121 Week 5 Chapter 8 Urinary System Recent

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  • Cranberry juice contain proanthocyanids; prevents e-=coli from attaching to cells in urinary tract lining. Also found in blueberries Bring in UA strips
  • Www.drrajmd.com “ I Thought I Had a Urinary Tract Infection – but it was a Life Threatening Cancer.” AUGUSTA, GA – “The prevalence of bladder cancer in the United States is higher than lung cancer; and its prevalence in women is similar to the number of women with cervical and ovarian cancers. More than a half million people have had or are living with bladder cancer today,” said Sylvia Ramsey, Georgia Military Community College (GMC) professor, poet, and national bladder cancer patient advocate. “Unfortunately, without a celebrity spokesperson championing public health messages, bladder cancer has become the forgotten cancer.” Concurring with professor Ramsey, noted urologist, clinical investigator and author Mark Soloway M.D., chairman, Department of Urology at the University of Miami School of Medicine said, “Bladder cancer is the second most common urologic malignancy in the United States after prostate cancer. We have made dramatic changes with the use of PSA, an early detection program, and tremendous public awareness. Unfortunately, we have not done the same with bladder cancer.” Ten years ago, Ramsey experienced a life-changing bladder infection. The blood that was noticed in her urine did not go away. The antibiotics did not solve the problem. Eventually she saw an urologist and underwent medical tests that showed she had bladder cancer, an invasive type that penetrated the muscle wall of her bladder. A surgery to remove her bladder included a radical hysterectomy and was followed by reconstruction to rebuild a bladder using a section of her colon -- referred to as an Indiana pouch. A section of her small intestine was used to connect to the umbilical site, making for an excellent cosmetic result and easier catheterization. “ I have been very lucky, I haven’t experienced follow-up infections, but I have been thrown into early menopause and body image concerns,” says Ramsey. “Writing this book forced me to look at what is really important – living life, not necessarily the weighty things that distract us.” As a 10-year bladder cancer survivor Ramsey is sharing a message of hope with the many people she meets at book signings, community events and through the BC Sisterhood (www.cafepress.com/bcsisterhood). “Life is as frail as thread and as strong as rope,” says Ramsey. It is Ramsey’s belief that life is about-facing ones fears, considering alternatives and choosing to persevere in spite of the risk. “ I thought I had a urinary tract infection,” recalls Ramsey. “That’s what I was initially treated for.” Upon further evaluation, Ramsey’s cancer was already invasive and engulfed the entire left side of her bladder. Once she was diagnosed, she began researching this cancer and potential treatments. Back then, she found very little information that was positive or oriented to women. Traditionally, bladder cancer is associated with older men, especially smokers. Ramsey’s positive attitude spurred her to communicate with her urologist to understand the next steps. He told her it would involve a radical hysterectomy and removal of the bladder. Depending on if the cancer had spread anywhere else, they would decide what else to do at that point. She researched the web and found information on an Indiana Pouch that she presented to her urologist, and they discussed the possibilities. He said if the cancer had not spread to other parts of the body they could take that route. Because of her attitude and her determination to get on with her life, he came up with an idea for the “stoma” that was not in the usual location. Sylvia’s positive attitude and active lifestyle made her a good candidate for the Indiana Pouch. Using a short section of her small intestine with two sphincter valves, the doctor ran it up to the natural opening in her navel. That is where she uses the catheter. Bladder cancer has the highest recurrence rate of all cancers. Ramsey also says that individuals with a history of smoking or exposure to chemical dyes are all at risk for bladder cancer. Medical studies have shown that firefighters, hairstylists working with permanent dyes, and leather and textile workers are among the occupations most linked to bladder cancer. As part of her follow-up care, Ramsey gets tested to monitor for any recurrence of the disease. Part of follow-up care includes the NMP22® BladderChek® Test, -- a simple urine test performed in the physician’s office to help diagnose and monitor the recurrence of bladder cancer. The test detects elevated levels of the NMP22 protein marker in a single urine sample. Most healthy individuals have very small amounts of the NMP22 protein marker in their urine, but bladder cancer patients commonly have elevated NMP22 protein marker levels, even at early stages of the disease.
  • Cystoscopy is a procedure that uses a flexible fiber optic scope inserted through the urethra into the urinary bladder. The physician fills the bladder with water and inspects the interior of the bladder. The image seen through the cystoscope may also be viewed on a color monitor and recorded on videotape for later evaluation Cystoscopy is performed with a cystoscope -- a specialized tube with a small camera on the end (endoscope). There are two types of cystoscopes: Standard, rigid cystoscope Flexible cystoscope Which cystoscope your doctor uses depends on the purpose of the exam. The procedure usually takes 5 - 20 minutes. The urethra is cleansed. A local anesthetic is applied. The scope is then inserted through the urethra into the bladder. Water or salt water (saline) is injected through the cystoscope to fill the bladder. As this occurs, patient will be asked to describe the feeling. As fluid fills the bladder, it stretches the bladder wall. This lets the provider see the entire bladder wall. If any tissue appears abnormal, a small sample can be taken ( biopsy ) through the cystoscope and sent to a lab for analysis.
  • An intravenous pyelogram (IVP) is an x-ray examination of the kidneys, ureters and urinary bladder that uses iodinated contrast material injected into veins. An intravenous pyelogram examination helps the physician assess abnormalities in the urinary system, as well as how quickly and efficiently the patient's system is able to handle waste. The exam is used to help diagnose symptoms such as blood in the urine or pain in the side or lower back. The IVP exam can enable the radiologist to detect problems within the urinary tract resulting from: kidney stones enlarged prostate tumors in the kidney, ureters or urinary bladder An IVP shows details of the inside of the urinary tract including the kidneys, ureters and bladder. Computed tomography (CT) or magnetic resonance imaging (MRI) may add valuable information about the functioning tissue of the kidneys and surrounding structures nearby the kidneys, ureters and bladder
  • Polycystic Kidney Disease At A Glance The two forms of polycystic kidney disease (PKD) are autosomal dominant PKD, a form that usually causes symptoms in adulthood autosomal recessive PKD, a rare form that usually causes symptoms in infancy and early childhood The symptoms and signs of PKD include pain in the back and lower sides headaches urinary tract infections blood in the urine cysts in the kidneys and other organs Diagnosis of PKD is obtained by ultrasound imaging of kidney cysts ultrasound imaging of cysts in other organs family medical history, including genetic testing PKD has no cure. Treatments include medicine to control high blood pressure medicine and surgery to reduce pain antibiotics to resolve infections dialysis to replace functions of failed kidneys kidney transplantation
  • Miracles exist by: Tanya on Mon, Sep 17 2007 I am 42 years old with Chronic glormerolonephritis [glomerulonephritis}. I was diagnosed at the age of 7, After a period of Henoch-Schonlein purpura. I had horrible back pain and so much blood in my urine that it looked like tomato juice. I was rushed to the hosp. where at first they called it acute g.n. [glomerulonephritis}. After my first biopsy my parents were told that I probably had about 30 days to live!!!! I was put on steroids and other experimental meds (1972). I obviously outlived the 30 days but still had lots of difficulty over the next years and also underwent two more biopsies. I grew up, got married and was told it probably wasn’t a good idea to try and have a baby; but I did, in fact, and I have four children. My disease mysteriously disappears in pregnancy! Yes, I’ve had setbacks, my kidneys are shrinking away, I’m constantly tired, my joints are swollen often and I have back and leg pain nowadays, BUT, I’m happy to be here and to have achieved all that I have (got my associates degree, teach aerotechnical English, my kids, keep in shape, traveled all over the globe, and am writing a novel.) I have wonderful friends and family even though most are far away (I moved to Italy). I’ve had doctors look through my records and look up at me and ask how the heck am I still around??? What can I tell you, miracles exist!!!! Samantha last year they diagnosed me with acute gn, this year im turnuing 14 years old, its hard sometimes with all the medical stuff going on, with the medication they put me on i gained ALOT of wieght and i have already signed up for 2 researches conducted by Washington University and the Childrens Hospital. My mom Said that im strong for hanging in there for all this time , it gets pretty lonely at the hospital when i stay over night. im usually the older one in the room. im hoping everthing will get easier. i have alot of friends that are there for me and stick up for me. i dont like explaining whats wrong with me because i break down and start crying. the Doctors say that everything is goign good and the hopfully i will be ably to get all the way off the Prednison, the medication im talking, so thats a plus, and i all losing the weight quickly, im becoming really active and doing many sport and next year i will be in high school, so im going to be doing alot of sports there to. everything is good
  • Hemodialysis/ peritoneal dialysis
  • Dietary restrictions: increase natural fiber, no added salt, limit red meat/animal proteins, limit calcium-rich foods (dairy), increase oxylate foods (dark green vegetables, nuts, chocolate)
  • 121 Week 5 Chapter 8 Urinary System Recent

    1. 1. Urinary System Diseases and Disorders
    2. 2. Objectives <ul><li>Identify anatomy and physiology of the urinary system </li></ul><ul><li>Recognize common symptoms and treatments of the urinary system diseases and conditions </li></ul><ul><li>Differentiate various diseases/ conditions of the urinary system </li></ul>
    3. 3. Objective #1: Identify anatomy and physiology of the urinary system
    4. 4. Function of the kidneys <ul><li>Excretion of unwanted substances </li></ul><ul><li>Maintenance of water balance </li></ul><ul><li>Regulation of acid-base balance </li></ul><ul><li>Regulation of blood pressure </li></ul><ul><li>Regulation of red blood cell production </li></ul>
    5. 5. Route blood travels through the kidneys
    6. 6. Objective #2: Recognize common symptoms of the urinary system <ul><li>Anorexia, nausea, vomiting </li></ul><ul><li>Malaise, fatigue, lethargy </li></ul><ul><li>Nocturia, hematuria, pyuria, proteinuria </li></ul><ul><li>Dysuria, urgency, frequency </li></ul><ul><li>Pain in lumbar region, flank, pubic area </li></ul><ul><li>Fever </li></ul><ul><li>Edema, ascites </li></ul><ul><li>Respiratory, cardiovascular (hypertension, shortness of breath) </li></ul>
    7. 7. Common Drug Treatments for Urinary Tract Diseases <ul><li>Diuretics used to treat edema, nephrotic disease, renal failure, cardiovascular disease </li></ul><ul><li>Sulfonamides (TMPSMZ, Septa, Bactrim) used to treat uncomplicated urinary tract infections </li></ul><ul><li>Urinary analgesics (Pyridium) </li></ul>
    8. 8. Objective #3 Differentiate various disease/conditions of the urinary system <ul><li>Polycystic Kidney Disease </li></ul><ul><li>Glomerulonephritis </li></ul><ul><li>End Stage Renal Disease </li></ul><ul><li>Renal Calculi </li></ul><ul><li>Cystitis/Urethritis </li></ul><ul><li>Tumors of the Bladder </li></ul>
    9. 9. Disease: Cystitis and Urethritis <ul><li>Description: inflammation of the bladder/urethra </li></ul><ul><li>Etiology: E-coli? </li></ul><ul><li>Signs & Symptoms: dysuria, frequency, urgency, pain </li></ul><ul><li>Diagnostic procedures: UA </li></ul><ul><li>Treatment: ABO/Sulfa </li></ul><ul><li>Prognosis: good </li></ul>
    10. 10. Disease: Tumors of the bladder <ul><li>Description: 4 th leading cause CA men; malignant; metastasizes </li></ul><ul><li>Etiology: smoking? </li></ul><ul><li>Signs & Symptoms: asymptomatic until advanced; hematuria </li></ul><ul><li>Diagnostic procedures: PE; UA; cystoscopy, IVP </li></ul><ul><li>Treatment: surgery, endoscopic resection, TURP </li></ul><ul><li>Prognosis: varies according to depth </li></ul>
    11. 11. Cystoscopy <ul><li>Scope inserted through urethra to view the bladder </li></ul><ul><li>cystoscopy-male </li></ul>
    12. 12. Intravenous Pyelography (IVP) <ul><li>X-ray of urinary system including kidneys, ureters, & bladder </li></ul><ul><li>Used to detect tumors, kidney stones, enlarged prostate </li></ul>
    13. 13. Disease: Polycystic Kidney Disease <ul><li>Description: defect of collecting tubules (cortex) </li></ul><ul><li>Etiology: genetic defect (adult onset) </li></ul><ul><li>Signs & Symptoms: colic, lumbar pain, hematuria, hypertension </li></ul><ul><li>Diagnostic procedures: PE reveals enlarged kidneys; urography; US; CT </li></ul><ul><li>Treatment: supportive; dialysis; transplant </li></ul><ul><li>Prognosis: poor – no cure </li></ul>
    14. 14. Disease: Glomerulonephritis (Acute poststreptococcal glomerulonephritis) <ul><li>Description: inflammation of the glomeruli; rate of filtration decreased, increase in fluid retention </li></ul><ul><li>Etiology: antigen-antibody complex becomes trapped in capillaries of glomeruli </li></ul><ul><li>Signs & Symptoms: hematuria, H/A, edema, lumbar pain </li></ul><ul><li>Diagnostic procedures: PE (Hx strep?), ↑BUN, ↑ creatinine , rapid SED, UA (blood & protein), renal bx </li></ul><ul><li>Treatment: supportive, bedrest, diet restrictions (salt, protein, fluid) </li></ul><ul><li>Prognosis: good </li></ul>
    15. 15. Disease: End Stage Renal Disease (ESRD); Chronic Renal Failure (CRF) <ul><li>Description: gradual deterioration of kidneys; unable to excrete urea & creatinine (toxic levels) </li></ul><ul><li>Etiology: diabetes; hypertensive renal disease </li></ul><ul><li>Signs & Symptoms: affects all body systems </li></ul><ul><li>Diagnostic procedures: blood tests ( ↑ creatinine, BUN, K, ↓ hematocrit, hemoglobin; UA reveals protein, low specific gravity; US; renal scan </li></ul><ul><li>Treatment: symptomatic; dialysis; transplant </li></ul><ul><li>Prognosis: very poor </li></ul>
    16. 16. Disease: Renal Calculi (Uroliths, Kidney Stones) <ul><li>Description: common cause of urine obstruction </li></ul><ul><li>Etiology: low urine volume, dehydration, UTI, prolonged bedrest </li></ul><ul><li>Signs & Symptoms: sudden, severe flank pain </li></ul><ul><li>Diagnostic procedures: UA, KUB, IVP </li></ul><ul><li>Treatment: lithotripsy; increase fluids; antibiotics </li></ul><ul><li>Prognosis: 60% chance will form another stone </li></ul>

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