Quiz #4 S/S

Urinary Tract Obstruction

Definition

  • Urinary Tract Obstruction: Blockage of urine flow anywhere along the urinary tract (from kidneys → ureters → bladder → urethra).

Causes

  • Kidney stones: Most common cause of urinary obstruction.

  • Enlarged prostate (Benign Prostatic Hyperplasia - BPH): Can compress the urethra.

  • Tumors: Can occur in various locations including bladder, prostate, or cervix.

  • Urethral stricture: Narrowing of the urethra which impedes urine flow.

  • Congenital anomalies: Birth defects leading to urinary tract obstruction.

  • Blood clots or scarring: Can block normal flow of urine.

Signs & Symptoms

  • Flank pain or lower abdominal pain: Pain in the side or front, indicating blockage.

  • Difficulty urinating or decreased urine output: Suggesting obstruction in the urinary tract.

  • Bladder distention: Can lead to a feeling of fullness in the bladder.

  • Hematuria: Presence of blood in the urine, signaling possible injury or infection.

  • Recurrent urinary infections: Consequence of obstruction leading to infection risk.

  • Nausea and vomiting: Particularly if the obstruction is severe or bilateral.

Complications

  • Hydronephrosis: Condition where urine builds up in the kidney due to obstruction.

  • Kidney damage or failure: Can occur if obstruction is prolonged.

  • Urinary tract infections: Increased risk due to urine stasis.

  • Hypertension: Potentially resulting from renal dysfunction or fluid overload.

Urinary Tract Infections (UTI)

A. Cystitis (Lower UTI)

Definition

  • Cystitis: Infection/inflammation of the bladder.

Causes

  • E. coli: Most common pathogen responsible for cystitis.

  • Poor hygiene: Can facilitate bacterial growth leading to UTI.

  • Sexual activity: May introduce bacteria into the urinary tract.

  • Catheter use: Increases risk of introducing pathogens.

  • Obstruction: Blocking urine flow may predispose to infections.

Signs/Symptoms

  • Dysuria: Painful urination.

  • Frequency and urgency: Increased need to urinate.

  • Suprapubic pain: Discomfort in the lower abdominal area.

  • Cloudy or foul-smelling urine: Indicative of infection.

  • Possible low-grade fever: May occur as a systemic response.

Complications

  • Pyelonephritis: Ascending infection that can occur from bladder to kidneys.

  • Recurrent infections: Potentially leading to chronic health issues.

B. Pyelonephritis (Upper UTI)

Definition

  • Pyelonephritis: Infection of kidney tissue and renal pelvis.

Causes

  • Ascending infection from bladder: Common pathway for infection.

  • Vesicoureteral reflux: Backflow of urine from bladder to ureters.

  • Obstruction: Blockages (such as stones or enlarged prostate - BPH) can lead to infections.

Signs/Symptoms

  • Flank pain or tenderness: Pain in the side, indicative of kidney involvement.

  • Fever and chills: Body's response to infection.

  • Nausea and vomiting: Systemic effects of infection.

  • Fatigue: General feeling of weakness.

  • Pyuria: Presence of pus in urine.

Complications

  • Renal scarring: Damage due to recurrent infections.

  • Abscess formation: Localized infection that can lead to further complications.

  • Sepsis: Systemic infection that can be life-threatening.

  • Chronic kidney disease: Resulting from recurring infections.

Kidney Stones (Renal Calculi)

Definition

  • Kidney Stones: Solid crystals formed from substances in urine (such as calcium, oxalate, uric acid).

Causes

  • Dehydration: Insufficient fluid intake leading to concentrated urine.

  • High calcium or oxalate levels: Contributing factors in stone formation.

  • Urinary stasis: Infrequent urination can lead to stone formation.

  • Recurrent UTIs: Infections can contribute to stone formation.

  • Gout or metabolic disorders: Affecting normal metabolism of minerals.

Signs/Symptoms

  • Severe flank pain (renal colic): Intense pain that radiates to the groin.

  • Hematuria: Blood may be visible in urine due to irritation or injury by stones.

  • Nausea and vomiting: Common when experiencing severe pain.

  • Restlessness and sweating: Body's response to pain.

  • Frequency or urgency: Increased need to urinate if stone is near the bladder.

Complications

  • Hydronephrosis: Urine accumulation in the kidney due to obstruction.

  • Obstruction: Can lead to severe complications if not treated.

  • Infection (pyelonephritis): Stones can lead to urinary infections.

  • Kidney damage: Possible result of prolonged obstruction.

Nephrotic and Nephritic Syndromes

A. Nephrotic Syndrome

Definition

  • Nephrotic Syndrome: Characterized by increased permeability of glomeruli leading to massive protein loss in urine.

Causes

  • Diabetes mellitus: Common cause leading to nephropathy.

  • Minimal change disease: A condition that can result in nephrotic syndrome.

  • Glomerulonephritis: Inflammation of glomeruli contributing to symptoms.

  • Lupus nephritis: Autoimmune disorder affecting kidney function.

Signs/Symptoms

  • Proteinuria: More than 3.5 g/day in urine.

  • Edema: Particularly in periorbital areas and ankles.

  • Hypoalbuminemia: Low levels of albumin in blood due to protein loss.

  • Hyperlipidemia and lipiduria: Increased fats in the blood and urine.

  • Fatigue: General feeling of tiredness or lack of energy.

Complications

  • Infection risk: Increased due to loss of immunoglobulins.

  • Thrombosis: Increased risk of blood clots.

  • Malnutrition: Possible due to protein loss.

  • Chronic kidney disease: Long-term risk due to kidney damage.

B. Nephritic Syndrome

Definition

  • Nephritic Syndrome: Inflammation of glomeruli leads to reduced filtration and blood loss in urine.

Causes

  • Post-streptococcal glomerulonephritis: Following streptococcal infection.

  • Lupus nephritis: A consequence of systemic lupus erythematosus.

  • IgA nephropathy: Disorder of immunoglobulin A deposition in kidneys.

Signs/Symptoms

  • Hematuria: Cola-colored or dark red urine due to blood.

  • Mild proteinuria: Less than in nephrotic syndrome.

  • Oliguria: Reduced urine output.

  • Hypertension: Elevated blood pressure.

  • Edema: Mild to moderate swelling, especially in the face and extremities.

Complications

  • Acute renal failure: Severe cases can lead to loss of kidney function.

  • Chronic kidney disease: Long-term damage to the kidneys.

  • Hypertensive crisis: Severe elevation in blood pressure.

Chronic Kidney Disease (CKD)

Definition

  • Chronic Kidney Disease (CKD): Progressive, irreversible loss of kidney function, defined as a GFR of less than 60 mL/min for at least 3 months.

Causes

  • Diabetes: Major cause including diabetic nephropathy.

  • Hypertension: Can lead to kidney damage.

  • Glomerulonephritis: Chronic inflammation of the glomeruli.

  • Polycystic kidney disease: Genetic disorder leading to cyst formation.

Signs/Symptoms

  • Fatigue and nausea: General malaise and gastrointestinal upset.

  • Edema: Swelling due to fluid overload.

  • Itchy skin: Often due to the accumulation of waste products.

  • Uremic breath: Foul odor on breath due to uremia.

  • Hypertension: Often presents with CKD.

  • Oliguria: Decreased urine output.

  • Anemia: Resulting from reduced erythropoietin production.

  • Confusion and weakness: Cognitive changes due to metabolic imbalances.

Complications

  • Anemia: Due to decreased red blood cell production.

  • Bone disease (renal osteodystrophy): Due to imbalances in calcium and phosphate.

  • Cardiovascular disease: Increased risk due to chronic kidney issues.

  • Electrolyte imbalances: Changes in levels, such as increased potassium (↑K↑K), increased phosphate (↑PO43↑PO₄³), and decreased calcium (↓Ca2↓Ca²).

Polycystic Ovary Syndrome (PCOS)

Definition

  • Polycystic Ovary Syndrome (PCOS): Hormonal disorder resulting in multiple cysts on ovaries and ovulatory dysfunction.

Causes

  • Genetic and hormonal imbalance: Elevated androgens and insulin resistance.

Signs/Symptoms

  • Irregular or absent periods (oligo-/amenorrhea): Irregular menstrual cycles or menstruation cessation.

  • Infertility: Difficulty conceiving due to ovulatory dysfunction.

  • Hirsutism: Excess hair growth in areas typically male-patterned.

  • Acne and oily skin: Due to hormonal imbalances.

  • Weight gain and obesity: Often seen in women with PCOS.

  • Polycystic ovaries on ultrasound: Characteristic finding in imaging studies.

Complications

  • Infertility: Risk of not being able to conceive.

  • Type 2 diabetes: Increased risk due to insulin resistance.

  • Endometrial cancer: Increased risk stemming from unopposed estrogen exposure.

  • Metabolic syndrome: Cluster of conditions increasing cardiovascular risk.

Benign Prostatic Hyperplasia (BPH)

Definition

  • Benign Prostatic Hyperplasia (BPH): Non-cancerous enlargement of the prostate gland leading to compression of the urethra.

Causes

  • Aging: Increased risk as men grow older.

  • Hormonal changes: Increased levels of dihydrotestosterone (DHT).

Signs/Symptoms

  • Hesitancy: Difficulty starting urination.

  • Weak urine stream: Reduced force of urination.

  • Dribbling: Involuntary leakage after urination.

  • Incomplete emptying: Feeling of not fully voiding the bladder.

  • Frequency and nocturia: Increased need to urinate, especially at night.

  • Urgency: Sudden, compelling urge to urinate.

Complications

  • Urinary retention: Can lead to acute urinary retention and bladder distention.

  • Hydronephrosis: Due to prolonged obstruction.

  • UTIs: Increased risk of urinary tract infections.

  • Bladder stones: Resulting from ongoing urinary retention.

Endometriosis

Definition

  • Endometriosis: Growth of endometrial tissue outside the uterus (for example, on ovaries, fallopian tubes).

Causes

  • Retrograde menstruation: Menstrual flow backing up into pelvic cavity.

  • Immune or genetic factors: Contributing to abnormal tissue growth.

Signs/Symptoms

  • Dysmenorrhea: Painful periods commonly associated with endometriosis.

  • Chronic pelvic pain: Continuous pain in lower abdomen.

  • Dyspareunia: Pain during intercourse.

  • Infertility: Difficulty in conceiving due to anatomical changes.

  • Heavy or irregular bleeding: May occur due to ectopic endometrial growth.

Complications

  • Infertility: Risk of not being able to conceive.

  • Adhesions and scar tissue: Potential for abnormal tissue connections forming.

  • Chronic pelvic pain: Ongoing pain impacting quality of life.

Cervical Cancer

Definition

  • Cervical Cancer: Malignant tumor of the cervix, primarily caused by Human Papillomavirus (HPV) infection.

Causes/Risk Factors

  • HPV infection: Especially types 16 and 18.

  • Early sexual activity: Increases risk of HPV transmission.

  • Multiple sexual partners: Higher risk of exposure to HPV.

  • Smoking: Contributes to carcinogenesis in cervical tissue.

Signs/Symptoms

  • Postcoital bleeding: Bleeding following intercourse.

  • Abnormal vaginal bleeding/discharge: Irregularities indicating possible malignancy.

  • Pelvic pain: May arise as the tumor progresses.

  • Advanced symptoms: May include weight loss, anemia, leg swelling.

Complications

  • Metastasis: Potential spread to pelvic region, lymph nodes, or lungs.

  • Renal failure: Caused by ureteral obstruction secondary to tumor growth.

  • Infertility: May occur from advanced disease affecting reproductive structures.

Vocabulary

  • Dysmenorrhea: Painful menstruation.

  • Amenorrhea: Absence of menstruation.

  • Hematuria: Blood in urine.

  • Priapism: Prolonged, painful erection not associated with sexual arousal.

  • Hydrocele: Fluid accumulation around the testicle.

  • Epididymitis: Inflammation of the epididymis, usually due to infection.

  • Gynecomastia: Enlargement of breast tissue in males, often due to hormonal imbalance or drug-related effects.