UTI, BPH & Prostate Cancer Flashcards
What is the effect of Renal Failure on Potassium levels?
Since the kidneys excrete Potassium, if the kidneys fail, then Potassium will not be excreted and instead level of Potasium in he body will increase causing Hyperkalemia.
What is Aldosterone’s effect on Sodium and Potassium?
As the adrenal glands secrete more Aldosterone, this causes the body to retain Sodium and excrete Potassium.
How does the kidney regulate oxygen?
The kidney stores Erythropoietin, which stimulates bone marrow to produce RBCs. RBCs carry hemoglobin which carries oxygen to cells.
What is the kidneys role in Vitamin D metabolism?
the kidneys Re responsible for the final conversion of inactive vitamin D to its active form. Vitamin D is used for the metabolism of calcium.
Urethrocele Vs. Cystocele Vs. Rectocele
1) Urethrocele - The bulging of the anterior vagina wall into the urethra.
2) Cystocele - Herniation of the bladder wall into the anterior vaginal vault.
3) Rectocele - Herniation of the terminal rectum into the posterior vagina.
Anti-Diuretic Hormone is also known by what other name?
Vasopressin
What is the link between the Glomerulus and the hormone Renin?
Renin is a hormone directly involved in the control of arterial BP; it is essential for the proper functioning of the Glomerulus.
Define Functional Capacity
A marked sense of fullness and discomfort with a strong desire to void usually occurring when the bladder contains 35 mL or more of urine.
What are the 4 age-related changes associated with the renal system?
1) Thickening of the renal arteries
2) ⬇ in the weight of the kidneys
3) Blood flow ⬇ by about 10% per decade
4) ⬇ bladder capacity
Approximately what percentage of blood passing through the glomeruli is filtered into the nephron?
Under normal conditions, about 20% of the blood passing through the glomeruli is filtered into the nephron, Mounting two about 180 L/day of filtrate.
Enlargement of the prostate causes which 4 renal problems?
1) Anuria
2) Oliguria
3) Frequency
4) Obstruction of urine flow
What is the normal ratio of BUN to creatinine?
10:1
What are the 3 primary signs of Glomerulonephritis?
1) Hematuria
2) Edema
3) Azotemia (excessive nitrogenous wastes in the blood)
4) Proteinuria ( > 3 to 5 g/day)
(T/F) Dietary protein is restricted when renal insufficiency and nitrogen retention (elevated BUN) develop?
True
What are the 3 types of Lower UTIs?
1) Cystitis - Bladder inflammation
2) Prostatitis
3) Urethritis
What are the 4 types of Upper UTIs?
1) Acute & Chronic Pyelonephritis - Infection of renal pelvis, tubules, and interstitial tissue of the kidneys.
2) Renal abscess
3) Interstitial nephritis
4) Perineal abscess
How does Ascorbic Acid (i.e., cranberry juice) help to prevent recurring urinary infections?
By making the urine more acidic
Which medication is a urinary analgesic administered for urinary discomfort associated with UTIs and what should you tech your patient about it?
Phenazopyridine (aka Pyridium) - Teach patients that this med will turn their urine dark orange.
Which types of fluids/drinks are discouraged in patients with UTIs and why?
Coffee, citrus, cola, alcohol, spices and tea because they irritate the urinary tract.
What are the differences in the manifestations of Acute and Chronic Pyelonephritis?
1) Acute Pyelonephritis - Usually manifested by enlarged with interstitial infiltration e of inflammatory cells.
2) Chronic Pyelonephritis - Kidneys become scarred, contracted, and non-functional.
In short, explain the following kinds of Incontinences:
1) Stress
2) Urge
3) Reflex
4) Overflow
5) Functional
6) Iatrogenic
1) Stress - Results from sneezing, coughing or changing positions because of pelvic floor dysfunction.
2) Urge - Strong urge to void but unable to hold it.
3) Reflex - When the patient doesn’t feel the urge to and as a result becomes incontinent.
4) Overflow - When the patient is unable to completely empty their bladder and as a result becomes incontinent because of the overflow.
5) Functional - When physical or mental impairment make it difficult for the patient to reach the bathroom in time.
6) Iatrogenic - Incontinence as a result of meds.
Which class of meds are the first to choice for incontinence and what is the mechanism of action?
Anti-Cholinergics - Inhibits bladder contraction
Which 2 surgeries, if recent, is a contraindication for urinary catheterization?
1) Radical prostatectomy
2) Urethral reconstruction
Urinary stones are formed in the urinary tract as a result of an increase in which 6 substances?
1) Calcium oxalate
2) Calcium phosphate
3) Uric acid
4) Cystine
5) Uric acid
6) Struvite (Magnesium, ammonium phosphate)
How does cranberry juice help to manage the mucous in patients with urinary diversions?
Cranberry juice helps to acidifying the urine and manage mucous production.
Which 2 metabolic defects are associated with renal stone formation?
1) Hyperparathyroidism
2) Hyperurecemia (Gout)
Why is the course of antibiotic treatment for acute Prostatitis so long?
Because most antibiotics diffuse poorly from the plasma into the prostatic fluid.
Which 4 conditions can cause an elevated Prostate-Specific Antigen (PSA) level in the absence of prostate cancer?
1) BPH
2) TURP
3) Acute urinary retention
4) Acute Prostatitis
What are the 8 SxS of Cystitis?
1) Frequency, urgency hand burning
2) Voiding small amounts to none
3) Lower abd discomfort & back pain
4) Cloudy, dark, foul-smelling urine
5) Hematuria
6) Bladder spasms
7) Chills & fever
8) N & V
What are the 9 SxS of Pyelonephritis?
1) Frequency, urgency hand burning
2) Voiding small amounts to none
3) Flank pain on the affected side
4) Cloudy, dark, foul-smelling urine
5) Hematuria
6) Bladder spasms
7) Chills & fever
8) Nausea
9) ⬆ WBC in urine
What is a dipstick urinalysis used for and what does it test for?
Used for UTIs and tests for presence of nitrates, WBCs, and leukocyte esterase.
What is Urised?
Urised is a urinary antiseptic, analgesic and anticholinergic combination used to treat UTIs. It is sometimes prepared with methylene blue which tints urine blue or green.
Can immobilization cause the formation of urinary stones?
Yes
What is the treatment in regards to pH when managing urinary stones of the following composition:
1) Calcium Oxalate
2) Cystine
3) Uric Acid
4) Struvite
1) Calcium Oxalate - ⬇ pH
2) Cystine - ⬆ pH
3) Uric Acid - ⬆ pH
4) Struvite - ⬇ pH
Which type of urinary stone is the medication Allipurinol used to treat?
Uric Acid urinary stones
Which type of urinary stone is caused by a urea-splitting bacteria?
Struvite urinary stones
Besides a sharp, severe pain at the location of the stone, what are the 4 other signs of a urinary stone?
1) Lumbar pain
2) N & V
3) Hematuria
4) Diaphoresis
What is Lithotripsy?
Shock wave used to break up urinary stones so that they can be passed
Does BPH predispose men to the development of prostate cancer?
No
What is the difference between BPH and prostate cancer in regard to the enlargement of the prostate?
BLH enlarges the prostate inward and closes off the urethral while prostate. Cancer enlarges the prostate outwards.
What are the obstructive and irritation symptoms of BPH?
1) ⬆ urinary fx
2) Nocturia
3) Hesitancy
4) Abdoominal strain with urination
5) ⬇ in volume and force of stream
6) Incomplete emptying
Which medication is used to treat BPH, how does it work, how long does it take to work and what are the 4 listed side effects?
1) 5-alpha reductive inhibitors (i.e., Finasteride) - works by ⬇ size of the prostate by suppressing androgen.
2) Takes 3-6 months for improvement
3) Side effects include ⬇ libido, ⬇ volume of ejaculation, ED, and hair growth.
How do Alpha-Adrenergic drugs work to manage BPH, how long do they take to work and what are the 3 listed side effects?
1) Alpha-Adrenergic drugs promote smooth muscle relaxation in the prostate and facilitates urine flow.
2) Takes 2-3 weeks to work
3) Side effects include Orthostatic hypotension, retrograde ejaculation and nasal congestion.
What are the 4 possible complications of TURP post-op?
1) Bleeding
2) Clot retention
3) Dilutional hyponatremia
4) Retrograde ejaculation
Prostate cancer is usually Asymptomatic in the early stages, but patients may eventually experience which 4 symptoms that are also common in patients with BPH?
1) Dysuria
2) Hesitancy
3) Dribbling
4) Fx
What is a Radical Prostatectomy, how long does the patient catheterized, and what are the 5 major post-op complications?
1) Radical Prostatectomy is the removal of the prostate, seminal vesicles, and part of the bladder neck in order to treat cancer.
2) Patients are catheterized for 1-2 weeks with a leg bag
3) Major complications include ED,incontinence, hemorrhage, retention and infection
