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Pathology - Year 2 AC > Week 7 - Urinary System And The Male Genital Tract > Flashcards

Week 7 - Urinary System And The Male Genital Tract Flashcards

1
Q

What is bacteruria?

A

Bacteria in the urine

May be asymptomatic or symptomatic

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2
Q

What is a urinary tract infection?

A

The presence of pure growth of >10^5 organisms in fresh urine

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3
Q

What is a UTI in the urethra called?

A

Urethritis

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4
Q

What is a UTI in the bladder called and what are the symptoms?

A

Cystitis

Symptoms: frequency, dysuria, urgency, haematuria, suprapubic pain

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5
Q

What is a UTI in the prostate called and what are the symptoms?

A

Prostatitis

Symptoms: flu-like symptoms, few urinary symptoms, swollen tender prostate on PR

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6
Q

What is a UTI in the kidney called and what are the symptoms?

A

Pyelonephritis

Symptoms: high fever, rigours, vomiting, loin pain, tenderness

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7
Q

What organism is the most common cause of UTI’s (>70%)?

A

E.coli

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8
Q

What organisms may cause UTI’s?

A

E.coli

Staphylococcus, proteus, klebsiella

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9
Q

How do you manage UTI’s?

A
  • plenty of fluids
  • urinate often - double void
  • antibiotics (trimethoprim usually first line treatment in uncomplicated UTI’s)
  • imaging (US in non resolving UTI’s, children, men and pyelonephritis)
  • severe cases - hospital admission (pyelonephritis and elderly)
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10
Q

What does the hormone renin do?

A

Help to control BP

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11
Q

What does the hormone erythropoietin do?

A
  • stimulates production of RBC’s in the bone marrow

- helps vitamin D production

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12
Q

What toxic metabolic waste products do the kidneys excrete?

A

Urea

Creatinine

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13
Q

What are the 2 types of renal failure?

A

Acute

Chronic

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14
Q

What is acute renal failure?

A
  • a significant deterioration in renal function occurring over hours/days
  • low urine volume (
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15
Q

What can cause acute renal failure?

A

Pre-renal (80% causes) - hypoperfusion (shock), sepsis

Renal - ATN damage to tubules due to ischaemia or nephrotoxins

Post-renal - renal tract obstruction (e.g. stones, tumours)

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16
Q

How is acute renal failure managed?

A
  • find and treat cause
  • treat exacerbating factors (hypovolaemia,sepsis)
  • stop nephrotoxic drugs (NSAIDs, ACE-I’s, gentamycin, vancomycin)
  • may need renal replacement therapy (haemofiltration/ dialysis)
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17
Q

What is chronic renal failure?

A
  • classified in to 5 stages - depending on glomerular filtration rate (GFR) - vol of fluid filtered from the glomerular capillaries into the Bowman’s capsule per unit time
  • symptoms usually occur by stage 4
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18
Q

What are the common causes of chronic renal failure?

A

Glomerulonephritis, diabetes, Reno-vascular disease, hypertension, polycystic disease

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19
Q

What is glomerulonephritis?

A
  • a group of disorders where there is damage to the glomerular filtration apparatus
  • may cause a leak of protein or blood into the urine
  • usually there is a deposition of immune complexes in one part of the nephron
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20
Q

What are renal stones?

A

-crystal aggregates that form in the collecting ducts of kidneys and can deposit anywhere in the renal tract

  • life time incidence - 15%
  • peak age - 20-40 yrs
  • male:female - 3:1
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21
Q

What are the risk factors for renal stones?

A
  • Dehydration, dietary factors
  • drugs (loop diuretics, antacids, corticosteroids, theophylline and aspirin)
  • renal tract abnormalities
  • recurrent UTIs
  • metabolic abnormalities (hyperparathyroidism, hyperthyroidism, cancer)
22
Q

how may kidney stones be detected?

A

-may be asymptomatic but might be detected on and X-ray or blood on a dipstick

  • pain - cause loin pain
  • ureteric stones cause renal colic (from loin to groin)
  • bladder and urethral stones cause pain on micturition with interrupted flow
  • often can’t lie still from the pain
23
Q

How are renal stones managed?

A
  • imaging options - KUB- X-ray or CT scan
  • pain relief
  • stones 5mm and causing obstruction - intervention
24
Q

What is renal cell carcinoma?

A
  • 85% of all renal cancers
  • usually presents between the ages of 50-70
  • 2:1 male predominance

-risk factors: smoking, obesity, hypertension, asbestos exposure, certain hereditary conditions

25
Q

What is the presentation of renal cell carcinoma?

A
  • 50% incidental findings on abnormal imaging
  • haematuria
  • loin pain
  • abdominal mass
  • para neoplastic syndromes (consequence of cancer in the body) e.g. polycythaemia, hypercalcaemia, hypertension
26
Q

What is used to treat renal cell carcinoma?

A

-radical nephrectomy
+-
-chemo

27
Q

What is the most common benign condition in the bladder?

A

Cystitis

28
Q

What are the most common malignant condition in the bladder?

A

Transitional cell carcinomas

29
Q

What is the presentation of transitional cell carcinoma?

A
  • classically - painless haematuria

- frequency, urgency and dysuria can occur

30
Q

What are the tests that can be conducted to test for transitional cell carcinoma?

A
  • urine for cytology

- cytoscopy and biopsy done via urethra

31
Q

How can transitional cell carcinoma be treated?

A
  • depends on stage (1-3) and spread
  • small lesions at early stage can be managed with diathermy on cytoscopy
  • later stages - radical cystectomy or palliative chemo/radiotherapy
32
Q

What does the prostate gland do?

A

Helps in secretion and maintenance of semen and spermatozoa

Usually weighs around 20gm

33
Q

What is benign prostatic hyperplasia?

A
  • common

- increase in the number of cells resulting in the formation of nodules - prostate weights 60-100gm

34
Q

What is hyperplasia?

A

Increase in the number of cells

35
Q

What are the signs and symptoms of benign prostatic hyperplasia?

A
  • usually those of lower urinary tract obstruction (increased frequency, hesitancy, nocturia, terminal dribbling)
  • can lead to increased risk of infection
  • enlarged prostate on PR
36
Q

How may benign prostatic hyperplasia be treated?

A
  • if small and asymptomatic then conservative, reduce fluid intake (esp. at night), reduce alcohol and caffeine, scheduled voiding
  • medical treatment - alpha-blockers - reduces smooth muscle tone in the prostate
  • TURP - transurethral resection of the prostate
37
Q

What are the risk factors of prostate cancer?

A
  • age
  • race (more common in black people and very uncommon in Asian people)
  • family history
  • hormone levels (inc. in prostate specific antigen (PSA) level)
  • diet - increased risk with fat consumption
38
Q

What are the signs and symptoms of prostate cancer?

A
  • may be asymptomatic (has a slow course)
  • nocturia, hesitancy, poor stream and terminal dribbling
  • examination shows hard, irregular prostate
39
Q

How is a diagnosis confirmed for prostate cancer?

A
  • raised PSA (prostate specific antigen) but may be normal in 30% of cases
  • biopsy
40
Q

How is prostate cancer treated?

A
  • depends on stage, age of patient and comorbidities
  • local disease can be treated with radical prostatectomy
  • hormonal therapy and radiotherapy for more advanced cases
41
Q

What is testicular torsion?

A

Twisted spermatic cord

42
Q

What are the symptoms of testicular torsion?

A
  • sudden onset of pain in 1 testis
  • pain in abdomen, N+V
  • testis = hot, swollen and tender
  • testis may lie high and transversely
  • most common in 11-30 yrs
43
Q

What tests are conducted to test for testicular torsion?

A
  • USS with Doppler

- may need exploratory surgery

44
Q

How is testicular torsion treated?

A

URGENT

  • surgery
  • if still viable, bilateral fixation (orchidopexy)
  • if abnormal then orchidectomy
45
Q

When are malignant testicular tumours most common?

A

15-44 years

46
Q

What are the risk factors for getting testicular tumours?

A
  • undescended testes
  • infant hernia
  • infertility
47
Q

What is the presentation of testicular tumours?

A

Painless testicular lump often noted after trauma or infection

48
Q

What is the most common germ cell tumour?

A
  • different categories

- most common = seminoma

49
Q

How are germ cell tumours treated?

A
  • depends on type of tumour and stage

- usually involves an orchidectomy and a combination of radiotherapy and chemo

50
Q

What is a germ cell?

A

A germ cell is any biological cell that gives rise to the gametes of an organism that reproduces sexually

51
Q

What are the risk factors of UTI’s?

A
  • females>males
  • sexual intercourse
  • pregnancy
  • diabetes
  • urinary tract obstructions - stones or catheters

Pathology - Year 2 AC (19 decks)

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