5
Diagnosis
Palpable abdominal mass
Palpable cervical LAP
NON DAIRNALBLE RIGHT SIDED VARICocele and lower extremity edema
Wilms tumor
Childhood tumor
Comprises 10% of all childhood malignancies
Rare in Adults
Most diagnosed at the age 3,5 yrs
Urothiliasis
Formation of urinary calculi
Renal bladder and urethral
Common types are calcium oxalate and calcium phosphate
Urinary stones are most commonly composed of
Calcium oxalate
Les common stones
Uric acid
Struvite
Calcium phosphate
Cystine
Risk factors for stone formation
Low fluid intake
High sodium
High purine
Low potassium diets raise ca Uric acid and oxalate which lead to stone formation
Which patients have 70% Chances of stones
RTA TYPE 1
Urine acidification
Diagnosis of urotheliais
CT ABDOMEN AND PELVIS WITHOUT CONTRAST
Presentation of stones
Flank pain
Hematuria
Recurrent UTI
INFECTIVE COMPLICTAION FEVER
Vomiting
Which drug is contraindicated in the colic pain
Pethidine
Shock wave lithotripsy contraindications
Pregnancy
Bleeding diathesis
Untreated uti
Morbid obesity
Arterial aneurism
Severe musculoskeletal malformations
Types of renal abscess’s
Perinephric ruptures out into the perineohric space
Paraneohric extends beyond the gerotas fascia
Renal abscess from heamatigenkus spread of staphylococci from infected skin lesion
What is a pynoneohrosis
Air- fluid levels in a dilated pelvicalceyal system
Pis filled kidney
Percutaneous nephrostomy tube is preferable for the drainage of the infected portion
How long does the uncomplicated cases take for medical treatment and complicated cases
Uncomplicated cases 6 months
Complicated cases 9-12 months
TYPES OF STIS
Urethitis and Cervictis
Epididymitis
Genitalia ulcers
HOV
HIV
