alteration in the GU
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What are the disorders of the bladder?
- Voiding dysfunction
- Inflammation and infection.
- Congenital disorders
What in incontinence? types?
- Report of any involuntary urine loss, Is never normal under any circumstances, i not a normal part of aging.
- Types: stress incontinence, urge incontinence, overactive bladder syndrome, mixed incontinence, neurogenic bladder, overflow incontinence, functional incontinence,
Stress incontinence? Urge incontinence? Overactive bladder syndrome? Mixed incontinence?
- Stress: occurs when intra-abdominal pressure increases, due to weakening of the pelvic muscle.
- urge: when the have the sense that they have to go, n they loose urine on the way to the restroom. this is due to overactive destrusor muscle. (treated w anticholinergics)
- Overactive bladder: increase urge during the day and at night, not necessary an incontinence.
- Mixed: It is stress and urge incontinence.
Neurogenic bladder? overflow incontinence? Functional incontinence?
- Neurogenic: Associated w something in the CNS, for instance a spinal cord tumor, or any pathology there.
- overflow: (BPH) benign prostatic hyperstrophy. ove rthe age of 65. Pt is not able to empty their bladder and causes an overflow.
- Functional: usually seen in nursing homes. they don't understand to go to the restroom. Or maybe the accessibility to the restroom is not appropriate.
What is enuresis? Pathogenesis?
- Bedwetting, most common in children.
- After the age of 6, children should not be bedwetting, if so, there might be a pathology behind it.
- Pathogenesis: daficiency in vasopressin (antidiuretic hormone).
- Issues w detrusor muscl.
What is Urolithiasis? Etiology? CM?
- Lower urinary tract stones - stones that can form anywhere in the UT, usually collect in the bladder.
- Main prob is when one of the stones blocks the urethra and causes bladder distention.
- Etiology: Include dehydration and immobility.
- CM: Hematuria is the most common.
What is cystitis? types? Patho? CM?
- inflammation of the bladder lining. (UTI)
- Types: uncomplicated (2 or less UTI per yr) and complicated.
- Patho: Since bacteria is cleared from the bladder by voiding, so dehydration and immobility can cause bacteria to stay.
- CM: dysuria, cloudy urine (fishy smell).
- Children show more like a systemic manifestation.
- Elderly could be asymptomatic.
Bladder cancer - More common in males than female - main manifestation is painless hematuria.
What is vesicoureteral reflux?
kidneys are damaged by the backflow of urine into the kidneys from the bladder. Main reason is the faulty valvular mechanism.
What is ureterocele? CM?
- It is congenital cystic dilation of the distal end of the ureter - 75% are located at the bladder neck or in the urethra.
- More often in females.
- CM: voiding dysfunction,hematuria, ursepsis (bc of the accumulation of bacteria in the bladder), FTT
What are the alretations in male genital and reproduction fucntion?
- Congenital anomalies.
- acquired disorders.
- infectious disorders (STDs for B females and males)
- Neoplastic disorder.
What are the most common congenital anomalies? describe them.
- Urethral valves: a tissues (valve) that did not get separated in the embryo n causes obstruction.
- Urethrorectal and vesicourethral fistulas: Rare, but almost always associated w imperferated anus. This causes gas and feces to pass through the urethra. greenish black color of the embryotic fluid.
- Hypospadias: urethral meatus is located on the lower aspect of the penis.
- Epispadias: urehtral meatus located in the upper aspect of the penis.
what are acquired disorders? Describe them.
- Priapism: usually males that take ED drugs, end up having a prolonged engorgement (blood cannot drain).
- Phimosis: It is when the foreskin cannot be retracted over the penis, usually due to inflammation and poor hygiene.
- Urethral strictures: fibriotic narrowing of the urethra that are ussually due to scar tissue from prior infection, or trauma (Gonorrhea common).
- CM: Decreased urinary stream, discharge, urinary retention.
- TX: dilate.
- Erectile dysfuction (impotence): Primary (never has had an erection) and secondary (no longer have erections). Most common cause is PV, diabetes.
- Infections diorders (STDs) look at other slide.
What are the most common Infections disorders? STDs.
- Gonococcal Urethritis.
- Nongonococcal urethritis.
- Genital herpes.
- Genital Warts.
1) What is Gonococcal urethritis? CM? Complications?
2) Nongonococcal urethritis? CM? complications?
- 1) It is the inflammation of the epithelial tissue due to Neisseria gonorrhoeae - 3 to 8 days incubation period. - Treat nongonococcal urethritis (chlamydia) bc they coinfect.
- CM: Urethral discharge and burning during urination. Urethritis, Cervicitis, Salpingitis (inflammation of the fallopian tubes)
- Discharge, Dysuria.
- Usually women are asymptomatic.
- Complications: long term complications such as Pelvic inflammatory disease (PID), and Epididymis.
- 2) caused by chlamydia trachomatis - causes urethral discharge and dysuria.
- CM: same a gonorrhea but less severe.
- Complications: PID but is not as common.
- * localized type of infection! Both
what is syphilis? Characteristics?
- systemic infection of vascular system caused by treponema pallidum.
- Chrs: 10 to 60 days incubation period - 5 phases (incubation, primary, secondary, latency, late) - 1st stage is the beggining of chancre)
What is herpes virus infections? CM? Differences b/t HSV-1 and 2? etiology?
- Infection caused by herpes simplex virus ( 2 subtypes: HSV-1 and 2) that may cause persistent or latent infections.
- CM: Vesicles (clear filled sacs), localized discomfort,
- HSV1: "cold sores" usually infection occurs above the waist. Usually affects children < 5yrs.
- HSV2: Genital herpes. Incubations 3 to 7 days.
- Etiology: Both types produce self-limiting initial infections, which can reoccur (like in immunosuppressed pts)
what is HPV? Etiology? Pathogenesis? CM? Prevention?
- Infection caused by the Human Papillomavirus.
- Warts are found on the external genitalia and anus - It is associated w cervical cancer.
- Etiology: It is highly communicable!
- Patho: long incubation period (1 to 20 months)
- CM: Occurs in cauliflower-like clusters (look like warts) with lots of pruritic (itchy).
- Prevention: HPV vaccine.
what are the disorders of the scrotum and testes?
- Congenital disorders
- Acquired disorders
- Infectious disorders
What are cryptorchidism? etiology
- undescended testicle, usually happens in premature babies.
- etiology: prematurity, congenital problems.
- True: inside the inguinal channel.
- Ectopic: Outside the inguinal channel.
- They need to be treated bc if untreated it can become cancerous.
What are the acquired disorders of the scrotum and testes? describe?
- Hypogonadism: reduction or absence of hormone secretion or other physiological activity of the gonads (testes or ovaries)
- cause by testicular failure - androgen deficiency in the aging male.
- Hydrocele: Fluid collection surrounding the testicle or spermatic cord. - 2 types: commnicative (fluid can move) and non (no fluid can move b/t the abdomen and the scrotum)-
- Spermatocele: Painless cystic masses containing sperm - Idiopathic.
- Testicular torsion: twisting of the spermatic cord.
- Epididymitis: Its a result from STDs or trauma that causes inflammation of testis -- pts are very sick.
- Neoplasms of the testes: usually seen in late adolescence to early adulthood -- early detection with testicular self-examination --
What are the disorders of the prostate?
- Bening prostatic hyperplasia.
- Prostate Cancer.
What is Benign prostatic hyperplasia? Pathogenesis? CM?
- It is the noncancerous enlargement of the prostate, and it doesn't become cancerous.
- It is very common in men over 60 (80%).
- It is idiopathetic -- although there is a correlation in low testosterone and increase of estrogen.
- Patho: decrease testosterone and increase estrogen level that cause a hyperplasia.
- CM: Decreased force of stream, nocturia, feeling of fullness in the bladder.
what is protatitis? types? etiology? CM?
- It is the inflammation of the prostate gland.
- There are 4 types: acute bacterial, chronic bacterial, nonbacterial, prostatodynia.
- Causitive organism: E.coli, proteus, and klebsiella.
- CM: ppl get really sick, w high fever, chillds, LBP. Usually pts need to go to the hospital to receive IV antibiotics.
Prostate cancer? Etiologies? Patho? CM? TX?
- Slow growing cancer (biggest issue) that is most prevalent from of cancer in men, rare in men under 50. 2 Cause of death.
- Etiology: Ideopathic, but w contributing factors such as genetic, hormonal, dietary, viral.
- Patho: Stage from A to D, where A is microscopic and D is metastasized cancer. (usually to the lymph nodes and bones, lungs and liver)
- CM: urinary symptmos, and elevated PSA are the most common.
- Tx: treatment depends on stage and pt's age.
What are the menstrual disorders? Describe them.
- Amenorrhea: Absence or supression of menstruation due to hormal disturbance. Treat the underlying cause not the manifestation (e.i anorexia)
- 2 types of amenorrhea: Primary (never had a period before) secondary (had a period and developed probs)
- Abnormal uterine bleeding patterns. Check other slide.
- Dysmenorrhea: Painful menstruations due to to contraction of the uterous. It is the most common menstrual abnormality (excess production of prostaglandin)
- 2 types: Primary (pain since the onset of menses) Secondary (had normal menses, but started w pain after due to, most common reason, Endometriosis)
Abnormal uterine bleeding patterns?
- Metrorrhagia: bleeding b/t menstrual cycles.
- Hypomenorrhea: Deficient amt of menstrual flow, reduced flow.
- Oligomenorrhea: Infrequent menstruation. Usually seen on the onset of menses or menopause.
- Polymenorrhea: Increased frequency of menstruation. Ppl having periods every 14 days or so.
- Menorrhagia: Increased in amt or duration of bleeding prolonged and heavy bleeding. Need to keep an eye on this one
- Abnormal uterine bleeding patterns: Nos associated with tumors, or anything else. It is most common around menarche, and menopause.
What are the alteration in uterine position and pelvic support?
- Uterine prolapse.
- Retrodisplacement of the uterus.
What is uterine prolapse? Types?
- Occurs when the cervix sags downward into the vagina, results from relaxation of pelvic structures -- The more vaginal deliveries, the more chances to get it.
- 3 types: 1st degree (halfway), 2nd (cervix starts to protrude), 3th (outside).
What is the retrodisplacement of the uterus?
- The body of the uterus is flexed into the posterior pelvis.
- There are 5 different positions.
- Causes dysmenorrhea and dyspareunia (painful intercourse)
What is cystocele?Etiology? CM?
- Protrution of the urinary bladder into the vaginal channel due to weakness of the vaginal musculature.
- Etiology: chilbirth, surgery, aging, obesity, lifting.
- CM: back pain, incontinence, dysuria, pelvic pressure, etc.
what are rectocele? Etiology? CM?
- Protusion of the anterior rectal wall into the posterior of the vagina.
- Etiology: Same as cystocele, childbirth, aging, obesity.
- CM: constipation, painful bowel movements, painful intercourse.
what are the inflammation and infection of the female reproductive tract?
- Pelvic inflammatory disease.
what is pelvic inflammatory diseases (PID)? Etiology?
- Any problems that deal with the oviducts, ovaries, and adjacent reproductive organs.
- EX: cervicitis, entometritis (uterus), salpingitis (oviducts), Oophoritis (ovaries).
- Etiologies: IUD, oral contraceptices, condoms.
- Patho: Bacteria invade the uretine and tubula tissue after migrating thorugh the cervix and scar tissue is fromed.
Vulvovaginitis? CM? Common organism?
- Inflammation of the vulva and vagina.
- CM: Thick, white vaginal discharge, malodorous, purulent discharge.
- organism: Candida albicans.
- Uterine leiomyomas: The most common (known:fibroids) -- estrogen and GH influence development. -- causes pain, abnormal bleeding, and discharge.
- Ovarian cysts: Bening sacs on ovary that contains fluids -- happens to ppl after menarches and before menapause. -- Idiopathic and usually assymptomatic -- The pain is cause when they rupture (like appendicitis)
- endometriosis: growth of the endometrium outside the uterus. -- Usually happens in nulliparous (never being pregnant) women > 30,40. -- It is the most common cause of infertility.
- Patho: the lining of the uterus backs up into the ovaries, instead of outside the vagina, and eventually covers the ovaries.
What are the areas of cancer of the female genital structures?
- Cervix Cancer.
- Endometrial Cancer.
- Ovarian Cancer.
- Vaginal Cancer.
- Cancer of the vulva.
What are the disorders of pregnancy?
- Pregnancy-induced HTN: Rapid rise in BP and proteinuria that could cause a stroke. -- multiple fetuses increase the changes. -- Characterized by salt and water retention.
- Hyperemesis gravidarum: Excessice vomiting during pregnancy causing dehydration and electrolyte imbalance, also no gain of weight and nutrition, might compromise the fetus.
- Placenta Previa: Placenta is implanted abnormally over the internal cervix. This interrupts fetal oxygen supply. Ideopathic.
- Abruption Placenta: Premature separation of placenta, usually related to trauma (car accident). This decreases the Oxygen supply to the baby. It is a medical emergency.
- Spontaneous Abortion: Miscarriage. usually caused by fetal abnormalities, faulty implantation, trauma, etc -- CM: vaginal bleeding abdominal cramps.
Disorders of the breast?
- reactive-inflammatory breast disorders: Mammary duct ectasia (mastitis) chronic inflammatory process -- Common in breast feeding.
- Breast abscesses: Common in persons predisposed to infections such as diabetes Mellitus or steroid therapy.
- Fat necrosis: Death of tissue after trauma or injury.
- Benign Breast Disorders: Fribrocystic breast disease is benign, usually caused by hormonal changes, aging, high caffeine diet. TENDER, FIRM, REGULAR, MOBILE. Usually not seen in postmenaposal women.
- Carcinoma of the Breast: It is the growth of abnormal cells in the breast. TUMORS TEND TO BE PAINLESS, HARD AND FIXED. Pathology of older women.
- Pathogenesis: Bc of the high amt of lymph nodes around the breast, there is a high chance of metastasis.
- CM: Dimpling of the skin, nipple retraction.
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