Unit IV Renal and Male Reproductive Signs and Symptoms

Vocabulary flashcards covering signs, symptoms, pathophysiology, and distinguishing clinical characteristics of renal, urinary, and male reproductive system disorders based on the VNSG 1509 Unit IV study sheet.

Urinary Retention

The inability to completely empty the bladder or passing only small amounts of urine, characterized by a distended lower abdomen, suprapubic discomfort, restlessness, and a high volume detected on a bladder scan (the initial, least-invasive diagnostic step).

Stress Incontinence

Involuntary leakage of small amounts of urine triggered by increased abdominal pressure (e.g., coughing, sneezing, laughing, or lifting), common in women after vaginal deliveries due to pelvic floor muscle weakness, and treated with Kegel exercises.

Urge Incontinence

Involuntary loss of urine preceded by a sudden, intense urge to void that cannot be suppressed, associated with an overactive bladder and managed through timed voiding schedules and limiting caffeine intake.

Overflow Incontinence

Continuous involuntary dribbling of urine from an overdistended bladder that never empties completely, commonly caused by mechanical obstructions such as benign prostatic hyperplasia (BPH).

Functional Incontinence

Urinary loss occurring in individuals with normal bladder physiology who are unable to reach a toilet in time due to physical mobility restrictions (such as arthritis) or cognitive impairments (such as dementia), managed with bedside commodes and scheduled toileting.

Reflex Incontinence

Predictable, involuntary bladder emptying occurring without warning, sensory awareness, or an urge to void, typically seen in individuals with spinal cord injuries.

Total Incontinence

Continuous, unpredictable, and uncontrolled leakage resulting from an inability of the bladder to store any volume of urine, often caused by surgical complications, trauma, or a urinary fistula.

Lower Urinary Tract Infection (Cystitis)

An infection of the bladder causing dysuria, urinary frequency, urgency, cloudy or foul-smelling urine, and suprapubic discomfort; in older adults, it may uniquely present as acute confusion, agitation, or falls without high fever or flank pain.

Upper Urinary Tract Infection (Pyelonephritis)

An infection of the kidney presenting with lower urinary tract symptoms along with fever, chills, flank pain, costovertebral angle (CVA) tenderness, nausea, and vomiting, carrying a significant risk of progressing to sepsis.

Acute Glomerulonephritis

An immune-mediated kidney disease developing $1$ to $3\,\text{weeks}$ after a streptococcal throat infection, marked by tea- or cola-colored urine, periorbital and facial edema (worst in the morning), hypertension, headache, oliguria, elevated ASO titers, and increased BUN and creatinine.

Renal Calculi (Kidney Stones)

Mineral concretions causing sudden, severe flank pain that radiates to the groin in waves, accompanied by restlessness, diaphoresis, nausea, vomiting, and hematuria; the presence of fever indicates an infection proximal to the obstruction.

Polycystic Kidney Disease (PKD)

An autosomal dominant hereditary disorder ($50\%$ transmission risk per offspring) characterized by bilateral kidney enlargement, hypertension, flank pain, hematuria, and abdominal enlargement; a severe sudden headache requires immediate evaluation for a ruptured cerebral aneurysm.

Bladder Cancer

A malignancy of the urinary bladder whose most common initial presentation is painless gross or microscopic hematuria, with cigarette smoking being the primary identifiable risk factor.

Renal (Kidney) Cancer

A malignancy that classically presents in advanced stages with the triad of hematuria, flank pain, and a palpable flank or abdominal mass, frequently accompanied by unexplained weight loss and fatigue.

Prerenal Acute Kidney Injury

Renal impairment caused by transient hypoperfusion to the kidneys due to hypovolemia (vomiting, diarrhea, hemorrhage, burns), shock, sepsis, or heart failure, which manifests with hypotension and low urine output and resolves with intravenous fluid administration.

Intrarenal Acute Kidney Injury

Kidney failure resulting from direct parenchymal damage caused by nephrotoxic agents (NSAIDs, IV contrast dye), glomerulonephritis, crush injuries, transfusion reactions, or acute tubular necrosis (ATN) from prolonged ischemia, which does not resolve with fluid resuscitation.

Postrenal Acute Kidney Injury

Kidney failure secondary to mechanical obstruction of urine flow distal to the renal pelvis (e.g., BPH, bilateral calculi, tumors, or kinked/occluded catheters), evidenced by bladder distension and reversed by clearing the blockage.

Oliguric Phase of AKI

A stage of acute kidney injury characterized by urine output dropping below $400\,\text{mL}$ per day (or under $30\,\text{mL/h}$), intravascular fluid overload, rising BUN and creatinine, and hyperkalemia manifested by peaked T waves, dysrhythmias, and paresthesias.

Diuretic Phase of AKI

A recovery phase of acute kidney injury characterized by large urine outputs ranging from $3$ to $5\,\text{liters}$ per day, placing the patient at high risk for dehydration and hypokalemia (flattened T waves, muscle weakness, and leg cramps).

Chronic Kidney Disease (CKD)

Progressive, irreversible loss of renal function primarily caused by diabetes mellitus and hypertension; Stage 5 (end-stage) is defined by a GFR below $15$, requiring dialysis or kidney transplantation.

Uremia

A toxic clinical syndrome resulting from the advanced accumulation of nitrogenous waste products in CKD, featuring an ammoniacal breath odor, metallic taste, severe pruritus, uremic frost, anorexia, confusion, and seizures.

Dialysis Disequilibrium Syndrome

A neurological complication occurring during or shortly after hemodialysis caused by rapid solute shifts leading to cerebral edema, manifesting as headache, nausea, vomiting, confusion, and seizures.

Arteriovenous Fistula Thrombosis

Clotting of a hemodialysis vascular access site, recognized clinically by the absence of a palpable thrill (buzzing sensation) and the disappearance of an audible bruit (whooshing sound).

Peritoneal Dialysis Peritonitis

An intra-abdominal infection complicating peritoneal dialysis, classically presenting with cloudy dialysate effluent, generalized abdominal pain, and fever.

Kidney Transplant Rejection

An immunologic graft failure signaled by fever, localized tenderness over the transplanted organ in the iliac fossa, decreased urine production, rapid weight gain, edema, and progressive increases in serum creatinine and blood pressure.

Benign Prostatic Hyperplasia (BPH)

Nonmalignant enlargement of the prostate gland in aging men causing urinary hesitancy, a weak stream, post-void dribbling, nocturia, and incomplete bladder emptying in the absence of fever.

Post-TURP Monitoring

Postoperative evaluation following a transurethral resection of the prostate where light pink urine and bladder spasms from the catheter balloon are expected findings, whereas frank, bright red blood or large blood clots must be reported immediately.

Prostatitis

An acute or chronic infection or inflammation of the prostate gland presenting with fever, chills, dysuria, and pain in the low back or perineal area, requiring multiple weeks of antibiotic therapy.

Prostate Cancer

A malignancy of the prostate that is typically asymptomatic in early stages (identified by elevated PSA and digital rectal examination) and presents with obstructive urinary symptoms or localized bone pain (back or hip) once metastasis occurs.

Phosphodiesterase Inhibitor and Nitroglycerin Interaction

A dangerous pharmacological interaction between erectile dysfunction medications and nitroglycerin that produces severe, life-threatening systemic hypotension.

Orchitis

An acute, painful inflammatory swelling of one or both testicles that frequently arises as a secondary complication of a systemic mumps infection.

Epididymitis

Inflammation of the epididymis often secondary to a sexually transmitted infection, characterized by scrotal pain, localized swelling, fever, and dysuria, and managed with antibiotics, scrotal elevation, and cold packs.

Testicular Cancer

A malignancy commonly affecting young men aged $15$ to $35$, typically presenting as a painless, firm or hard testicular nodule accompanied by a feeling of scrotal heaviness, evaluated via scrotal ultrasound and monthly self-examinations.

Priapism

A persistent, painful penile erection unrelated to sexual stimulation that lasts longer than $4\,\text{hours}$, representing an urologic emergency requiring prompt intervention.

Phimosis

A condition in which the uncircumcised foreskin is excessively tight and cannot be retracted back over the glans penis, leading to edema, difficulty maintaining hygiene, and potential infection.

Peyronie's Disease

An acquired disorder characterized by fibrous scar tissue plaques developing along the penile shaft, producing curvature of the erect penis, palpable induration, and painful erections.

Penile Cancer

A malignant lesion presenting as an unhealing sore, nodule, or wart-like growth on the penis that is typically painless but may produce abnormal discharge or bleeding.