Alyssa Shared "Urinary System" - 22 Picmonics
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Urinary System
Incontinence
- 1) Stress Incontinence
- Kegel Exercises
- Pessary
- Urethral Sling Surgery
- Diagnose with Q-tip test
- 2) Overflow Incontinence
- A) Due to detrussor underactivity:
- Loss of urine with no warning
- Large or small volume loss
- B) Due to Obstruction
- Due to pelvic organ prolapse, fibroids
- Weak stream, difficulty initiating
- Sensation of incomplete emptying
- Identify underlying cause
- Bethanechol
- Occasional self-cath
- 3) Urgency Incontinence
- Oxybutinin
- Bladder training
Urinary Incontinence Drugs
- Bladder Overactivity/ Urge Incontinence
- Muscarinic Receptor Antagonists
- Oxybutynin
- Tolterodine
- Fesoterodine
- Trospium
- Solifenacin
- Darifenacin
- Mirabegron
- Onabotulinumtoxin A
- Urethral Underactivity
- Estrogens
- Alpha Adrenergic Agonist
- Duloxetine
Pyelonephritis Assessment
- Cause/Mechanism
- Ascending Urethral Bacteria
- Assessment
- Dysuria
- Fever
- Fatigue
- Flank Pain
- Costovertebral Tenderness
- Nausea and Vomiting
1 min
Urinary Tract Infection Symptoms
- More Common in Elderly
- Most Common in Females and Babies
- Change in LOC
- Dehydration
- Fever
- Urgency
- Urethral Infection
- Burning
- Smelly Urine
- Dark Cloudy Urine
- Frequency of Urination
2 mins
UTI Tx in Pregnancy
- Nitrofurantoin
- Amoxicillin
- Cephalexin
Lower UTI (cystitis) and Upper UTI (pyelonephritis) clinical features
- Lower UTI (cystitis)
- Urinary Frequency and Urgency
- Hematuria
- Bladder fullness
- Dysuria
- Upper UTI (pyelonephritis)
- Fever/Chills "Shake and Bake"
- Nausea and Vomiting
- Abdominal Pain
- Dehydration
- WBCs
Renal Calculi Assessment
- Cause/Mechanism
- Hypercalcemia (Most Commonly)
- Signs and Symptoms
- Flank Pain
- Radiates Toward Bladder
- Renal Colic
- Urinary Tract Infection
- Urinary Retention
- Hematuria
- Considerations
- Stone Recurrence
2 mins
Renal Calculi Interventions
- Interventions
- Increase Fluid Intake
- Opioids
- NSAIDs
- Antibiotics
- Lithotripsy
- Surgical Stone Removal
- Considerations
- Identify Type CT-KUB
- Low Sodium Diet
2 mins
Urinary tract infections
- Cystitis presents with dysuria, frequency, urgency, suprapubic pain, and WBCs (but not WBC casts) in urine. Primarily caused by ascension of microbes from urethra to bladder. Males— infants with congenital defects, vesicoureteral reflux. Elderly—enlarged
- prostate
- Ascension to kidney results in pyelonephritis, which presents with fever, chills, flank pain, costovertebral angle tenderness, hematuria, and WBC casts.
- Escherichia coli Leading cause of UTI. Colonies show green metallic sheen on EMB agar.
- Staphylococcus saprophyticus 2nd leading cause of UTI in sexually active women.
- Klebsiella pneumoniae 3rd leading cause of UTI. Large mucoid capsule and viscous colonies.
- Serratia marcescens Some strains produce a red pigment; often nosocomial and drug resistant.
- Enterococcus Often nosocomial and drug resistant.
- Proteus and pseudomonas.Diagnostic markers: ⊕ Leukocyte esterase = evidence of WBC activity. ⊕ Nitrite test = reduction of urinary nitrates by bacterial species (eg, E coli). ⊕ Urease test = urease-producing bugs (eg, Proteus, Klebsiella).
Chronic Pyelonephritis
- Involves renal calyces and pelvis
- Must be in setting of:
- 1) Reflux nephropathy
- 2) Obstruction
- Gross
- Corticomedullary scars
- Overlying blunted calyces (particularly at poles)
- Micro
- Thyroidization of kidney
- Secondary FSGS
Nephrolithiasis Urolithiasis Renal Calculi
- Calcium Oxalate (CaO): MC
- HypoCa → inc oxalate absorption
- workup: low urine pH (acidic)
- RF: Crohn, ethylene glycol, vitamin C
- Mgmt: Urine Alkalinization (citrate), Thiazides
- Calcium Phosphate (CaP)
- Basic Urine pH
- Ammonium Magnesium Phosphate
- Urease(+) organisms
- Struvite Crystals, Staghorn Calculi, Coffin Lid
- Uric Acid
- RF: Acidic Urine pH, Hot Climate
- Rhomboid, Rosette, Radiolucent
- Mgmt: Urine Alkalinization (bicarb, citrate)
Erythropoietin
- Mechanism
- Stimulates RBC Production
- Indications
- Chronic Renal Failure
- Anemia
- Side Effects
- Increased Risk of Thrombosis
- Pelvic and Limb Pain
- Hypertension
- Considerations
- Do Not Shake
- Monitor Hemoglobin (Hgb) Weekly
- May Accelerate Tumor Progression
2 mins
Dialysis
- Hemodialysis
- Rapid Shifts of Fluid and Electrolytes
- Disequilibrium Syndrome
- Hypotension
- NO BP IN ARM with Shunt or Fistula
- Assess for Thrill and Bruit
- Peritoneal Dialysis
- Slow Process
- Peritonitis
- Loss of Protein
- Hyperglycemia
3 mins
Chronic Kidney Disease Interventions
- Interventions
- Daily Weights
- Strict I/O
- Renal Diet
- Strict Medication Regimen
- Erythropoietin
- Manage Hyperkalemia
- Manage CKD-MBD
- Dialysis
- Kidney Transplant
2 mins
Chronic Kidney Disease Late Symptoms Assessment
- Metabolic Acidosis
- Severe Uremia
- Arrhythmias
- Edema
- CNS Depression
- Anemia
- Oliguria
- Pruritus
- Considerations
- End Stage Renal Disease (ESRD)
- GFR < 15mL/min
2 mins
Chronic Kidney Disease Early Symptoms Assessment
- Characteristics
- GFR < 60mL/min
- Accumulation of Waste Products
- Clinical Features
- General Malaise
- Hypertension
- Proteinuria
- Hyperkalemia
- Mineral and Bone Disorders
- Neuropathy
2 mins
Ureaplasma Urealyticum
- No Cell Wall and No Gram Stain
- A8 agar
- Urethritis
- Urethritis mainly in men
- Urease Positive
- Resistance to cell wall inhibiting antibiotics
Urethral Injury
- Urethral Meatus
- blood
- Posterior urethra
- Urine Leaks to Retropubic Space
- anterior urethra
- Perineal Pain
- Contraceptive Sponge
- Boggy Prostate
- scrotal hematoma
Urinary Excretory Anatomy
- Characteristics
- Renal Medulla
- Renal Cortex
- Nephron
- Bowman's Capsule
- Glomerulus
- Proximal Tubule
- Loop of Henle
- Distal Tubule
- Collecting Duct
- Ureter
- Urinary Bladder
- Urethra
2 mins
Proximal Tubule
- Characteristics
- Na+ Reabsorbed Via Active Transport
- Water Follows Na+
- Most Of Glucose Reabsorbed
- Most Of Amino Acids Reabsorbed
- Bicarbonate Exchanged For H+
- Drugs and Toxins Excreted
- Filtrate Osmolarity Same As Plasma
- Leads To Loop Of Henle
2 mins
