Chapter 9. Urinary System

Question 1

• Test that studies the content of urine for abnormal substances such as protein or signs of infection.
• This evaluates the storage of urine in the bladder and the flow of urine from the bladder through the urethra.
• Urinary system is composed of?

Answer 1

• Urinalysis
• Urodynamic tests
• The urinary system includes two kidneys, two ureters, the bladder, two sphincter muscles, and the urethra

Question 2

Infx of these organs:

Urethra, Bladder, Ureter, Kidney

Answer 2

Uretha- Urethritis
Bladder- Cystitis (symptoms urgency of urination, burning, painful urination)
Ureter- Ureteritis
Kidney- Pyelonephritis (flank pain)

Question 3

Physiological Factors that increase risk of urinary tract infections adn causative agents.

Answer 3

Decrease resistance of mucus membrane. (e.g. menopause)
Increase in vaginal pH
Colonize colon spread to UTI
Colonization of urethra and peri-urethral tissue
-E. colu comm. acq 80% and hosp 50%

Question 4

Uncomplicated UTI: Occ. females with normal GUT. Cystitis, the most comm. infx org. is E. coli (80-90%).
Complicated UTI: occ. in indiv. with funcx or struc. abnorm. of GUT. Virtually UTI in men are complicated. E. coli (50%). Patient with cystitis.
Give symptoms of each.

Answer 4

Un: Internal dysuria, frequency, suprapubic discomfort, urgency, and fever, urine burns. N and v.
tx: cotrimox, Nitrofurantoin
Com: High fever, blood in urine (turbid urine), vomiting and sepsis. Urine burns. N and v
Tx: Ciprofloxacin

Question 5

enlargement of the prostate gland that can interfere with ur. funcx in older men. It causes blockage by squeezing the urethra, which can make it difficult to urinate. Men with this includes an incz in freq. of bladder emptying both during the day and at night.
Give symptoms and tx

Answer 5

BPH
Symptoms: Urine obstructions inc. freq. urine, drop by drop, incomplete voiding, nocturea and irritation
Tx: DOC to dec. prostate size Finasteride 5 mg. Alpha blocker tamsulosin, alfuzosin, terazosin are for symptomatic BPH.
Jet urination- NOT A SYMPTOM

Question 6

In this disorder, the bladder wall can become inflamed and irritated. The inflamm., scarring and stiffening bladder, dec. capacity, pinpoint bleeding, and, in rare cases, ulcers in bladder lining. The cause is unknown at this time.

Answer 6

Painful bladder syndrome/Interstitial
cystitis (PBS/IC): is a chronic bladder
disorder also known as frequency-urgency-dysuria syndrome.

Question 7

can form anywhere in urinary tract and cause pain radiates in flank area, sharp, sudden severe pain, may be intermittent depends on stone movement, N and v, bleeding (hematuria), obstruction of flow of urine, or an infection.

• Depending on the site of stone it is referred as.
• The process of stone formation

Answer 7

• Stones (calculi)
• kidney stone, ureteral stone, or bladder stone
• urolithiasis, renal lethiasis, or nephrolithiasis

Question 8

Give risk factors for kidney stones:

Stone forming chemicals:

Answer 8

Risk factors: Infections, urinary stasis, immobility, hypercalcemia, hyperuricemia, high urinary oxalate levels. Increased incident in men over age 40
-Ca, oxalate, urate, cystine, xanthine and phosphate
Ca oxalate (CaC2O4) most common

Question 9

List of drug associated with urolithiasis/ nephrolithiasis

Answer 9

Sulfa drugs (antibiotics/sulfonylureas) Fibrates
Topiramate
Vit. D overdose
Bisphosphonates 
Calcium supplements

Question 10

• inflammation of the prostate gland that results in urinary frequency and urgency, burning or painful urination, a condition called dysuria, and pain in the lower back and genital area, among other symptoms
• Define proteinuria

Answer 10

• Prostatitis
• Proteinuria- presence of abnormal amounts of protein in the urine. Healthy kidneys take wastes out of the blood but leave in protein

Question 11

Detrusor muscle during:

• parasympathetic activity (voiding)
• anticholinergic activity (storage)

Answer 11

• Detrusor musc contraction (voiding)

- Detrusor musc relaxation and tightening of sphincter (storage).

Question 12

Bladder during:

• beta agonist activity.
• alpha agonist activity.

Answer 12

• Bladder relaxation

- Bladder neck/sphincter contraction

Question 13

Types of Continence and tx.

• Urethral blockage
• Bladder unable to empty properly

Answer 13

Overflow

Tx: Diuretics

Question 14

Types of Continence and tx.

• Bladder over sensitivity from infection
• Neurological disorders, Parkinson’s

Answer 14

Urge

Tx: Oxybutynin

Question 15

Types of Continence:

• Relaxed pelvic floor
• Increase abdominal pressure

Answer 15

Stress

Tx: Estrogen cream, suppositories, ovule

Question 16

-Urinary incontinence is caused by drugs that cause urinary retention side effects

Answer 16

-Overflow

Question 17

-Which of the following conditions have NO urinary burning sensation?
-Which cause difficulty to urination in stream?
UTI, Prostatitis, BPH, Ui or Cystitis

Answer 17

• Urinary incontinence

- BPH

Question 18

Testosterone is catalyzed by 5-alpha reductase to what and causes what?What drugs inhibit 5-alpha reductase?

Answer 18

Dihydrotestosterone cause prostate growth.

-Androgen antagonist