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Pothoven - Kidney, bladder and prostate disease
Kidney, bladder and prostate disease lecture
22
Medical
Professional
11/18/2012

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Cards

Term
Nephrologic/Glomerular hematuria
Definition
significant proteinuria (>1 gm/24 hrs)
Dysmorphic RBCs
Red cell casts
Warrants a nephrology evaluation
Term
Renal cysts
Definition
Benign
Present in 50% of people over 50
Typically asymptomatic
No treatment required unless very large and causing pain
Term
Angiomyolipoma (AML)
Definition
Benign solid renal tumor
Frequently associated with tuberous sclerosis
Typically an incidental finding on imaging study
spontaneous bleeds occur in 10%
Presence of fat rules out RCC and is diagnostic of AML
Term
Oncocytoma
Definition
Benign tumor derived from distal tubules
Looks like RCC and must be treated surgically
Term
Renal Cell Carcinoma (RCC)
Definition
Most lethal of all GU cancers
Metastatic disease has poor prognosis (0-15% 5 year survival rate) - most common site of metastasis is the lungs
Tobacco use is a risk factor
majority of cases are sporadic/idiopathic
associated with Von Hippel Lindau disease
Term
Clear cell RCC
Definition
most common tumor subtype
Term
Cystitis - symptoms
Definition
urgency
frequency
dysuria
hematuria
foul-smelling urine
suprapubic pain
Term
Urinary analysis of UTI
Definition
Leukocye esterase
Nitrate
Blood, gross or microscopic
>10 WBCs/HPF
Term
Interstitial Cystitis (Painful Bladder Syndrome)
Definition
Syndrome of chronic pain, pressure or discomfort associated with the bladder - no identifiable cause
Term
Interstitial Cystitis symptoms
Definition
Urinary frequency
Nocturia
Pain with bladder filling
Pelvic floor tension
Hematuria
Small bladder capacity
Term
Interstitial Cystitis - associated disorders
Definition
Fibromyalgia
IBS
Endometriosis
Vulvodynia
Multiple allergies
Term
Interstitial Cystitis - etiology
Definition
Increased mast cell concentration in bladder - histamine irritates the bladder
Deficiency in GAG layer in bladder lumen
Neurogenic hypersensitivity at the level of the bladder of sacral SC
Pelvic floor muscle dysfunction
Term
Bladder cancer
Definition
Second most common GU cancer
Male:female = 2.5:1
Mean age at diagnosis = 70
smoking is #1 risk factor (50% of cases)
Term
Noninvasive bladder cancer (Ta, T1, CIS)
Definition
70% of all bladder cancers
70-80% of these recur
5 year survival rate - 80-100%
Term
Muscle invasive bladder and metastatic bladder cancer
Definition
Radical cystectomy with urinary diversion is the gold standard
Metastatic disease has poor prognosis with 5 year survival rate of 5-30%
Term
Alpha-1A receptors
Definition
mediate prostatic smooth muscle tone
Term
Prostate transition zone
Definition
most important zone in BPH
Term
Prostate peripheral zone
Definition
where most cancers form
Term
BPH complications
Definition
Acute urinary retention
Renal insufficiency
Chronic/recurrent UTIs
Uncontrolled gross hematuria/clot retention
Bladder caliculi
Term
BPH pharmacotherapy
Definition
alpha antagonists - works right away
5-alpha reductase inhibitors - works over time
Term
Prostate cancer
Definition
most common solid organ cancer in men
age is strongest risk factor
more likely in african-americans
Sites of metastasis - Lungs (first organ it goes to), Pelvic lymph nodes, bone
First malignancy found to be hormone dependant
Term
PSA
Definition
Enzyme produced by prostatic epithelial cells
specific to prostate but elevations are not specific to cancer
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