Term
| acute renal failure due to tubular damage. Major causes are ischemia and toxin exposure (endogenous and exogenous). Usually manifested by oliguric renal failure that is reversible, but ranging in duration from days to weeks. There is a 20-50% mortality rate (medical), up to 70% (surgical). |
|
Definition
|
|
Term
| may be caused by chronic dialysis; incidence increases as time span of dialysis increases; has a tendency toward malignant transformation. |
|
Definition
| Acute cystic kidney disease |
|
|
Term
| an acute decline in glomerular filtration rate with oliguria, increase in BUN and serum creatinine and sometimes anemia. |
|
Definition
|
|
Term
| disease of unknown cause characterized by extracellular accumulation of amyloid in various tissues and organs. |
|
Definition
|
|
Term
| generalized massive edema. |
|
Definition
|
|
Term
| detects presence of antibody to the antigen streptolysin-0 produced by group A (beta hemolytic) streptococci; test may be more reliable indicator of recent strep infection than throat culture in patients with rheumatic fever. |
|
Definition
|
|
Term
| abnormal muscle tremor consisting of involuntary jerking movements, may be due to diseases the interfere with brain metabolism. |
|
Definition
|
|
Term
| excess of urea/nitrogen in the blood; uremia. |
|
Definition
|
|
Term
| presence of abnormal amounts of Bence-Jones protein in the urine usually indicative of a neoplastic process such as multiple myeloma, amyloidosis, etc. |
|
Definition
|
|
Term
| (IgA Nephropathy) this primary renal disease of IgA deposits is the most common cause of acute glomerulonephritis in the United States. Most commonly seen in males ages 15-30 y/o with macro-or micro-hematuria, 20% progress to ESRD. |
|
Definition
|
|
Term
| degradation product of amino acids from endogenous and exogenous protein; urea is filtered by the glomerulus and normally 50% is reabsorbed. |
|
Definition
| Blood Urea Nitrogen (BUN) |
|
|
Term
| formed from gelled protein precipitated in the renal tubules and molded to tubular lumen; can be diagnostic when found on microscopic examination of the urine. |
|
Definition
Cast
(red blood cell cast, white blood cell cast, hyaline cast, etc.) |
|
|
Term
| clinical syndrome associated with progressive azotemia, signs/symptoms of uremia, HTN and renal osteodystrophy. |
|
Definition
| Chronic Renal Failure (CRF) |
|
|
Term
| the end product of creatine metabolism, creatinine is released in the anaerobic phase of muscle contraction. It is a normal alkaline constituent of urine and blood. |
|
Definition
|
|
Term
| process of diffusing fluids and solutes across a semipermeable membrane. The difference in their rates of diffusion through a semipermeable membrane enables the removal of toxic substances in order to maintain fluid, electrolyte and acid base balance. Two types are used in treatment of acute/chronic renal failure: hemodialysis and peritoneal |
|
Definition
|
|
Term
| syndrome that can develop in chronic dialysis patients probably related to a high aluminum content of dialysate; characterized by speech disturbances, personality change, seizures, and finally dementia. |
|
Definition
|
|
Term
| when chronic renal failure has progressed to the point that patient can no longer maintain homeostasis of electrolytes/fluids necessary for life. Usually, this is when creatinine clearance is < 10-20 ml/min. Degree of symptoms varies greatly among patients. Treatment options are dialysis or renal transplantation. |
|
Definition
| End-stage Renal Disease (ESRD) |
|
|
Term
| Involuntary release of urine usually associated with bed-wetting |
|
Definition
|
|
Term
| rate of filtrate formation by the kidneys |
|
Definition
Glomerular Filtration Rate (GFR)
estimated by caculating cratinine clearance. |
|
|
Term
| renal disease characterized by bilateral inflammatory changes in glomeruli that may be acute, subacute or chronic: |
|
Definition
|
|
Term
| glomerulonephritis associated with hemoptysis caused by antiglomerular basement membrane antibody disease; uncommon, rapidly progressive, usually in younger men and frequently leads to end stage renal disease. |
|
Definition
|
|
Term
| removal of soluble waste products and water from blood by diffusion of blood through a semipermeable membrane. Chronic therapy is usually 3-6 hours X 3 days/wk. |
|
Definition
|
|
Term
| combination of acute renal failure, thrombocytopenia and hemolytic anemia. Seen in children after respiratory or gastrointestinal illness. Seen in adult females who use oral contraceptives and in females with acute renal failure postpartum. Also due to treatment with mitomycin and cyclosporin A. Prognosis for children is good; poor prognosis for adults. |
|
Definition
| Hemolytic-Uremic syndrome (HUS) |
|
|
Term
| excessive uric acid in blood |
|
Definition
|
|
Term
| adverse condition in a patient occurring from medical treatment. |
|
Definition
|
|
Term
| radiologic study of the kidney and collecting system using intravenous injection of a radiopaque contrast medium, contraindicated in patients with increased risk for acute renal failure, or those with chronic renal failure or multiple myeloma. |
|
Definition
| Intravenous Pyelogram (IVP) |
|
|
Term
| blood in the urine that can only be seen by microscopy. |
|
Definition
|
|
Term
| a nephrotic syndrome, so-called because under light microscopy the glomeruli appear totally normal; electron microscopy, however, reveals fusion of epithelial foot processes in the kidney; more common in children and usually responds well to corticosteroids. |
|
Definition
|
|
Term
| malignant neoplasm of plasma cells usually arising in the bone marrow and manifested by skeletal destruction, Bence-Jones proteinuria and anemia. |
|
Definition
|
|
Term
| presence of myoglobin in urine; seen in crushing injuries and in deficiency of muscle phosphorylase; occasionally seen after vigorous exercise in some people. |
|
Definition
|
|
Term
| degeneration of renal tubular epithelium; usually defined by simultaneous presence of heavy proteinuria, hypoalbuminemia, lipidura, hyperlipidemia, and peripheral edema. |
|
Definition
| Nephrotic syndrome (nephrosis) |
|
|
Term
| inflammation of the kidneys, characterized by hematuria, hypertension and azotemia. |
|
Definition
| Nephrotic Syndrome- Nephritis |
|
|
Term
| any disease of the kidney; three classes: prerenal, renal and postrenal. |
|
Definition
|
|
Term
| Substance that causes destruction of kidneys |
|
Definition
|
|
Term
| (renal calculi/kidney stones) mineralized solids that can lodge in the urinary tract, upper and lower. |
|
Definition
|
|
Term
| Radionuclide studies used to measure renal function and blood flow, to determine each kidney's contribution to function, to check for functioning tissue and to look for obstructions/renovacular disease. |
|
Definition
|
|
Term
| secretion of diminished amount of urine in relation to fluid intake. |
|
Definition
|
|
Term
| excessive excretion of urine. |
|
Definition
|
|
Term
| pathology affecting parenchyma (essential cells) of kidney. |
|
Definition
| Parenchymal renal failure |
|
|
Term
| dialysis using the patient's peritoneum as the filtrate membrane; may be continuous ambulatory peritoneal dialysis (CAPO) (4-6 exchanges daily) or intermittent continuous cyclic peritoneal dialysis (CCPD) using a cycler machine at night. |
|
Definition
|
|
Term
| inherited autosomal dominant disease with hematuria, hypertension and chronic UTIs; cysts on kidneys can be quite large; usually presents in fourth decade of life, |
|
Definition
| Adult Polycystic Kidney Disease (PKD) |
|
|
Term
| uncommon autosomal recessive disease with hematuria, hypertension and chronic UTIs; cysts on kidneys can be quite large; |
|
Definition
|
|
Term
| combined inflamination of parenchymia, calyces, and renal pelvis |
|
Definition
|
|
Term
| Acute pyelonephritis is caused by? Chronic pyelonephritis may be due to? |
|
Definition
1. bacterial infection.
2. infection, obstruction or both. |
|
|
Term
| condition of more than the normal number of WBC’s in the urine. |
|
Definition
|
|
Term
| radiographic view of kidney vascularity using iodinated contrast medium; used for diagnosis of renal artery stenosis. |
|
Definition
|
|
Term
| usually percutaneous needle biopsy done to diagnose and assess prognosis/treatment options. Most commonly performed in patient presenting with nephrotic syndrome early in disease to help in identifying disease that might respond to corticosteroid treatment, or after kidney transplant for immunomodulation to treat organ rejection. |
|
Definition
|
|
Term
| cancer of the kidney, more common in men, ages 55-60, strong association with smoking; usually requires nephrectomy. |
|
Definition
|
|
Term
| demineralization of bone due to abnormal levels of parathyroid hormone (PTH) occurring in chronic renal failure. |
|
Definition
|
|
Term
| inflammatory autoimmune disorder; occurs usually in young women with characteristic rash over sun-exposed areas, joint symptoms, and depressed hemoglobin, WBCs, platelets, circulating immune complexes that become trapped in capillaries of visceral structures. 70% of patients with SLE develop clinically significant renal disease. |
|
Definition
| Systemic Lupus Erythematosis (SLE) |
|
|
Term
| product of renal tubular cells and is a normal constituent of urine; comprises the matrix substance of tubular casts. |
|
Definition
|
|
Term
| [H+] ion concentration in urine; tested on urine dipstick |
|
Definition
|
|
Term
| determine by solute concentration in urine; >400 suggests water-conserving ability is functioning; tested on urine dipstick. |
|
Definition
|
|
Term
| test on urine dipstick compares how much heavier urine is than an equal volume of distilled water (water = 1.000) |
|
Definition
|
|
Term
| one of the common tumors of childhood that presents as a palpable abdominal mass; May also have hypertension and hematuria, abdominal pain and wt loss. Therapy is usually a combination of surgical resection, radiation and chemotherapy. |
|
Definition
| Wilms Tummor (nephroblastoma) |
|
|
Term
| List the essential symptoms, signs, and laboratory findings associated with ARF. |
|
Definition
Azotemia
Oliguria
may have HTN, Pericardial Friction rub
sudden increase in BUN and serum creatinine
include hypocalcemia, hyperphosphatemia, hyperkalemia, or metabolic acidosis. |
|
|
Term
| the most common cause of ARF. This syndrome is associated with a decrease in GFR resulting from renal hypoperfusion (decrease in renal blood flow). |
|
Definition
|
|
Term
|
Definition
Prerenal Azotemia
Intrinsic Renal Failure
Postrenal Azotemia |
|
|
Term
| 3 causes of Intrinsic Renal Failure |
|
Definition
Actute Tubular Necrosis
Acute Interstitial Nephritis
Glomerulonephritis |
|
|
Term
| Intrinsic renal failure Caused by HTN, exogenous toxins like aminoglycosides, vanc, acyclovir, contrast. Endogenous agents from rhabdomyolysis, seizures, etoh abuse. Labs show Granular muddy brown casts. |
|
Definition
|
|
Term
| Interstitial and inflammatory resopnse with edema and tubular cell damage. Medications cause this most of the time. NSAIDS, sulfonamides. Patients present with fever and rash. U/A shows, RBC WBC WBC casts and proteniuria |
|
Definition
| Acute Intersitial Nephritis |
|
|
Term
| Patients present with hematuria, RBC casts, mild proteinuria Least common cause of intrinsic renal failure. |
|
Definition
|
|
Term
| Cause of Acute Renal Failure from urinary obstruction anywhere in the urinary system but BOTH kidneys Must be involved. (prostatic enlargement, renal stones, infections, tumors |
|
Definition
|
|
Term
| Describe the three phases that occur in the clinical course of ARF, and list four common complications that may occur. |
|
Definition
Oliguric Phase
Diuretic phase
recovery phase
complications: hyperkalemia, metabolic acidosis, uremia, electrolyte imbalance |
|
|
Term
| Give the treatment and prognosis of ARF. |
|
Definition
restrict fluids to match loss
restrict protein
give at least g/d carbohydrates
Mortality rate is 20-50% and higher in surgical patients |
|
|
Term
| 1.What is the cause of pain in the urinary tract |
|
Definition
| Renal, Ureteral, vesical pain, Prostatic, pain, Penile pain, testicular pain. |
|
|
Term
| Pain typically due to acute urinary retention; it is suprapubic and related to micturation. Acute cystitis pain is usually in the distal urethra. |
|
Definition
|
|
Term
| pain usually located in the ipsilateral costovertebral angle; may radiate to the umbilicus and referred to the ipsilateral testicle in men and labium in women. Pain from infection is usually constant, whereas obstructive pain may come and go. N/V may accompany the pain. |
|
Definition
|
|
Term
| pain usually acute and results from obstruction; may be two different patterns: distention may cause a dull ache, while spasms may result in colic. The site of the pain may indicate the obstruction. |
|
Definition
|
|
Term
| is usually from inflammation and is located in the perineum; it may radiate to the lumbosacral spine, inguinal canal or lower extremities. Because of the prostate’s proximity with the bladder neck, inflammation of the prostrate may result in irritative urinary voiding symptoms. |
|
Definition
|
|
Term
| pain in the flaccid penis is secondary to inflammatory processes caused by STD’s or paraphimosis; pain in the erect penis may be due to Peyronie’s disease or priapism. |
|
Definition
|
|
Term
pain is of three variations:
1. Pain within the scrotum may be due to acute trauma, torsion, or epididymitis/orchitis. The pain may radiate to the ipsilateral groin area.
2. A chronic “heaviness” without radiation is usually due to a varicocele or hydrocele
3. The pain may be radiation from elsewhere, usually the kidney, inguinal canal or retroperitoneum. |
|
Definition
|
|
Term
Are these“irritative or obstructive” voiding symptoms.
Urgency
Frequency
Dysuria
Nocturia |
|
Definition
|
|
Term
Are these“irritative or obstructive” voiding symptoms.
Hesitancy
Intermittency
Decreased force
Post-void dribbling |
|
Definition
|
|
Term
| Describe the evaluation and treatment for hematospermia. |
|
Definition
•thorough history to include whether blood is seen initially (prostate) or at the end (seminal vesicle).
•digital rectal exam with prostate massage.
•urinalysis with microscopy.
•Microscopy of prostate secretions.
• Consider cytoscopy if the patient has hematuria, consider transrectal ultrasound with prostate biopsy if abnormal rectal exam. |
|
|
Term
| inability to retract the foreskin over the glans penis. Can be congenital or acquired (more in adults due to hygiene, chronic balanitis). |
|
Definition
|
|
Term
| entrapment of the foreskin behind the glans penis. Examples such as cathetherization w/o reducing the foreskin or vigorous sexual activity, can lead to it. Will present with pain, edema, tenderness, and erythema. Check for encircling foreign bodies. This should be reduced emergently! |
|
Definition
|
|
Term
| Most common congenital anomaly of the penis. Positioning of the urethral meatus along the ventral shaft of the penis toward the perineum |
|
Definition
|
|
Term
| malformation in which the urethra opens on the dorsum of the penis. |
|
Definition
|
|
Term
| soft, nontender fullness that will transulluminate. May wax/wane in size. Ultrasound can distinguish between this and spermatolecele and testicular tumors. |
|
Definition
|
|
Term
| formation of a venous varicosity in the spermatic vein. Increased incidence in left. “Bag of worms” consistency. Does not transilluminate. |
|
Definition
|
|
Term
| sign on upper aspect of scrotum and normal cremasteric reflex suggest testicular torsion |
|
Definition
|
|
Term
| Gross hematuria is considered |
|
Definition
malignancy until proven otherwise. Other diseases that present with gross hematuria include:
•ureteral stone if accompanied by renal colic
•with irritative voiding in young females consider acute UTI with hemorrhagic cystitis
•staghorn calculi
•glomerulopathies
• PKD |
|
|
Term
| implies an anterior urethral source (penile). |
|
Definition
|
|
Term
| implies bladder neck or prostatic urethral source. |
|
Definition
|
|
Term
| implies a bladder or upper urinary tract source (ureter, kidneys, or bladder). |
|
Definition
|
|
Term
| four different types of incontinence. |
|
Definition
|
|
Term
| What are the essentials of diagnosis for renal cell carcinoma? |
|
Definition
a.Hematuria (micro or macro)
b.Flank pain/mass
c.Systemic Sx (fever, weight loss)
d.Solid renal mass on ultrasound/CT |
|
|
Term
| second most common urologic cancer |
|
Definition
Bladder cancer
Risk factors include smoking and exposure to industrial dyes/solvents. Hematuria is the presenting symptom in 85-90% of cases |
|
|
Term
| most common neoplasm occurring in males ages 20 – 35. |
|
Definition
|
|
Term
| patient-identified painless testicular nodule. Patients typically delay presenting this finding to a physician/PA for 3 – 6 months. |
|
Definition
| What is the typical presentation of testicular cancer? |
|
|
Term
| entity occurs when the urinary tract is initially sterilized during therapy but a persistent source of infection in contact with the urinary tract remains. |
|
Definition
persistent bacteriuria
1) Ureter (ureteritis cystica)
2) Bladder (cystitis: Hemorrhagic cystitis, cystitis cystica, vesicular cystitis, cystitis emphysematosa, cystitis glandularis), chronic covert bacteriuria, asymptomatic bacteruria
3)Prostate and seminal vesicles, (acute bacterial prostatitis, chronic bacterial prostatitis, chronic nonbacterial prostatitis), seminal vesiculitis
4)Urethra (Gonorrheal urethritis, nongonococcal urethritis), urethral diverticula
5)Acute bacterial epididymitis, recurrent bacterial epididymitis, chronic epididymitis nonbacterial epididymitis.
6)Infected kidney stones, obstructive uropathy, foreign bodies |
|
|
Term
| discuss the difference between male/female host susceptibility factors. |
|
Definition
Female: short urethra (facilitates ascent of organisms), adhesin receptors (more binding sites for pathogens), lack of fucosyltransferense activity (nonsecretors-more prone to UTI’s)
Male: uncircumcised males (underside of the foreskin has propensity for colonization of bacteria), lower zinc levels |
|
|
Term
| Compare and contrast acute cystitis with chronic interstitial cystitis |
|
Definition
Acute cystitis is characterized by dysuria and pyuria in the absence of fever and systemic toxicity. Acute cystitis is especially common in young sexually active women, who may also be at risk for sexually transmitted causes of urethritis and vaginitis. Acute onset of gross hematuria is the presenting complaint in some women with acute cystitis, frequently accompanied by dysuria.
Chronic interstitial cystitis is defined as inflammation and irritation of the bladder wall. The etiology is unknown, and treatment is not specific. Symptoms are lower abdominal or vaginal pain, urinary frequency, and urgency. Histologically, the bladder wall shows a unifocal or multifocal inflammatory infiltration with mucosal irritation and scarring that ultimately results in contraction of the smooth muscle, diminished urinary capacity, and symptoms of frequent, painful, urination and hematuria. Typically middle-aged women are affected. |
|
|
Term
Tx for
Uncomplicated UTI
complicated UTI |
|
Definition
1. Bactrim/Septra DS (trimethoprim-sulamathoxazole 160/800 mg) II tabs PO single dose, Cephlexin 500mg PO QID x 3 days, Ciprofloxacin 500mg PO BID x 3 days, Nitrofurantoin 100mg PO BID x 7 days,
2. Antibiotic usage will be administered perenterally ( I.E. Ampicillin & gentamycin) |
|
|
Term
| List the four essentials of diagnosis of acute pyelonephritis and the class of bacteria that is the most causative agent. |
|
Definition
1)Fever
2)Flank pain
3)Irritative voiding symptoms
4)Positive urine culture.
Most causative organism: Gram-negative bacteria to include: E. coli, Proteus, Klebsiella, Enterobacter, and Pseudomonas. |
|
|
Term
| Give three essentials of diagnosis for acute epididymitis |
|
Definition
fever
irritative voiding symptoms
painful enlargement of the epididymis |
|
|
Term
| identify distinguishing clinical features of epididymitis versus testicular torsion. |
|
Definition
|
|
Term
| Nephritic Syndromes: name 3 |
|
Definition
Post-streptococcal Glomerulonephritis
IgA Nephropathy
Rapidly progressive glomerulonephritis |
|
|
Term
|
Definition
| peripheral edema is the hallmark. Ascites and anasarca develop as consequence of the severity of the hypoalbuminemia. |
|
|
Term
| disorder of the kidneys characterized by renal tubule injury and inflammatory infiltrates in the interstitium. Patients with this disease have an inability to concentrate urine, salt wasting and metabolic acidosis. |
|
Definition
tubulointerstitial dz
usually an allergic reaction. |
|
|
Term
| List four common management problems common to all patients with Nephrotic Syndrome. |
|
Definition
Protein Loss
Peripheral Edema
Hyperlipidemia
Hypercoagulable state (from loss of antithrombin and other proteins involved in clot formation) |
|
|
Term
|
Definition
Minimal Change Dz
Focal Glomerular Sclerosis
Membranous Glomerulonephritis
Membranoproliferative-Glomerulonephropathy |
|
|
Term
| Proteinuria has 3 categories: |
|
Definition
1.Transient/Intermittent- stress and excersise
2.Orthostatic• Fever, excerise
3.Persistent • Usually reflects underlying disease (Pathologic) |
|
|
Term
| Name the secondary glomerular disease that is the major cause of end stage renal disease in the US today |
|
Definition
|
|
Term
| First indicator of diabetic nephropathy |
|
Definition
| persistant microalbuminuria |
|
|
Term
| systemic autoimmune disease in which renal involvement occurs in 35-90% of cases. Patientsmay present with nephritic or nephrotic syndrome. Renal biopsy should be performed when patients with SLE first show urinary abnormalities. Biopsy will help to determine what pattern of renal disease and what type of treatment is needed. |
|
Definition
| Systemic Lupus Erythematosus SLE |
|
|
Term
| when primary, is idiopathic and can present a nephrotic or nephritic syndrome. When secondary can be due to a number of immune-mediated diseases. There are two subtypes of this disease. Type I is associated with Hepatitis B & C, Strep infections, bacterial endocarditis and cancer. Type I usually presents with a nephrotic syndrome. Type II presents with a nephritic syndrome and has a circulating IgG auto-antibody. |
|
Definition
| Membranoproliferative glomerulonephritis |
|
|
Term
2. Be able to identify four essentials of diagnosis of acute bacterial prostatitis. List
laboratory findings. |
|
Definition
Fever
Irritative voiding symptoms
perineal or suprapubic pain; exquisite tenderness common on rectal exam
Positive urine cultures
Labs:CBC showing leukocytes and a left shift. Urinalysis shows pyuria, bacteriuria and varying degrees of hematuria. Urine cultures will demonstrate the offending pathogen. |
|
|
Term
| treatment and prognosis for Bacterial Prostatitis. |
|
Definition
Treatment includes hospitalization along with parenteral antibiotics (ampicillin and aminoglycoside. Should urinary retention develop, urethral catheterization or instrumentation is contraindicated, and a percutaneous suprapubic tube is required.
prognosis is good |
|
|
Term
| Name the one bacterial organism known to be responsible for chronic prostatitis |
|
Definition
| one gram positive organism (Enterococcus) is associated with chronic infections. |
|
|
Term
| three entities that may mimic chronic prostatitis. |
|
Definition
chronic urethritis
Cystitis secondary to prostatitis
Anal Disease |
|
|
Term
| Give the incidence of nonbacterial prostatitis and the presumed possible etiologies. |
|
Definition
| Nonbacterial prostatitis is the most common of the prostatitis syndromes, and its cause is unknown. It is believed to represent an inflammatory disorder. |
|
|
Term
a non-inflammatory disorder that affects young and middle-aged men and has variable causes, including voiding dysfunction and pelvic floor musculature dysfunction. The prostate is normal in this entity.
Symptoms are the same as chronic prostatitis, yet there is no history of UTI.
Labs are normal |
|
Definition
prostatodynia,
Bladder neck and urethral spasms can be treated with -blocking agents. |
|
|
Term
| prostatic cancers originate in the peripheral zone of the prostate, BPH originates in the _______ and _________ zones |
|
Definition
| periurethral and transition zones |
|
|
Term
| Give three laboratory studies that must be done on a patient with suspected BPH. |
|
Definition
| Serum urea nitrogen and creatinine Urinalysis, Prostate-specific antigen is often measured in order to increase the sensitivity of prostatic cancer detection, although it is elevated in BPH. |
|
|
Term
| most useful urodynamic technique for the assessment of BPH. |
|
Definition
|
|
Term
| . Discuss the medical and surgical treatment modalities presently used for BPH and the indications for surgery. |
|
Definition
| Medical management may target either stromal or epithelial hyperplasia as they both appear to contribute to prostatic enlargement. It appears that prostatic androgen levels play at least a permissive role in BPH, and therapies that reduce their levels will reduce the prostatic size and improve obstructive symptoms. Reduction of testosterone levels |
|
|
Term
| . List the essentials of diagnosis for prostate cancer |
|
Definition
•Prostatic induration in digital rectal examination or elevation of PSA.
•Most often asymptomatic.
•Systemic symptoms [weight loss, bone pain] in 20% of patients. |
|
|
Term
| most common cancer detected in American men. |
|
Definition
|
|
Term
| Describe three special studies that are usually done for a patient with suspected prostatic cancer |
|
Definition
| Modern transrectal ultrasound, MRI of the prostate, Radionuclide bone scan |
|
|
Term
| Discuss the present screening recommendations for prostatic cancer. |
|
Definition
| digital rectal examination, PSA testing, and transrectal ultrasound - |
|
|
Term
| how prostatic cancer is staged. |
|
Definition
| Gleason grading system whereby a "primary" grade is applied to the architectural pattern of cancerous glands occupying the largest area of the specimen and a "secondary" pattern is applied to the next largest area of cancerous growth. Grading is based on architectural [rather than histological] criteria, and five possible "grades" are possible. |
|
|
Term
defined as the consistent inability to maintain an erect penis with sufficient rigidity to allow sexual intercourse.
•Incidence is age-related
•Most cases organic rather than psychogenic |
|
Definition
|
|
Term
| may indicate androgen deficiency from hypothalamic, pituitary or testicular disease |
|
Definition
|
|
Term
• Typical symptoms: urethral discharge (male), burning on urination. May also infect rectum, throat. In women, cervicitis•
Antibiotic resistance (penicillin especially) is common problem. • Bacterial cause (Neisseria Gonorrhoeae). |
|
Definition
|
|
Term
| • most common STD in U.S. • Curable with antibiotics (Doxycycline)- • Symptoms: urethritis, cervicitis, PID. Chlamvdia trachomatis |
|
Definition
|
|
Term
| 3rd most common STD U.S. • Non curable. Acyclovir prevents recurrences or shortens their duration |
|
Definition
Genital Herpes -
Diagnosis confirmed by viral culture or by tzank smear. |
|
|
Term
| Chronic, infectious disease caused by the spirochete Treponema Pallidum, transmitted by sexual contact, capable of involving most body structures. |
|
Definition
|
|
Term
|
Definition
Primary chancre: painless lesion
secondary: wide spread mucosocutaneous lesions....Involves palms and soles
Latent Syphilis:
Tertiary:
•Skin - nodular gummatous lesions, may ulcerate
•Neurosyphilis |
|
|
Term
| Ragged erythematous PAINFUL ulcer with necrotic base caused by the fastidious bacterium Haemophilus Ducreyi. |
|
Definition
|
|
Term
| Superative (draining/weeping) inguinal lymphadenitis with matted nodes and secondary ulceration and fistula formation caused by Chlamydia Trichomatis types Ll, L2, and L3. |
|
Definition
| Lymphogranuloma Venereum (LGV) |
|
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Term
| • Definition: Mildly contagious, chronic indolent progressive ulcerogranulomatous disease of skin and mucous membranes caused by the gram negative encapsulated Calymmatobacterium Granulomatis (Donovania Granulomatis). |
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Definition
Granuloma Inguinale•
Wrights or Giemsa stain for Donovan Bodies
• RPR Negative
• Treatment: Tetracycline 500 mg Q.I.D. |
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Term
| Viral diseases that may be venereally related |
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Definition
Molluscum
Condyloma Acuminata
Herpes symplex TypeII |
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Term
| Usually limited to the genital region but has been found in eyelashes, eyebrows, mustaches, beards and occasionally in hair of the head. Sexual contact is the most common means of transmission but has been contacted from fomites and toilet seats. |
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Definition
Pediculosis pubis (CRABS)• Treatment -
Kwell cream or shampoo as per directions |
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Term
| 1. List the five major types of urinary stones and give the most common type. |
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Definition
a)calcium oxalate b) calcium phosphate c) struvite d) uric acid e) cystine
most common types are composed of calcium. |
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Term
| 4 types of calcium kidney stones: |
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Definition
1. hypercalciuric-> 200 mg/24 hours can be caused by absorptive, resorptive and renal disorders.
2. hyperuricosuric-secondary to dietary excesses or uric acid metabolic defects
3. hyperoxaluric-due to primary intestinal disorders
4. hypocitraturic-secondary to chronic diarrhea |
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Term
| 3 contib factors to the production of urinary stones: |
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Definition
Geographic factors: deve countries young boys prone to bladder calculi...indust countries most clculi are renal or ureteral stones: high humid areas
diet and fluid intake: those with stone should decrease Na and protein intake
Genetic factors: cystinuria (autosomal recessive) |
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Term
| Patients present with acute colic. Pain occurs suddenly and may awaken the patient. Flank pain is severe with nausea and vomiting. Patient will be constantly moving. may be referred to the ipsilateral testes or labium. what is going on? |
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Definition
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Term
| 4. Give the laboratory findings common to this diagnostic entity, tell which imaging study should be ordered to diagnose most stones. |
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Definition
| There is usually hematuria. Infection must be ruled out. Urinary pH is a clue as to a cause if it is a stone. A plain film of the abdomen and renal ultrasound will diagnose most stones. If it remains uncertain an IV urography is indicated. |
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Term
| 5. Discuss the medical treatment and preventive measures recommended for calcium nephrolithiasis. |
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Definition
| The most important thing a patient can do to reduce stone recurrence is to increase fluid intake. Doubling their previous intake is recommended. Preventative therapy will vary depending on the type of stones the patient has. |
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Term
Distal ureteral stones are best managed with
Therapy for patients with renal calculi? |
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Definition
ureterscopic stone extraction or extracorporeal shock wave lithotripsy (ESWL).
Patients with renal calculi do not require therapy unless they have pain, UTI or obstruction. If < 3cm ESWL is used. If > 3 cm percutaneous nephrolithotom |
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Term
| Most common cause of respiratory acidosis |
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Definition
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Term
| Woman who leaks when she sneezes |
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Definition
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Term
| Overflow of urine when pressure is greater than sphincter |
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Definition
urge incontinence
or maybe overflow incontinence |
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Term
| One cause of incontinence |
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Definition
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Term
| Appropriate imaging for hydronephrosis |
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Definition
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Term
| Hernia that goes into scrotom |
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Definition
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Term
| First line treatment for stage 1 renal dz |
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Definition
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Term
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Definition
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Term
| Cystic enlargement of epididymis |
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Definition
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Term
| What is true about severe hypertension and renal dz? |
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Definition
| renal dz causes HTN, HTN causes renal dz, hyperreninemia, decreased excretion of sodium and water |
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Term
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Definition
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Term
| Don’t screen males over what age for prostate cancer |
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Definition
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Term
| Most common cancer of GU tract |
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Definition
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Term
| hard, nontender prostate nodule on palpation |
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Definition
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Term
| eosinophils and a rash on torso and legs. This occurred after treatment of a staph infection to a stab wound in the leg→ |
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Definition
| drug induced acute interstitial nephritis |
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Term
| Main thing for acute renal failure— |
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Definition
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Term
Anemia with kidney dz
normocytic, microcytic, macrocytic |
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Definition
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Term
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Definition
| patients with CKD and heart failure |
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Term
| If young boy comes in with gross hematuria, his brother died after kidney transplant at 21 and started wearing hearing aids at 16, you want to |
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Definition
| screen mother for blood in her urine |
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Term
| Proteinuria with nephrotic syndrome is |
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Definition
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Term
| Lab marker for bone dz in CKD |
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Definition
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Term
| Kidney dz on ACEI—monitor for |
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Definition
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Term
| Most common electrolyte imbalance |
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Definition
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Term
| Ability of kidneys to conserve sodium |
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Definition
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Term
| Ability of kidneys to function is measured |
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Definition
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Term
| Concentration ability of kidneys measured by |
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Definition
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Term
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Definition
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Term
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Definition
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Term
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Definition
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Term
| Woman with acute MI comes in and several days later her kidneys start to fail, what does she have? |
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Definition
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Term
| Careful prescribing drugs to: |
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Definition
| 25 female for amoxicillin with creatinine of 1.5 |
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Term
| woman with edema and acute renal failure should be on what type of restriction |
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Definition
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Term
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Definition
| all of above (cyclosporins, NSAIDS…) |
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Term
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Definition
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Term
| girl went for sports physical with protein |
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Definition
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Term
| guy that was unconscious with positive urine dipstick with no RBCS |
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Definition
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Term
anuria How many ml
normal
Polyuria |
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Definition
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Term
| ketones in urine can be from |
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Definition
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Term
| what is true about diabetic nephropathy and kidneys? |
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Definition
| Asymptomatic mild proteinuria |
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Term
| BPH is cellular growth of |
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Definition
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Term
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Definition
acute cystitis,
urniary retention |
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Term
| Wilms tumor most common in |
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Definition
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Term
| 25 year old male with malaise, gross hematuria, flank pain, fever, palpable mass |
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Definition
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Term
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Definition
| urethra opening on dorsal side of penis |
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Term
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Definition
woman came in with n/v, then had abdominal pain
Often due to vomiting |
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Term
| After first hematuria, do another urinalysis and look at |
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Definition
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Term
| Guy with Hep B and nephrotic syndrome— |
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Definition
| membranous glomerulonephritis |
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Term
Nephrotic or Nephritic
Minimal change dz |
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Definition
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Term
| Acute bacterial prostatitis |
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Definition
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Term
| Top on diff list for lower UTI in women |
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Definition
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Term
| What would you see in PKD— |
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Definition
| aneuryism, cortical cysts, all of above |
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Term
| What can you treat uncomplicated cystitis with in a girl |
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Definition
Bactrim/Septra DS (trimethoprim-sulamathoxazole 160/800 mg) II tabs PO single dose,
Cephlexin 500mg PO QID x 3 days, Ciprofloxacin 500mg PO BID x 3 days, Nitrofurantoin 100mg PO BID x 7 days, |
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Term
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Definition
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Term
| Pyelonephritis can occur in |
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Definition
| 6 month pregnant womana guy with renal colic, and hydronephrosis |
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Term
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Definition
| Small Kidney, so this would rule out ATN with xray |
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Term
| To prevent stones do this? |
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Definition
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Term
| Abnormal finding on testicular exam |
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Definition
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Term
| Lower pole of kidney—hard to feel in what type if patients |
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Definition
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Term
| Hypoalbuminemia—does not change with |
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Definition
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Term
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Definition
| Normal finding on urinalysis |
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Term
| best specimen for UPE best specimen for UPE |
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Definition
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Term
| 2. 32 yo female with back pain like last year with stone. CT shows 7mm stone in distal ureter. Don’t think she can pass it. What do you do? |
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Definition
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Term
| 5. Fever 103. Low back pain. Hx of prostatitis- first step?- |
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Definition
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Term
| Where does most renal resorption occur? |
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Definition
| proximal tubule, not regulated |
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Term
| Big cause of ketones on UA |
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Definition
| DKA, Starvation, vomiting |
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Term
| Most useful test for eval severity of renal failure |
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Definition
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Term
| Bladder CA, what important questions do you ask |
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Definition
| smoking, drinking, toxins (occupational dyes, paints) |
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Term
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Definition
a. Nsaids avoided- TRUE
b. Ace and arbs can be used?- TURE
c. Serum phos should be monitor- TURE
d. Parathyroid hormone monitor?- TRUE |
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Term
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Definition
| 33. Urine specimen with 3-5 rbcs hpf- |
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Term
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Definition
| poor hygiene, decr fluids, uncontrolled DM |
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Term
| How differentiate between cystists and acute pyelonephritis |
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Definition
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Term
Most common noncutaneous cancer in males
2nd leading cause of male cancer mortality |
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Definition
Prostate Cancer
African-American men > Caucasian or Hispanic
Rarely occurs before age 45
>95% are adenocarcinoma |
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Term
| prostate Cancer Differential Diagnosis |
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Definition
Benign Prostatic Hypertrophy
Prostatitis
Cystadenoma (benign) |
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Term
Uncommon
Most curable form of urologic cancers
Occurs most frequently among young men and is the most common solid tumor in men between 2-034 years of age
Cumulative life-time risk of developing testicular cancer is 1:500 |
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Definition
Testicular Cancer
Germ cell tumors
90-95% of all testicular tumors
Seminoma |
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Term
Most common: testicular swelling
Testicular pain 25-50%
Misconception: painful testicular mass excludes testicular malignancy |
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Definition
| Testicular Cancer Signs and Symptoms |
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Term
Testicular Cancer Diagnosis-Imaging
Testicular Cancer Diagnosis: Tumor Markers |
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Definition
Scrotal ultrasound
AFP (alpha fetoprotein)
LDH (lactate dehydrogenase) |
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Term
2nd most common urological cancer, after prostate carcinoma
Transitional cell carcinoma is most common |
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Definition
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Term
| Classic triad: flank pain, abdominal mass, hematuria (20%) |
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Definition
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Term
| A solid lesion of the kidney is RCC until proven otherwise!! |
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Definition
| CT scan is the most valuable test for RCC |
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Term
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Definition
| Radical nephrectomy with lymphadenectomy is gold standard for localized RCC with a normal contralateral kidney |
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Term
| Wilms’ Tumor versus Neuroblastoma |
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Definition
Wilms’ Tumorn (goal is to preserve renal fnxn)
One side of abdomen
Rarely cause axis change
Metastasis less common
Neuroblastoma
Cross the midline
“Drooping lily”
Metastasis, tumor calcification common |
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