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49 Cards in this Set
- Front
- Back
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6 functions of the kidney
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Formation and excretion of urine
Maintaining acid/base balance, electrolyte balance Control BP with renin Formation of RBCs Activation of Vit D Maintain Ca blanace |
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Structures of urinary tract
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Kidney
Ureter Bladder Urethra |
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"Constitutional" symptoms associated with Genitourinary disease?
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Fever
Chills Malaise Anorexia Weight loss |
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Musculoskeletal symptoms associated with GU disorders?
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Unitlateral costovertebral tenderness
Pain low back, flank, inner thigh, leg Ipsilateral shoulder pain |
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Urinary problems (General) that may signal GU dx
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Dysuria (painful, burning)
Nocturia (>1x/night) Incomplete empyting Hematuria Proteinuria Frequency (>q2h) Problem stopping flow of urine (dribbling) |
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Symptoms specific to females that may signal GU disorder?
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Abnormal vaginal bleeding
Painful menstration Change in menstrual cycle Pelvis masses/lesions Vaginal itching or discharge Pain during intercourse |
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Symptoms specifc to males that may signal GU disorder?
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Difficulty starting/continuing stream of urine
Discharge from the penis Penile lesions Testicular or penis pain Enlargment of scrotal contents Swelling or mass in the groin Sexual dysfxt |
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Symptoms of visceral pain arising directly from kidney (upper urinary tract)
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Pain over skin (hyperesthesia) over flanks and kidney
Pain posterior subcostal and costovertebral region slightly below where 12th rib ends posteriorly Aching or dull, boring pain |
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Where is ureter pain felt? What is it caused by?
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Groin/genital area
Caused by an obstruction that is intermittent or constant that is sever colicky pain |
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S/s for both kidney and ureter dysfunction?
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Radiation toward lower abdomen
Rebound tenderness n/v Intestinal motility |
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What is Pseudorenal pain caused by?
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Secondary to radiculitis of T10-T12
Often associated with traumatic injury Pain is influenced by body position |
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Where is pain felt for lower urinary tract (bladder/urethra) dysfxt and what is it characterized by?
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Pain felt above pubis or in area above lower abdomen
Characterized by: urinary urgency, sensation to void, dysuria (painful) |
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Risk factors for Renal and Urinary Tract Problems
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>60 yo
DM, HTN, MI, stroke Kidney dx or stones UTIs Autoimmune disease |
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3 types of upper urinary tract infections?
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Pyelonephritis - primary urinary cells
Acute or chronic glomerulonephritis Renal papillary necrosis |
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s/s of Upper Urinary Tract Infections (pyelonephritis, glomerulonephritis, renal paillary necrosis)
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Unilateral costovertebral tenderness
Flank pain Ipsilateral shoulder pain Fever Chills |
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2 types of Lower Urinary Tract infection
More common in males or females? |
Cystitis - classic bladder infection
Urethritis - infection of urethra More common in females |
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s/s of Lower Urinary Tract Infection (cystitis, urethritis)
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Urinary frequency and urgency
LBP Pelvic/lower abdominal pain pyuria Dysuria Hematuria Bacteriuria Dyspareunia (painful intercourse) |
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Route of bacteria entry into urinary system
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ASCENDING from urethra up
Urine is good medium for bacterial growth |
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What may staph UTI lead to?
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Osteomyelitis of vertebral body
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Primary Obstructive Disorders
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Neoplasms
Congenital malformations Strictures - tight band that will prevent flow of urine Renal or urethral calculi |
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Secondary Obstructive Disorders
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Prostate enlargement
Abdominal aortic aneurysm Prego PID Endometriosis Abdominal neoplasm |
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Acute obstructive disorder and classic example
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Renal or urethral stone
Excruciating, spasmodic, radiating pain |
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Chronic obstruction
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Pain is absent to mild b/c no rapid distention
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Where do calculi form? Where may they travel?
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In the kidney - start off as a kidney stone
May become uretal stone once it leaves the kidney Uretal stones cause more severe pain as the stone is lodge and causes a backflow of urine, sudden expansion of the ureter |
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4 types of Prostatitis
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Acute bacterialprostatitis
Chronic bacterial prostatitis Chronic prostatitis/pelvis pain syndrome (inflamm or non-inflamm) Asymptomatic inflamm prostatitis |
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Signs/symptoms of prostatitis
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Voiding - frequency, urgency, nocturia
Sudden fever/chills d/t bacterial infections LBP, inner thigh, peroneal pain Testicular/penile pain General malaise Arthralgias Myalgias |
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BPH and incidence... how man report symptoms?
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Benign Prostate Hyperplasia
Men > 50, affects 50% of all men 60-69 and 80% of men 70-90 Only 1/2 develop symptoms |
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Cell types with BPH
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See an increasing number of new cells and dec cell death
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Incidence of prostate cancer
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50-75% of men by age 75
3rd most common cancer 2nd leading cause of death in men in US If you live long enough, you will get it too |
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Diagnosis of prostate cancer
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Elevated PSA (prostate specific antgen)
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Staging of prostate cancer
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1A - not palpable, may be found in surgical procedure
2B - Palpable, but not spreading 3C - Spread beyond prostate 4D - Lymph node involvement |
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Issues with surgery for prostate cancer
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Urinary incontinence
Pelvic floor dysfxt Impitence |
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4 types of urinary incontinence
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Stress - bladder/urethra support is weak (sneeze/cough/lifting causes leakage)
Urge - overactive bladder = strong drive to void Mixed - urge and stress Overflow |
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What is overflow incontinence?
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Overdistention of the bladder = unable to empty completely
Muscle is stretched out and not able to fully empty Infection |
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What may exacerbate urinary incontinenece?
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Not taking in enough fluids b/c concentrated urine is a bladder irritant
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Risk factors for urinary incontinence
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Age
Overweight Chronic cough Chronic constipation History of UTI Neurologic disorders DM Meds - diuretics, herbs, caffeine, alcohol |
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Risk factors for urinary incontinence specific to women
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Prego, recent birth
Previous bladder/pelvic surgery Pelvic trauma/radiationBladder/bowel prolapse Menopause Tobacco |
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Risk factors for urinary incontinence specific to men
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Enlarged prostate
Prostate or pelvic surgery Radiation |
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Acute renal failure - how long does it last
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Abrupt cessation of kidney activities
Often reversible Return in fxt in 3-12 months |
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ESRD
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Irreversible - complex condition that has multiple systemic complications
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Risk factors for ESRD
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Age
DM HTN Chronic UTIs Kidney transplant |
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Manifestations of renal failure
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Fatigue/malaise
Skin/nails = pallor, ecchymosis,dry skin, thick/brittle nails Skeletal system = osteomalacia/porosis, bone bane, myopathies, tendon rupture Neurological (CNS) = memory loss, dec'd alertness, irritability, difficulty concentrating, lethargy and sleep disturbances Peripheral NS = mm weakness, tremor, cramping, carpal tunnel |
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Risk factors for bladder cancer
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>40
Tobacco Occupation: caustic agents Parasitic infections hx Race: caucasians higest, asians lowest Men 2-3x more likely Family hx |
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Symptoms of bladder or renal cancer
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Blood in urine
Pain during urination Urinary urgency |
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Risk factors for renal cancer
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>40
Obese HTN Long term dialysis Men 2x more likely |
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Risk factors for testicular cancer
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Males btw 15-35
Family hx Undescended testicle Diagnosis of HIV |
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Staging of testicular cancer
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Stage 1: confined to testicle
Stage 2: Spread of Ca. to retroperitoneal lymph nodes Stage 3: Ca spreads to lymph nodes |
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Symptoms of testicular cancer
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Lump, enlargement, swelling, hardness of testes
Sig dec in size of one testicle Dull ache lower abdomen/groin Unexplained malaise LBP Enlargement or tenderness in breast tissue Associated with infertility |
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Immediate referral symptoms?
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Blood in urine
Pain with urinary incontinence B/B incontinence with saddle anesthesia |
