UROLOGY Flashcards
hematuria
blood in urine
azotemia
high nitrogen in blood
oliguria
less than 0.5ml/kg/hr. bad urine production
proteinuria
elevated protein in urine, sign of injury
Glomerular Filtration Rate (GFR)
blood through kidneys
What are the factors tied to know when an obstruction is present?
degree of blockage, location, duration, timing
What are the obstructive urologic disorders?
renal pelvis: renal calculi, trauma
ureter: renal calculi, pregnancy, tumors, trauma
bladder and urethra: bladder cancer, neurogenic bladder, prostatic hyperplasia, prostate cancer, urethral strictures, trauma
What are the two complication of obstruction?
stasis of urine flow
back-up pressure (hydrometer, hydronephrosis, post-renal kidney failure)
What is nephrolithiasis?
renal calculi or kidney stones
clumps of crystals in the UT
formed from salt and minerals inside kidney from excess in urine
Risk Factors for nephrolithiasis
men, 20s-30s, white, family hx, congenital defect, hot weather, obesity
What is the pathogenesis of nephrolithiasis?
-urine=solvent+solute
-problem: super-saturation with solute (calcium oxalate/uric acid)
-crystals form in nephron
-crystal formation enhanced by dehydration/immobility/sedentary lifestyle
What are the 4 types of stones?
cystine, calcium, uric acid, struvite
What are the clinical manifestations of kidney stones?
stomach pain, backache, vomiting, dizziness, fever, blood in urine, diaphoresis, increased HR/RR
Pharmacology for kidney stones
IV Narcotics (morphine/hydromorphone)
NSAIDs
IV Fluids
Preventative Meds for kidney stones
calcium = thiazide diuretics
struvite = antibiotics
urate = allopurinol
What are the urinary system protective mechanisms against UTIs?
pH or urine = acidic
presence of urea
men = prostatic secretions
women = urethral gland secretions
uni-directional urine flow
epithelial and immune cells
Risk factors for UTI
CAUTI, females (perineal irritation), age, nursing home, pregnancy, sexual activity, spermicide use, immobility, incontinence, urine/stool, decreased cognition, bad personal hygiene
Pathogenesis of UTIs
ascending pattern: from contaminated perineum to urethra
then to bladder (cystic)
then to kidney (pyelonephritis)
CM of urethritis
dysuria - painful urination
asymptomatic
CM of cystitis
frequency
urgency
subrapubic discomfort
dysuria
CM of Upper UTI
sudden onset: fever, chills, CVA tenderness
dysuria, N/V, anorexia
complication of UTIs
sepsis - severe systemic response
Who is at risk to become septic?
elderly patients, diabetes, immunosuppressed patients
HIGH MORTALITY
Treatment of Sepsis
source control!
administration of ABX
cultures & supportive care
