WWeek #8- Genitourinary/Renal/Reproductive

Question 1

common Genitourinary disorders to be called for?

Answer 1

UTI, Urologic stones disease, AKI, Chronic Kidneys disease(home dialysis disconnect), urinary retention/incotinence, Foley catheters (Type/care)

Question 2

common disorders with the male reproductive tract?

Answer 2

Testicular torsion, Epididymitis, Orchitis, Prostate enlargement

Question 3

common disorders with the female Gynecological system?

Answer 3

Dysmenorrhea/amenorrhea, PID<ovarian>, Endometriosis</ovarian>

Question 4

What types of pain are common in GU disorders?

Answer 4

Visceral: hollow structures, ie:ureter/bladder
referred: achy, cramping, deepening, poorly localized pain.

Question 5

what is a UTI?

Answer 5

Urinary tract infection characterized by bacteriuria in the presence of symptoms. Usually develops in the lower Urinary tract and can spread to higher structures when untreated—>pyelonephritits/urosepsis

Question 6

Men UTI symtpms….

Answer 6

Bacterial colonization of the UT—> kidnyes, ureter, bladder
- dysuria, inflammation of urethra, epididmytitis ( inflmmation of epididymis), Prostatisis, orchitis ( infllmmation of the prostate), Pyelonephritits,

Question 7

UTI in women…

Answer 7

occurs in abour 20% of every women in their lifetime, more frequent, usually involve cyctitis, inhibits perurethra vagaina, grwquent voiding reduces UTI

Question 8

common UTI s/s…

Answer 8

Dysuria, clouds.foul smell, pain on palplation of lower abdo ( men usually), increased frequency/urgency to void

Question 9

Pyelonephritis

Answer 9

kidney infection/infection of renal pelvis, cause by another infection which spreads
- dysuria, flank pain, increased frequency, nocturia, dark/cloudy urine, N?V, fever, chills, spepiss++

Question 10

Urinalysis?

Question 11

Hydronephrosis?

Answer 11

kidneys swell due to urine build up if untreated it can damage the kidneys, unilateral.

Question 12

Urologic stone disease

Answer 12

Renal calculi: most common in men over 60(prostatic hypertrophy), gynecologic surgery, pregnancy & cancers of pelvic organs= important in women obstructions
s/s: flank/groin pain that increases when moving, dysuria, pain++

Question 13

How often does trauma occur to the genitourinary system?

Answer 13

-3-10% of trauma pt→ GU
-10-15% of trauma pt w abnormal injuries→ GU involvement
-Renal injuries constitute 45% of all GU injuries
-Ureteral injuries → 5%

Question 14

Testicular torsion?

Answer 14

spermatic crd which provides blood supply to the testicles is twisted
- congenital anomaly: Bell clapper deformity: undecended testicle, sexual arousal, trauma, exercise, cold etc.
- sudden onset/constant or intermittent,
Hx: 50% hve had it previously, needs surgery,6-12 hrs=++risk

Question 15

Epididmymitis & Orchitis

Answer 15

• inflmmation of the epididmytis & convoluted duct that supples the testees w/ sperm ( both epididmysiz and orchitis)
  Hx: scrotal pain, edemal. frequent urination, STI, dysuria, N/V/fever/chills, flank pain, bilateral involvement=10%
  Tx: antibiotics

Question 16

prostate enlargement

Answer 16

• beginign porstatic hyperplasia—> restricts the flow of urine
  s/s: urinary frquency/urgency/hesitancy/incomplete void,
  RX: erectile dysfunction meds are used for prostate

Question 17

urinary retention emergency

Answer 17

commonly caused by: protstic hypertropphy, anticholinergic drugs, bladder stabalizers/tricycilic antidepressants, urethral calculus, bladder neck hypertrophy etc…

Question 18

urinary incotinenece

Answer 18

• involuntary peeing, 15-30%
  Hx: onset ( pregnancy/postpartum/surgery), duration of complains/patterns
  tax: emesis bag for pee

Question 19

Assessments:

Answer 19

ask if they are having flu like symptoms, feeling like their bladder is full, oligera, anurea, asses colour, frequency, heamturia,
Hx: of catheter, how much pee, etc

Question 20

what are some risks of elderly men w hx of prostate enlargement?

Answer 20

septic shock: tachycardia, hypotension, tachypnea, fever

Question 21

UTI: management…

Answer 21

supportive care, findings of; tahycardia, delayed cap refill—>shock/depletion and needs IV fluid resuscitation
- ketolarc for pain management, transport in position of comfort

Question 22

common antibiotics for UTI in men…..

Answer 22

ciprofloxacin, Ertapenem, Cialis, Phenazopridine

Question 23

(Female repro) Dysmenorrhea/amernorrhea

Answer 23

• > 3missed periods in a row or age 15 w/o any periods yet

Question 24

Menorrhagia?

Answer 24

excessive mentstraul bleeding common in teens and perimenaopause, spontaneous abortions

Question 25

Gynecological:

Answer 25

• PID: pelvic inflammatory disease
• infections of uterus, fallopian tubes, ovaries, peritoneum
• STI
• manage pain

Question 26

endometriosis/endometritis:

Answer 26

itis- Infection of the uterine lining
Osis-endometrial tissue is found outside of the uterus due to hormonal chnages of the mentral cycle bleeding

Question 27

Ovarian cysts:

Answer 27

• fluid filled pockets that develop in the ovaries that can rupture–>severe abdo pain
• whe the burst they can bleed into the abdo

Question 28

interstitial cycitis

Answer 28

• chronic bladder condition, mild-severe pain, w/ s’s of uit or sti
  manage s/s relife

Question 29

AKI

Answer 29

toxic build up of waste that impairs kidney function and can take hours to days to occur

Question 30

Risk factors/causes for AKI

Answer 30

• elderly, diabetic, chronic kidney disease, dehydration, chronic diease (CHF), women, cancer, anemia,
• exposures: sepsis, circulatory shock, burns, trauma, cardiac surgery etc
• patho: deceased renal perfusion, oxidative stress, ob, hypoxic injury etc

Question 31

etiology of AKI

Answer 31

educed renal blood flow–> decreased GFR
- pre=-renal shock: due to decreased renal BF
- intra-renal: direct damage to the kidneys and their structures ex;NSAIDS
- post renal: Obstructions
(community acquired=25%)(hospital acquired=10-15%)

Question 32

what would a patient in AKI look like?

Answer 32

• decreased urine out put, edema in extremities & face, fatigued, SOB, alt loa, N

Question 33

chronic kidney disease:

Answer 33

• due to over 70% death to nephrons 80%–>endstage renal fialure

Question 34

s/s of chronic kidney disease

Answer 34

lethargy, GI, alt mental status, utremia, jaundice, arrhythmias, edema, diaphoresis

Question 35

cons of peritoneal dialysis

Answer 35

can give a falsely high BGL read & may need to Tx w/ s’s releif