The Urinary System

Question 1

What are some of the risk factors for Urinary Tract Infections?

Answer 1

• Female
• Sexual Intercourse
• Pregnancy
• Diabetes
• Urinary tract obstructions (stones/ catheters)

Question 2

What are UTIs of the urethra called

Answer 2

Urethritis

Question 3

What are UTIs of the Bladder called?

Answer 3

Cyctitis

Question 4

What are UTIs of the prostate called?

Answer 4

Prostatitis

Question 5

Pyelonephritis is a name given to what contition?

Answer 5

It’s a UTI of the kidney

Question 6

What is the most common causative organism (bacteria) for utis?

Answer 6

E.Coli

others are staphyloccus, proteus and klebsiella

Question 7

Cystitis symptoms?

Answer 7

• Frequency of urination
• Dysuria (painful/ difficulty urinating)
• Urgency
• Haematuria (blood in urine)
• (suprapubic pain)

Question 8

Symptoms of Pyelonephritis (kidney UTI)?

Answer 8

• High fever
• Rigors (feeling cold, fever, shivering)
• vomiting
• loin pain/tenderness

Question 9

What are these symptoms of?

• Flu-like symptoms
• Few Urinary symptoms
• Swollen tender prostate

Answer 9

Prostatitis (UTI of the prostate)

Question 10

How do you mange/treat UTIs?

Answer 10

• Drink plenty
• Urinate often
• Antibiotics (trimethoprim first)
• Imaging (in non resolving utis in children, men and phelonphritis)
• Severe cases may require hospital admin (especially phylonephritis and in elderly)

Question 11

What hormones do the kidneys excrete?

Answer 11

• Renin (helps to control bp)

- Erythropoietin (stimulate RBC production)

Question 12

Name some of the toxic metabolic waste products the kidneys excrete?

Answer 12

• Urea

- Creatinine

Question 13

What disorder are these symptoms describing?

• Significant deterioration in renal function occuring over hours/ days
• Low urine volume (less that 400mls in 24 hours)
• Rising plasma urea and creatinine levels
• Usually comes in the setting of other severe ilnesses.

Answer 13

ACUTE RENAL FAILURE

Question 14

What are some of the common causes of chronic renal failure?

Answer 14

• Glomerulonephritis
• Diabetes
• Renovascular disease
• Hypertension
• Polycyctic disease

Question 15

What factor helps define the 5 stages of chronic renal failure?

Answer 15

GLOMERULAR FILTRATION RATE

It’s the volume of fluid filtered from the glomerular capillaries into the bowman’s capsule per unit time.

Question 16

Acute and chronic renal failure can be made worse by nephrotoxic drugs. What are some of these drugs?….

Answer 16

Some nephrotoxic drugs:

• NSAIDS
• ACE- 1
• Gentamycin
• Vancomycin

Question 17

What is Glomerulonephritis?

Answer 17

It’s a group of disorders where there is damage to the glomerular filtration apparatus. This may cause a leak of protein or blood into the urine.

Question 18

What is another name for Crystal aggregates the form on the collecting ducts of the kidneys and can deposit anywhere in the renal tract?

Answer 18

STONES

Peak age of getting them is 20-40 yrs. Males more likely than females.

Question 19

What are some of the risk factors for getting STONES in the urinary tract.

Answer 19

• Dehidration
• Dietary Factors (chocolate, tea, rhubarb)
• Drugs (loop diuretics, antacids, corticosteroids, theophylline and aspirin)
• Renal tract obstruction
• Reoccurant UTIs
• Metabolic abnormalities (hyperparathyroidism, hyperthyroidism, cancer)

Question 20

What is the most common type of renal cancer?

Answer 20

Renal cell carcinoma (85%) of all renal cancers.

Question 21

Some risk factors for renal cancer….

Answer 21

• Smoking
• Obesity
• Hypertension
• Exposure to asbestos
• certain hereditary conditions

Question 22

What are the presentations/ symptoms of kidney cancer (renal cell carcinoma)?

Answer 22

• Loin pain
• Haematuria
• Abdominal Mas
• 50% incidental findings on abdominal imaging
• Paraneoplastic syndroms (hormone secretion by tumour). Eg- polycythaemia, hypercalcaemia, hypertension

Question 23

What is the most common benign condition of the bladder?

Answer 23

Cystitis

UTI of the bladder

Question 24

What’s the most common malignant condition of the bladder?

1. Small cell carcinoma
2. Renal cell carcinoma
3. Transitional cell carcinoma

Answer 24

TRANSITIONAL cell carcinoma

They are the most common malignant condition in the bladder

Question 25

Name some classical symptoms of Transitional cell carcinoma (bladder cancer)

Answer 25

- Painless haematuria (blood in urine) - Frequency, urgency of urination - Painful urination (dysuria)

Question 26

What is Benign prostatic hyperplasia?

Answer 26

It's a common condition where there is an increase in prostate cells resulting in the formation of nodules on the prostate.

Question 27

What are these symptoms related to? - Urinary tract obsruction - Increased frequency - Hesitancy - Nocturia (weeing at night) - Terminal dribbling - Incresed risk of infection - Enlarged prostate

Answer 27

There are all symptoms of: BENIGN PROSTATE HYPERPLASIA

Question 28

How may you treat Benign prostate hyperplasia?

Answer 28

- Reduce fluid intake at night - Reduce alcohol and caffeine - Scheduled voiding (bladder training) - Meds: Alpha blockers- which reduce the smooth muscle tone in the prostate - TURP: transurethral resection of the prostate

Question 29

Who is at risk of Prostate cancer?

Answer 29

- Older males - Race (common in black people, uncommon in asian people) - Family history - Hormone levels - Diet (High fat diets)

Question 30

Name some signs / symptoms of prostate cancer...

Answer 30

- May be asymptomatic - Nocturia, hesitancy, poor stream, terminal dribbling - Hard irregular prostate - Raised Prostate Spectific Antigen (PSA)

Question 31

What is testicular torsion?

Answer 31

It's the twisting of the spermatic cord. - Sudden onset of pain in 1 testis - Pain in abdo, nausea and vomitting - Tesetis is hot, swollen and tender - Testis may lie high and transversely - Most common in 11-30 year olds.

Question 32

What might these symptoms be describing? - Pain in 1 testis - Abdo pain, n+v - Hot, swollen, tender testis - Testis may lie high and transversely

Answer 32

This may be TESTICULAR TORSION

Question 33

How may you treat Testicular torsion?

Answer 33

- SURGERY is urgent - Bilateral fixation (orchiodopexy) - fixing an unascended testis in the scrotum. - Orchidectomy (removal of the testis)

Question 34

Some signs / symptoms of testicular tumours?

Answer 34

- Unascended testis - Infant hernia - infertility - painless testicular lump (often noted after trauma/ infection)