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Bedwetting or noctural enuresis
- I'd like to start this flashcard off by saying that I'VE BEEN TYPECAST!!!!
- *ahem*
- when children wet the bed more than twice per month after age 5 or 6
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Treatments for bedwetting
- counseling
- urination regimen
- urinary bladder conditioning
- medications (demopressin nasal spray or imipramine)
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Neurogenic urinary bladder
malfuntioning urinary bladder due to neurologic dysfunction or insult emanating from internal or external trauma, disease or injury
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Potential causes of neurogenic urinary bladder
- stroke
- cancer
- dementia (Alzheimer's)
- spinal cord injury
- metabolic disorders (diabetic neuropathy)
- multiple sclerosis
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Symptoms of neurogenic urinary bladder
- urinary bladder spasms
- failure to empty urinary bladder completely
- lack of feeling of fullness or urgency
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Treatments of neurogenic urinary bladder
- indwelling catheter
- pelvic floor muscle exercises
- medications
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Medications for neurogenic urinary bladder
- anticholinergics (to relax overactive urinary bladder)
- cholinergic agonists (activates nerves in underactive urinary bladder)
- antibiotics
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Renal cell carcinoma (hypernephroma)
causes 85% of all kidney cancers leading to enlargement then destruction of the kidneys
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Transitional cell carcinoma
found in transitional cells lining the urinary bladder, ureter or renal pelvis
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Renal carcinoma
rare disease of renal connective tissue accounting for less than 1% of all kidney tumors
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Causes of urinary bladder tumors
- smoking
- industrial chemical exposure
- radiation and chemotherapy
- chronic urinary bladder infection or irritation
- parasitic infection
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Treatments for urinary bladder tumors
- chemotherapy (single or combination drug)
- fulguration (destroys tissue using an electric current)
- immunotherapy (infusion of Bacillus Calmetter-Guerin solutino into the urinary bladder)
- surgical removal of the urinary bladder
- ileal conduit
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Urethritis
inflammation of the urethra
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Causes of urethritis
- UTI
- STD
- chemical exposure
- "straddle" injury in men
- urethral obstruction in women
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Acid-base imbalance
minor deviation from normal range (7.35-7.45) can severly affect many organs and may lead to death (<6.8 or >7.8)
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Mechanisms that control blood acid-base imbalance
- lungs (by exhaling CO2)
- kidneys (by forming HCO3-)
- bicarbonate-carbonic buffer system
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Acid-base disorders referred to as:
- acidosis (acid accumulation or alkali loss)
- alkalosis (alkali accumulation or acid loss)
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Acid-base disorders due to changes in:
- arterial CO2 partial pressure (PaCO2)
- serum HCO3-
- serum pH (<7.35=acidemia and >7.45=alkalemia)
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Compensation
occurs when either the lungs (Co2) or kidneys (HCO3-) respond to cause of the disorder and pH levels remain in the normal range
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Decompensation
occurs when neither the lungs nor kidneys compensate adequately for alterations in CO2 and HCO3- and pH levels move out of the normal range
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Role of lungs in acid-base imbalances
- rapid, multi-step process involving release of CO2 from the lungs in concert with the respiratory center of the brain
- -when CO2 accumulates in the blood, the pH of the blood decreases (acidity increases)
- -brain regulates CO2 levels exhaled by controlling the speed and depth of the breathing
- -as breathing becomes faster and deeper, exhaled CO2 levels and the pH of the blood increases
- -by adjusting the rate and depth of breathing, the brain and lungs are able to regulate the blood pH minute by minute
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Role of kidneys in acid-base imbalances
- affect blood pH by exreting excess acids or bases
- unlike the lungs, compensation by kidneys generally takes several days
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Role of bicarbonate-carbonic acid system in acid-base imbalances
involves carbonic acid (a weak acid formed from CO2 in blood) and HCO3- (the corresponding weak base) to minimize pH changes by adjusting the proportion of acid and base
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Metabolic acidosis
develops when the amount of in body is increased through ingestion of susbtance that is metabolized to acid
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Causes of metabolic acidosis
- diabetic ketoacidosis
- drugs (azetazolamide, asprin, alcohol, iron)
- lactic acidosis
- loss of HCO3-
- kideny failure
- poisons (carbon monoxide, cyanide, ethylene glycol, methanol)
- renal tubular acidosis
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Treatment of metabolic acidosis
- depends on cause
- insulin for diabetes
- removal of toxic substance from blood
- etc...
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Causes of repiratory acidosis
- lung diseases
- sleep-disordered breathing
- drug overdose
- neuromuscular diseases that impair breathing
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Treatment of respiratory acidosis
- beta2-adrenergic receptor agonist/glucocorticosteroid
- supplemental O2
- mechanical ventilation
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Causes of metabolic alkalosis
- loss of acid from vomiting or drainage of the stomach
- overactive adrenal gland
- diuretics
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Treatment of metabolic alkalosis
replace water and electrolytes (Na+ and K+) while treating the underlying cause
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Causes of repiratory alkalosis
- anxiety
- aspirin overdose
- fever
- low O2 levels in the blood
- pain
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Treatment of respiratory alkalosis
- slow down rate of breathing
- pain medications
- breathing into a paper bag may raise blood CO2 levels by breathing CO2 back in after breathing it out
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