SA Sx Urinary II

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HLW
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175767
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SA Sx Urinary II
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2012-10-05 16:50:26
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SA Sx Urinary II
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SA Sx Urinary II
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  1. What are 5 types of incontinence?
    • urge (inflammation/infection)
    • congenital (ectopic ureter, patent urachus)
    • paradoxical (partial obstruction)
    • neurogenic
    • urethral sphincter mechanism incompetence
  2. For incontinence due to urethral sphincter incompetence, what are some medical options to try before sx?
    estrogen, testosterone, sympathomimetic drugs
  3. What are sx options for urethral sphincter incompetence?
    • colposuspension
    • cystourethopexy
    • injecting teflon or collagen around sphincter
    • hydraulic occluders
  4. what is usual age for bladder lithiasis? What % are lower urinary tract v. kidney stones?
    • 3-7 years
    • 90% LUT/10% renal
  5. What is another possible differential is bladder appears to have radiolucent stones?
    blood clot
  6. what are problems associated with thin walled bladder?
    • hematuria
    • can't shrink back down so retain urine/difficult to express
  7. Which stones are usually large and multiples?
    struvite
  8. What breed is more prone to get struvites?
    • german shepherd
    • schnauzer
  9. what breed is prone to ammonium urate?
    • dalmation (genetic, lacks enzyme)
    • bull dog
    • PSS (collie, yorkshire, schnauzer)
  10. What breed is prone to cystine cystoliths? what about oxalates?
    • dachshund
    • basset
    • yorkshire
    • chihuahua
    • oxalates=schnauzer
  11. What breed is most susceptible to recurrece of cytoliths?
    • dachshund (47%)
    • dalmation (33%)
    • schnauzer (18%)
  12. What should be attempted if calculi is in urethra?
    try to flush into bladder for removal
  13. For combined scrotal urethrostomy and cystotomy, which opening can be left open for recurrent situations? Where is incision made?
    • prescrotal incision
    • leave urethra open if recurrent
  14. what are some common neoplasias seen in bladder? which effects the trigone?
    • leiomyoma (fibroma)
    • transitional cell carcoma (common at trigone)
    • adenocarcinoma
    • leiomyosarcoma
    • rhabdomyosarcoma
  15. What is treatment option for TCC?
    piroxicam (immune modulator to slow growth)
  16. what are cauliflower like lesions in the bladder and how are they treated?
    • polyps
    • cystectomy to remove tumor w/margins (pediculated better prognosis)
  17. what are clinical signs for bladder trauma?
    • dysuria, anuria
    • hematuria
    • fluid in abdomen
    • swelling and discoloration of skin
    • abdomen distention and pain
    • uremia
  18. Uroabdomen is medical emergency. What are some clinical signs?
    • hyperkalemia
    • uremia
    • dehydration
    • abdominocentesis/radiology
  19. what is normal urine production rate?
    1-2 ml/kg/hr
  20. Is diagnostic peritoneal lavage or abdominocentesis preferrable?
    DPL (wear gloves and scrub first)
  21. when performing the water test in the bladder, how is urethra occluded?
    ringer in rectum to hold it down
  22. what are indications for urinary diversion?
    • neoplasia
    • trauma
    • neurogenic incontinence
    • temporary following sx, exp. repaired rupture bladder
    • (last resort technique!)
  23. Following urinary diversion, what are some post op concerns?
    • antibiotics needed intermittently for life
    • culture for abs limited value bc mix w/feces
    • ascending infection
    • urine scald w/cystostomy
    • incontinence w/cystostomy
  24. what are causes of feline urinary incontinence?
    • neurogenic causes (common)
    • iatrogenic from sx
    • juvenile vaginal aplasia w/abnormal bladder, short urethra
    • FLUTD (thick wall so decr. compliance)
  25. do males or females have problems with urethra. blockage more often?
    • males (cone shaped end in cat)
    • fem: shorter/wider
  26. how do you know appropriate length for urinary catheter? where can catheter get stuck when trying to place?
    • premeasure or mark w/sharpie once urine starts to flow upon placement
    • at ischial arch
  27. What is hypospadia?
    incomplete closure on midline of penis/urethra --> can resemble a vulva and result in incontinence
  28. where in male do uroliths commonly lodge?
    behind os penis (form gran. tissue and embed) --> dilate and back flow
  29. What is common age for urolith? Breed disposition?
    • 3-7yr
    • schnauzer, dalmation, bull dog, dachshund, basset, terrier, beagle, GS, poodle

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