GU Disorders Notes

GU Disorders

Overview of the Urinary System

• Distinct Systems:

• Female urinary and reproductive systems are distinct.

• Male urinary and reproductive systems overlap in some structures.

• Both share a common secretion point for urine and semen, referred to as the genitourinary system.

• Nephrology:

• Field of medicine focused on renal (kidney) disorders.

Functions of the Urinary System

• Homeostasis:

• Maintains blood volume and balances water, electrolytes, and pH.

• Nutrient Retention:

• Key elements retained in blood including glucose, potassium, and hydrogen.

• Waste Management:

• Removal of metabolic waste products from the bloodstream.

• Blood Pressure Regulation:

• Contributes to maintaining optimal arterial blood pressure.

• Erythropoiesis:

• Development and production of red blood cells.

Acute Kidney Failure

• Cause: Major risk factor is the loss of blood pressure and blood flow to the kidneys.

• MAP (Mean Arterial Pressure):

• Normal MAP = Diastolic + 1/3 (Systolic - Diastolic).

• Risk of kidney failure increases if MAP falls below 65 mmHg.

Renal Anatomy and Physiology

• Nephron Structure:

• Nephrons consist of the renal corpuscle, proximal convoluted tubule, loop of Henle, distal convoluted tubule, and collecting duct.

• Specialized functions: reabsorption and secretion of water, ions, and nutrients.

• Key Hormones:

• ADH (Antidiuretic Hormone): Regulates water reabsorption in the kidneys.

• Aldosterone: Promotes sodium retention, influencing blood pressure.

• ANP (Atrial Natriuretic Peptide): Reduces blood volume and pressure by influencing renal function.

Renal Emergencies

• Risk Factors for Complications:

• Older age, diabetes, hypertension.

• Common Conditions:

• Acute renal failure, chronic renal failure, renal calculi (kidney stones), urinary tract infections (UTIs).

Diabetic Nephropathy

• Impact: Leading cause of Chronic Kidney Disease (CKD).

• High blood glucose causes glomerulus constriction, reducing kidney blood flow.

Testing and Diagnosis

• Diagnosis Techniques:

• CT scans, urine output measurements, blood tests, urine tests, and biopsies are used to diagnose renal disorders.

Chronic Renal Failure

• Progression: Involves a gradual decline in kidney function by 70% or more.

• End-stage Kidney Disease: Requires dialysis or transplant when 80% of nephrons are lost.

Dialysis Techniques

• Hemodialysis: Blood filtered through a machine with a semi-permeable membrane; performed in outpatient clinics typically 3 times a week.

• Peritoneal Dialysis: Uses the peritoneal membrane to filter blood; can be done at home, involving an indwelling catheter for solution exchanges.

Renal Calculi (Kidney Stones)

• Formation: Result from crystal aggregation in the kidney’s collecting system.

• Symptoms: Severe pain, potential for complications like obstruction or hemorrhage.

• Treatment Options:

• Small stones: increased fluid intake, pain relievers.

• Large stones: sound waves or surgical intervention may be necessary.

Urinary Tract Infections (UTI)

• Common Causes: Bacterial infection, improper hygiene, and anatomical factors (shorter female urethra).

• Symptoms: Painful urination, frequent urge, potential fever, and abnormal urine appearance.

• Complications include possible kidney infection if untreated.

Sexually Transmitted Infections (STIs)

• Common STIs: Chlamydia, Gonorrhea, Syphilis.

• Testing: Important for early detection and treatment; sexual history relevant in patient assessment.

Key Vocabulary

• Cystitis: Inflammation of the bladder; often related to UTI.

• Pyelonephritis: Kidney infection, may arise from untreated UTI.

• Urethritis: Inflammation of the urethra.

• Renal Colic: Pain from kidney stones, indicating obstruction.

• Hematuria: Presence of blood in urine.

• Anuria: No urine output.

• Oliguria: Low urine output.

• Micturition: Process of urination.