Term
|
Definition
| urinating more than once/night |
|
|
Term
| #1 reason for change in urine color/odor: |
|
Definition
|
|
Term
| Oliguria definition. What should you always consider with this symptom? |
|
Definition
- decrease in amount of urine being produced
- renal failure |
|
|
Term
|
Definition
|
|
Term
| Blood in the urine can be red or brown, remember this b/c pts may say no blood, but it could be brown and don't know its blood. |
|
Definition
|
|
Term
| Associated symptoms with UTI: |
|
Definition
- nausea
- vomiting
- distention
- bloating
- fatigue |
|
|
Term
| GU symptoms with fever, consider __ and __. |
|
Definition
|
|
Term
| GU symptoms with fatigue, consider __ or __. |
|
Definition
|
|
Term
| GU symptoms and weight loss, consider: |
|
Definition
|
|
Term
| GU symptoms and edema, consider: |
|
Definition
|
|
Term
| GU symptoms and gynecomastia, consider: |
|
Definition
|
|
Term
| Pertinent past medical history with a GU patient: |
|
Definition
- Hx of bladder/kidney infections
- Diabetes
- Hypertension
- Smoking
- Prostate abnormalities
- Congenital disorders
- Sterility
- Sexual dysfunction
- STDs
- Hx of cancer
- Past surgeries |
|
|
Term
| Smoking is correlated with what cancers related to GU? |
|
Definition
- bladder cancer
- renal cell carcinoma |
|
|
Term
| __% of women have recurrent UTIs. |
|
Definition
|
|
Term
| Why are DM pts more prone to UTIs? |
|
Definition
| - they tend to spill glucose in their urine and glucose feeds bacteria |
|
|
Term
| __ and __ both cause you to spill protein into urine, which can cause GU issues. |
|
Definition
|
|
Term
|
Definition
| - tends to localize in the mid-back, flank, lower abdomen, or groin, often radiates to groin |
|
|
Term
| Colickly GU pain in males indicate __ of the ureter. |
|
Definition
| obstruction (the back up of urine and stretching of the ureter is what causes pain) |
|
|
Term
| Constant GU pain is more suggestive of an ___ __. |
|
Definition
| - inflammatory cause- UTI (may be somewhat relieved with urination, but does not come and go as dramatically as kidney stone pain) |
|
|
Term
| Kidney pain is typically __ and __ and below the __rib. |
|
Definition
- dull and constant
- 12th rib |
|
|
Term
| Kidney pain is caused by distention of the __ __, it spreads to the __ and __ __. The development of pain may be chronic or slow, can be painless. |
|
Definition
- renal capsule
- umbilicus and lower abdomen |
|
|
Term
| Pple with kidney infections look really sick, not just a little back ache, usually nauseated/fever etc. |
|
Definition
|
|
Term
| Ureter pain is typically caused by __, it is __, __, and __. |
|
Definition
- obstruction (stone)
- colicky
- severe
- RADIATES |
|
|
Term
| Ureter 3 areas of obstruction: |
|
Definition
1. Uretopelvic Junction
2. Ureter crossing iliac vessels
3. Vesicoureteral Junction |
|
|
Term
| Symptoms of a stone lodged at the uretropelvic junction: |
|
Definition
| - flank/CVA pain, +/- radiation to groin |
|
|
Term
| Symptoms of a stone lodged in the ureter over the iliac vessels: |
|
Definition
- flank pain
- lower abdominal quadrant pain
- +/- radiation to groin |
|
|
Term
| Symptoms of a stone lodged at the vesicoureteral junction: |
|
Definition
- flank
- lower abdominal quadrant pain
- frequency and urgency |
|
|
Term
| f a stone is causing frequency and urgency, it is likely at the: |
|
Definition
|
|
Term
| Ureteral pain is usually colicky but if the renal capsule is involved there may also be constant back pain. |
|
Definition
|
|
Term
| Acute urinary retention can cause agonizing ___ pain, whereas chronic bladder distention is usually ___. |
|
Definition
- suprapubic pain
- chronic- painless |
|
|
Term
| Constant suprapubic pain unrelated to urination is not __ in origin. |
|
Definition
|
|
Term
| GU pain associated with infection is usually referred to the __ __. |
|
Definition
|
|
Term
| Prostate pain is often described as __ discomfort or __ in the perineal/rectal area. |
|
Definition
|
|
Term
|
Definition
|
|
Term
| Prostate pain is usually related to __. It also may be associated with __, __, and ___. Lumbosacral referred pain is uncommon. |
|
Definition
- inflammation
- dysuria, urgency, and frequency |
|
|
Term
|
Definition
- usually localized
- due to trauma, torsion, or infection
- consider referred pain from obstruction
- consider inguinal hernia |
|
|
Term
| Testicular cancer is usually ___. |
|
Definition
|
|
Term
| The __ __ deformity is associated with increased risk for testicular torsion. With this deformity the testes is not attached to the scrotal wall. |
|
Definition
|
|
Term
| Testicular torsion tends to occur at __ due to activation of the __ reflex. |
|
Definition
- night
- cremasteric refle |
|
|
Term
| After fixing testicular torsion, an __ is performed to prevent it from occuring again. |
|
Definition
| - orchiopexy (suture testes to scrotal wall) |
|
|
Term
| With epididymis, pain can be felt in the __ or __ __. __ is the usual cause. It can be confused with ___. |
|
Definition
- groin or lowr abdomen
- infection - usual cause
- confused with appendicitis |
|
|
Term
| Pt has a inflammed erythematous scrotum with pain in the groin and lower abdomen: |
|
Definition
|
|
Term
| __ ___ account for most of the mimicry b/w GU and GI symptoms. |
|
Definition
Renointestinal reflexes
common autonomic and sensory innervations b/w the systems |
|
|
Term
| The right kidney is closely related to: |
|
Definition
- hepatic flexure
- duodenum
- head of pancreas
enlarged/inflammed kidney could displace these structures and cause associated symptoms
- common bile duct
- liver
- gall bladder |
|
|
Term
| The left kidney is closley related to: |
|
Definition
- splenic flexure
- stomach
- pancreas
- spleen
enlarged/inflamed kidney could displace these structures and cause associated symptoms |
|
|
Term
|
Definition
|
|
Term
| Causes of urinary frequency: |
|
Definition
- inflammation
- urinary retention
- loss of compliance
- reduced capacity |
|
|
Term
| Nocturia could be due to __ or __ disease. |
|
Definition
|
|
Term
|
Definition
| - painful urination, usually burning |
|
|
Term
| Dysuria is usually related to inflammation of the __, __, or __. |
|
Definition
- bladder
- urethra
- prostate |
|
|
Term
| Dysuria with more pain associated with the end of urination suggests __ involvement, likely a spasm. |
|
Definition
|
|
Term
| Physiological enuresis occurs in kids up to age __. |
|
Definition
|
|
Term
| After age 3, a child can be diagnosed with __ enuresis, in which they have never had a 6 month period of continence. Or they can be diagnosed with __ enuresis, which occurs in children who were previously continent for 6 months or more. |
|
Definition
|
|
Term
| If daytime wetting or other symptoms also occurs, there is probably some sort of issue going, check for infection or structural abnormality. |
|
Definition
|
|
Term
| If daytime wetting or other symptoms also occurs, there is probably some sort of issue going, check for infection or structural abnormality. |
|
Definition
|
|
Term
| Classic example of bladder outlet obstruction: |
|
Definition
| Benign Prostatic Hyperplasia (BPH) |
|
|
Term
| Symptoms of bladder outlet obstruction (BPH): |
|
Definition
- hesitancy
- weak stream
- terminal dribbling
- sudden urgency
- urinary retention
- interruption of urinary stream
- sense of residual volume |
|
|
Term
|
Definition
| urine loss without warning |
|
|
Term
|
Definition
- loss of urine associated with physical strain (cough/laugh)
- this is often seen in women who have had many babies> pelvic floor instability |
|
|
Term
| Type of incontinence seen in women who had many children: |
|
Definition
| Stress incontinence- weakened pelvic floor muscles |
|
|
Term
|
Definition
| - loss of urine associated with urgency due to bladder spasms |
|
|
Term
|
Definition
| loss of urine due to a full bladder that can't hold anymore |
|
|
Term
| Things to consider with oliguria and anuria: |
|
Definition
- consider acute renal failure
- may be shock/dehydration
- could be bilateral ureter obstruction |
|
|
Term
|
Definition
- gas in the stream
- look for fistula to bowel |
|
|
Term
|
Definition
- usually due to increase in alkalinity
- consider infection |
|
|
Term
|
Definition
- cannot be ignored
- MUST CONSIDER CANCER
- timing and color of blood can provide diagnostic clues |
|
|
Term
| Bright red blood in stream is probably from the: |
|
Definition
- bladder
- ureter
- prostate |
|
|
Term
| Dark redish brown hematuria is probably from the ___. |
|
Definition
|
|
Term
| Classic description of bladder cancer: |
|
Definition
|
|
Term
| If blood comes out at the beginning of the urine stream, its probably from the ___. |
|
Definition
|
|
Term
| If blood comes out at the end of the urine stream, its probably from the __ or __. |
|
Definition
|
|
Term
| If blood persists for the duration of the urine stream, its probably from the ___. |
|
Definition
|
|
Term
| Hematospermia is usually __, if lasts longer than a month, then may be a problem. |
|
Definition
|
|
Term
| How many Tanner Stages are there: |
|
Definition
5
1- preadolescent
5- mature |
|
|
Term
| Small yellow-white sebaceous cysts may be seen on the scrotum (normal)- can remove them but not necessary |
|
Definition
|
|
Term
|
Definition
|
|
Term
| purulent penile discharge |
|
Definition
|
|
Term
| With hypospadias, the meatus is __. |
|
Definition
| ventral (underneath the penis) |
|
|
Term
|
Definition
| condyloma acuminata (genital warts) |
|
|
Term
| Gummas are associated with __ __. |
|
Definition
|
|
Term
| Balanitis is inflammation of the __ __. It is more common in ___ males and most commonly caused by a __ infection. |
|
Definition
- glans penis
- uncircumcised
- fungal infection |
|
|
Term
| The kidneys are ___, and thus hard to palpate. The __ kidney is lower than the left kidney b/c of the liver. |
|
Definition
- retroperiotoneal
- right |
|
|
Term
An empty bladder is normally non-palpable
Percussion may be better at detecting distention and masses
In chronic retention, the bladder could extend above the umbilicus
Suprapubic tenderness may be due to cystitis |
|
Definition
|
|
Term
| Peyronie's disease is a condition in which __ form of the penis due to trauma or scarring, resulting in the penis deviating in one direction. Tmt is cosmetic. |
|
Definition
|
|
Term
| When you palpate the penis, you are looking for __ or __. |
|
Definition
- plaques (Peyronie's disease)
- induration (strictures of the urethra tend to feel indurated- swollen and firm) |
|
|
Term
|
Definition
| abdomen> internal inguinal ring> inguinal canal> external inguinal ring> prescrotal (prepubic)> normal position |
|
|
Term
| A hydrocele with __ __, whereas a mass or blood filled testes will be __ with __. |
|
Definition
- transilluminate red
- dark with transillumination |
|
|
Term
| When examining a pt for an inguinal hernia, insert the __ finger into the lower scrotum and follow the __ __ superiorly. Insert finger through __ ring and into __ __. Place the other hand on the patient's body overlying the __ __. Ask patient to cough. |
|
Definition
- index
- vas deferens
- external ring
- inguinal canal
- inguinal canal
may feel something hit finger or push out on hand> either one= hernia |
|
|
Term
| when examining for hernia use right hand on right side and left hand on left side |
|
Definition
|
|
Term
| When checking for inguinal hernia, you feel bowel contact the TIP of your finger: |
|
Definition
| - Indirect Inguinal Hernia |
|
|
Term
| When checking for inguinal hernia, you feel bowel medial to the inguinal canal: |
|
Definition
|
|
Term
| When checking for an inguinal hernia, you feel bowel protrude inferior and lateral to the inguinal canal: |
|
Definition
|
|
Term
| Most inguinal hernias are not visible. |
|
Definition
|
|
Term
| Indirect inguinal hernias go through the __ __. |
|
Definition
|
|
Term
| Direct inguinal hernias go through __ __. |
|
Definition
|
|
Term
| Femoral hernias go through the __ __. |
|
Definition
|
|
Term
| The epididymis is __ and __ to the testis. It should be palpated for size and induration. |
|
Definition
|
|
Term
| Small spermatoceles may be present on the ___. These are __ __ masses often at the head of the __. These are normal and benign. |
|
Definition
- epididymis
- small painless
- epididymis |
|
|
Term
| Chronic painless induraction of the epididymis suggests: |
|
Definition
- schistosomiasis
- TB
- other chronic infection |
|
|
Term
| Chronic painless induraction of the epididymis suggests: |
|
Definition
- schistosomiasis
- TB
- other chronic infection |
|
|
Term
| A painful and tender epididymis usually indicates ___. |
|
Definition
|
|
Term
| The prostate normally feels __ with an average size of __ cm, or 20 grams, a walnut. |
|
Definition
|
|
Term
| If the prostate feels mushy, it is likely __. |
|
Definition
|
|
Term
| If a prostate feels indurated, it is likely ___. |
|
Definition
|
|
Term
| If a prostate feels stone-hard, it is likely ___. |
|
Definition
|
|
Term
| Malignant tumors of the testicles spread to what lymph node? |
|
Definition
| left supraclavicular node- Virchow's node |
|
|
Term
| Tumors of the prostate can spread to the : |
|
Definition
left supraclavicular node- Virchow's node
internal abdominal lymph nodes |
|
|
Term
| Tumors of the bladder spread to what lymph nodes? |
|
Definition
| internal abdominal lymph nodes |
|
|
Term
| Cancers of the penis, glans penis, scrotal skin, and distal urethra mets to what nodes? |
|
Definition
|
|
Term
| If you want to know what is qualitatively present in urine: |
|
Definition
|
|
Term
| If you want to know what is quantitatively present in urine? |
|
Definition
|
|
Term
| If you want to know what is quantitatively present in urine? |
|
Definition
|
|
Term
| If you want to know antibiotic sensitivity of a UTI, what lab do you order? |
|
Definition
|
|
Term
| BUN (blood urea nitrogen) is produced by the __ when __ is broken down. The __ is then carried to the ___ to be excreted in urine. If kidneys are not functioning well, the BUN will be ___. |
|
Definition
|
|
Term
| Is BUN in the bmp and cmp? |
|
Definition
|
|
Term
|
Definition
- affected by diet (high protein diet will result in elevated BUN)
- affected by hydration status (if dehydrated> not sending as much blood to kidneys> BUN builds up) |
|
|
Term
| Examples of decreased blood flow to kidneys resulting in elevated BUN (even when kidneys are fine): |
|
Definition
- Congestive Heart Failure
- Shock
- Dehydration |
|
|
Term
| If uncertain about why BUN is elevated, look at the ___ __. If the ratio is ___ than ___, it means you have __ ___ __ to the kidneys, so the kidneys are __. |
|
Definition
- BUN:Cr ratio
- greater than 20:1
- decreased blood flow
- kidneys are fine |
|
|
Term
| Creatinine is a waste product produced in your __ from the breakdown of ____. It is created at a ___ rate and all is __ and __ by the kidneys. |
|
Definition
- muscles
- creatine
- constant rate
- filtered and excreted |
|
|
Term
| Doubling of creatinine represents __ ___ in ___. |
|
Definition
|
|
Term
| If the creatinine has doubled, the GFR is ___. |
|
Definition
|
|
Term
| If the kidneys are not functioning well, the creatinine will be ___. |
|
Definition
|
|
Term
| Glomerular Filtration Rate (GFR) is the amount of blood filtered by the __ per ___. |
|
Definition
|
|
Term
| A blood test can estimate GFR using the patient's __ __, __, __, and __. |
|
Definition
- serum creatinine
- age
- sex
- race |
|
|
Term
| Best test to measure kidney function: |
|
Definition
|
|
Term
| Best test to determine stage of kidney disease: |
|
Definition
|
|
Term
| GFR less than __ for __ or more months is considered chronic kidney disease. |
|
Definition
- less than 60
- 3 or more months |
|
|
Term
| There are __ stages of chronic kidney disease (CKD) categorized based on __. |
|
Definition
|
|
Term
| Patients with a GFR less than or equal to __ should see a nephrologist. |
|
Definition
|
|
Term
| Any kind of kidney damage lasting for 3 or more months, even when normal kidney function is considered: |
|
Definition
|
|
Term
| GFR DOES NOT COME ON BMP OR CMP- HAVE TO ORDER IT SEPARATELY IF YOU WANT IT |
|
Definition
|
|
Term
| Cr and BUN are part of CMP and BMP, but GFR is NOT. |
|
Definition
|
|
Term
| Used to evaluate rate and efficiency of kidney filtration: |
|
Definition
|
|
Term
| For our purposes Cr Clearance is the same thing as __. |
|
Definition
|
|
Term
Cr clearance is amount of creatine cleared from blood in a given time, but almost all cr gets cleared from blood, so if you’re measuring how much gets cleared you are basically measuring GFR.
With GFR and Cr Cleareance, you don’t randomly order these, order these if you suspect kidney problems. |
|
Definition
|
|
Term
| The amount of creatinine cleared from the body depends on the ___ at which __ is carried to kidneys and its __ of the glomeruli to __ that blood. |
|
Definition
- rate at which blood is carried
- effectiveness of the glomeruli to filter that blood |
|
|
Term
| Cr clearance can be affected when something has damaged the __ preventing them from filtering properly or when there is __ in blood to the kidneys. |
|
Definition
|
|
Term
| Urine test that measures amount of albumin excreted: |
|
Definition
|
|
Term
Healthy kidneys do not excrete albumin
Damaged kidneys can allow albumin to leak into the urine |
|
Definition
|
|
Term
|
Definition
| 30-300 mg albumin/ L urine |
|
|
Term
|
Definition
| greater than 300mg/L urine |
|
|
Term
| Microalbumin/Cr ratio compares amount of albumin in urine to amount of Cr in urine. The body creates Cr at a constant rate, this allows you to tell if body is excreting albumin at increased rate. |
|
Definition
|
|
Term
|
Definition
- plain film of kidneys, ureters, and bladder
- size and position of kidneys
- may see calcifications and stones with calcium |
|
|
Term
| Excretory Urography is used to outline the __ __. |
|
Definition
- collecting system
- give pt IV contrast or injected contrast into bladder- it will highlight renal pelvises and ureter and bladder, can show blockages, this isn’t done very often
- mostly been replaced by ultrasound, CT, and MRI |
|
|
Term
| Voiding cystourethrogram- through a catheter, insert contrast into the bladder and then take films as they urinate, and as they urinate it should come out through urethra, but do this test to check for reflux of urine back up into ureters and kidneys (this can cause infections) |
|
Definition
|
|
Term
| Phlebolith is a calcification in a __ that may confused with a ureteral stone. A phlebolith has __ edges with a central __. Phlebotliths are usually closer to the ___ of the pelvis than ureteral stones would be. |
|
Definition
- vein
- round
- translucencny
- margin
(these are not dangerous and benign) |
|
|
Term
| Ureteral stones have __ edges and are in the ___, which lies closer to the __ of the pelvis. |
|
Definition
- jagged
- ureters
- center |
|
|
Term
IVP: intravenous pyelogram. Take films as contrast going through. Here the stone is blocking the contrast flow.
These are done when something doesn't get better in a reasonable amount of time. |
|
Definition
|
|
Term
| What test besides CT or MRI could you use to assess renal blood supply? |
|
Definition
| angiography (largely replaced by CT and MRI) |
|
|
Term
| What would you use to assess kidneys, prostate, testis, and penis? |
|
Definition
|
|
Term
| what would you use to assess bladder? |
|
Definition
|
|
Term
| used to detect renal mass (cystic vs. solid), might show engorgement of calcices due to obstruction of ureter: |
|
Definition
|
|
Term
Bladder Ultrasound
Bladder volume
Wall thickness
Bladder calculi
Bladder tumors |
|
Definition
| largely replaced by cystoscopy |
|
|
Term
| Used to assess testicular inflammation, inguinal hernia, and testicular torsion: |
|
Definition
| - ultrasound of tesis- excellent resolution, good for assessing masses and blood supply |
|
|
Term
| Used in evaluation of flank pain, hematuria, infection, trauma, and to characterize and stage carcinoma? |
|
Definition
|
|
Term
| Should you use contrast with renal CT if you think they have a stone? |
|
Definition
|
|
Term
| would you use contrast with renal CT if suspected renal carcinoma? |
|
Definition
|
|
Term
| Used in bladder tumor staging and to assess for bladder rupture following trauma? |
|
Definition
|
|
Term
| CT Also useful in evaluation of prostate CA, undescended testes, lymph nodes (cancer spread), renal vasculature, etc. |
|
Definition
|
|
Term
|
Definition
- congenital abnormalities
- renal vein thrombosis
- cancer staging
- characterize adrenal tumors |
|
|
Term
| Used to evaluate hematuria when considering bladder tumor? |
|
Definition
|
|
