Fundamentals of Disease

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Acute glomerulonephritis is an

inflammation of the kidneys primarily affecting children and young adults.

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Acute glomerulonephritis usually occurs 1-4 weeks after a

streptococcal infection (throat/skin)

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Signs and symptoms of acute glomerulonephritis include:

chills, pyrexia, anorexia, wakness, edema (face/ankles), albuminuria, hematuria, casts in the urine

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The Px for acute glomerulonephritis is generally good if

a chronic degeneration of nephrons don't occur

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Chronic glomerulonephritis is an

inflammation of the kidneys that may persist for years with remissions and relapses

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Chronic glomerulonephritis is usually accompanied by

HTN

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A sign of chronic glomerulonephritis is

low specific gravity (spec. grav.) of the urine

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The end result of chronic glomerulonephritis can be

renal atrophy (no development) and RF

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renal failure

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RF causes

uremia

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Uremia (azotemia) means

a blood condition of excessive nitrogenous (N) waste

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RF prevents the kidneys from eliminating:

nitrogenous (N) wastes

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Blood tests used to detect RF include:

BUN, Cc, Cys C, GFR

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BUN

blood urea nitrogen

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creatine clearence

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Cys C

cystatin C

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GFR

glomerular filtration rate

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ARF

acute renal failure

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Causes of ARF:

hypovolemic shock, blood type/Rh incompatibility, kidney disease, trauma, poisoning

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Signs and symptoms of ARF:

oliguria, anuria, uremia, ammonia breath, hyperkalemia, muscle weakness

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Oliguria

scanty urine <500 cc/day

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Anuria

no urine production

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Uremia

azotemia

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Hyperkalemia

excessive potassium

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Tx of ARF:

remedy the cause, HD (hemodialysis)

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CAPD

continuous ambulatory peritoneal dialysis

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CRF

chronic renal failure

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CRF is usually caused by long standing kidney disease such as:

chronic glomerulonephritis, chronic HTN, DN (diabetic neuropathy)

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Tx for CRF:

HD and kidney transplantation

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CRF can also be caused by:

ATN (acute tubular necrosis)

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Causes of ATN include nephrotoxic agents such as:

certain antibiotics (Gentamicin), dyes used in diagnostic procedures

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polyonephritis

a suppurative inflammation of a renal pelvis

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Pyelonephritis is usually caused by pyogenic organisms such as:

E. coli, strep, staph; they can causes abscesses to form

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Signs/symptoms of polyonephritis include:

chills, pyrexia, back/abdonminal pain, dysuria, pyuria, bacteruria, hematuria

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Tx for polyonephritis includes the use of:

antibiotics (Bactrim)

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The Px for polyonephritis is

good

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Renal carcinoma occurs more frequently in

50-6o yr old men

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The incidence of renal carcinoma doubles for

smokers

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The Px for renal carcinoma is poor because

metastases (spread) to the lungs, liver, bone, and brain usually occur before signs and symptoms appear

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The chief sign of renal carcinoma is

painless hematuria

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A WT (Wilm's tumor) is a:

malignant fast growing renal tumor in very young children.

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The Px for WT is

poor but remission rates are increasing

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The medical terms for kidney stones are

nephrolithiasis and urinary (renal) calculi

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Urinary calculi occur more frequently in 20 to 40 year old

men (4 to 1 men/women)

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Signs and symptoms of nephrolithiasis occur when a calculus obstructs a

ureter

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Signs and symptoms of nephrolithiasis include:

Sharp severe retroperitoneal pain radiating to the inguinal region, hematuria

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Causes of nephrolithiasis include:

dietary Ca excess, dietary protein and Na excess, hyperparathyroidism

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A calculus that fills the renal pelvis completely is called a:

staghorn calculus

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Tests commonly used to detect a renal calculus include:

KUB, renal ultrasound, CT, IVP

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KUB

kidneys, ureters, bladder

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IVP

IV pyelogram

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Tx for a calculus that impedes the flow of urine is a:

ESWL (extra corpeal wave lithotripsy)

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Hydronephrosis occurs when

a kidney becomes extremely dilated with urine

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Causes of hydronephrosis include:

renal calculus, tumor, BPH (benign prostatic hypertrophy)

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Tx for hydronephrosis involves

removal of the obstruction before permanent damage to a kidney(s) occurs.

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CKD

chronic kidney disease

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The leading risk factors for CKD include:

DM, HTN, weight gain, smoking

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Women who drink two or more cans of regular soda per day are

twice as likely to develop CKD

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Cystitis is an:

inflammation of the urinary bladder AKA urinary infection

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Cystitis is more common in women because

the female urethra is shorter than in males

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The chief causative agent of cystits is

E. Coli (eschericha coli)

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Signs/symptoms of cystitis include:

urinary frequency, urgency, dysuria, bacteriuria, pyuria

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Tx for cystitis includes:

forcing fluids, antibiotics

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The Px for cystitis is

good

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Methods to decrease the incidence of cystitis include:

Wiping from front to back after a BM, Take showers instead of baths, dont douche, dont wear tight pants, cotton underwear, urinate after coitus, increase fluid intake, vitamin C

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Urethritis is:

inflammation of the urethra

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Urethritis in males may be caused by:

GC (gonococci)

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Signs/symptoms of urethritis:

dysuria, balanorrhea, testicular edema

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Urethritis in females commonly accompanies:

cystitis

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Tx for urethritis includes:

antibiotics (amoxcillian)

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PID stands for:

pelvic inflammatory disease

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PID refers to an:

inflammation of the female pelvic reproductive organs.

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Common causes of PID:

STDs, GC and chlamydia

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Signs/symptoms of PID:

lower abdominal pain, pyrexia, dysuria, pungent leukorrhea, dyspareuria

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A complication of untreated PID is:

infertility

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Tx for PID includes:

antibiotics, ASA, bed rest, and fluids

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Vaginitis is an inflammation of the vagina commonly caused by

Candida albicans, trichomonas (sexually transmitted parasite)

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Candidiasis is AKA:

yeast infection

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Signs and symptoms of vaginitis include:

pungent leukorrhea, vaginal pruritus, vaginal burning/soreness

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The incidence of yeast infections can be reduced by drinking 2 or more glasses of

milk daily

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Atrophic vaginitis is caused by

atrophy (no development) of the vaginal septa (walls).

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Atrophic vaginitis is commonly caused by a decrease in

estrogen associated with menopause

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A common complaint of atrophic vaginitis is:

dyspareunia (painful copulation)

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Tx for atrophic vaginitis includes:

ERT AKA HRT, Antibiotic creams, steroid creams, water soluble lubricants

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Puerperal sepsis is an infection of the endometrium occurring after:

parturition or abortion

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The most common cause of puerperal sepsis is:

poor aseptic technique during parturition/abortion

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The poor aseptic technique allows pathogens such as:

staphlococci, streptococci, or E.coli to enter the uterine wall; causes necrosis of the endometrium

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A complication of puerperal sepsis is:

septic shock

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Signs/symptoms of puerperal sepsis include:

pyrexia and chills, profuse or pungent lochia (smelly discharge after birth)

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Tx for puerperal sepsis is:

antibiotic therapy

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Cervical cancer refers to a:

malignancy of the Cx

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Cervical cancer has a good Px if:

detected before metastasis

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The most common test to detect cervical malignancy is the

PAP test every two years

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After age 30 and after 3 consecutive negative PAP tests:

every three years

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Pap tests should begin within :

3 years of becoming sexually active or by age 21

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CIS

Carcinoma in situ - A cervical lesion detected before metastasis

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Tx for CIS:

conization, cryosurgery, cauterization, hysterectomy

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Risk factors for cervical malignancy include:

poor hygiene, HPV, x sexual partners, early intercourse, smoking

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Fibroid tumors are:

benign tumors of the myometrium

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Fibroid tumors are also called:

leiomyomas

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The risk of developing leiomyomas is

1 in 5 women under the age of 50

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Signs and symptoms of fibroid tumors include:

pelvic pain, menorrhagia, metrorrhagia, dyspareunia

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Tx options for leiomyomas include:

myoectomy, myolysis, hysterectomy

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The most common ovarian neoplasm is an

ovarian cyst

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An ovarian cyst is usually:

benign, fluid filled sac

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An ovarian cyst will usually resolve with time but a large cyst that interferes with blood flow can be:

removed surgically

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PCOS

polycystic ovary syndromes - characterized by androgen (testosterone) and insulin imbalance

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Signs/symptoms of PCOS include:

wt gain, HTB, increased facial/body hair, alopecia, irregular menses, MDD, infertility

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PCOS can increase risk for:

cardiovascular disease and DM

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Tx for PCOS include:

healthy diet, regular exercise, BCPs, stop smoking

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Signs and symptoms of an ovarian malignancy include:

Prolonged abdominal bloating and pelvic pain, chronic fatigue, anorexia, wt loss, prolonged urinary frequency

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Risk factors for an ovarian malignancy include:

high fat diet, nulliparity, family hx of cancer, childbearing after 30, delayed menopause

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Ovarian malignancies occur more frequently:

perimenopausal and postmenopausal

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Tx for ovarian malignancy include:

oophorectomy, hysterectomy, chemotherapy, radiation

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If caught before metastasis, the five year survival rate for an ovarian malignancy is :

93%

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If caught after metastasis the five year survival rate for an ovarian malignancy is :

20-30%

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A chemical in the blood that can elevate with the presence of an ovarian malignancy is:

Ca-125

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The risk of ovarian neoplasms decreases with the use of:

BCPs

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The most common breast malignancy is an:

adenocarcnioma

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Adenocarcinomas occur more often in:

nulliparity, women w/ a family hx of breast Ca

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Adenocarcinomas frequently occur around the time of:

menopause

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Common signs of a breast malignancy include:

A hard fixed lump in the upper outer quadrant of a breast, Axillary lymphadenopathy , dimpling skin, papillary retraction, papillary discharge

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ACS mammogram recommendations include:

annually for 40-49 yr olds if hx exists, ages 50-74 every 2 yrs

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BSE should be preformed

every month starting at age 20

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A woman’s lifetime risk of developing a breast malignancy is

1 in 8

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Confirmation of the suspected tumor can be made with a:

stereotactic needle biopsy

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Malignant breast tumors can metastasize to the lungs, liver, brain, and bone via the :

lymphatic system

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Tx for breast malignancy includes:

lumpectomy, mastectomy, radiation, chemotherapy

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Factors that increase the incidence of a breast malignancy include:

ETOH,smoking, sedentary lifestyle, sugar, ERT, BCPs, nulliparity, folate deficiency

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Breast malignancy risk can be significantly reduced by :

moderate exercise, healthy weight, and breastfeeding

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Breast malignancies are more common in women over the age of :

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The younger a person is with a breast malignancy:

the more aggressive the disease

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The most common benign tumor of a breast is called a:

fibroadenoma

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Fibroadenomas are usually solid, round, rubbery, painless and:

move freely

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A second type of benign tumor of a breast is called :

FCC (fibrocystic changes), AKA lumpy breasts

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FCC usually occur in both breasts and increase in size and tenderness just prior to:

menses

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A third type of benign breast tumor is a fluid filled:

cyst

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Breast cysts are round, moveable, and may increase in size and become tender just prior to:

menses

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TSS is commonly caused by proliferation of :

staph (toxic shock syndrome)

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TSS is associated with:

tampon use

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Signs of TSS include:

hyperthermia, rash, peeling skin, GI distress, hypotension

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Tx for TSS includes:

fluid replacement, antibiotic therapy

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Women who use tampons are encouraged to:

change them frequently and avoid super-absorbent

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PMS is a group symptoms that start 1 to 2 weeks :

before menstruation and usually cease with the onset of menses

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Signs and symptoms of PMS include:

lower abdominal bloating and pain,Breast swelling and tenderness,Cephalalgia,WT gain,Acne,Insomnia,Mood swings, anxiety, MDD, irritability, hostility, crying spells, cravings, clumsiness, fatigue

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Tx for PMS includes:

increase water intake, exercise, support groups, stress management, avoid ETOH, caffeine and sugar, OTC analgesics

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MDD is a severe form of:

PMS

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The signs and symptoms of PMDD are severe enough to :

interfere with work, social activities, and relationships.

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Tx for PMDD includes:

sedatives and antidepressants.

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Endometriosis is a condition caused by:

ectopic endometrium

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The ectopic endometrium responds to the cyclic hormonal stimulation and can cause:

pelvic pain/bloating, menorrhagia, metrorrhagia, fatigue, sterlity

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Tx for endometriosis includes:

laparoscopic excisions of the ectopic endometrium, OCPs causing anmenorrhea

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An EP occurs when a fertilized ovum implants in tissue other than the :

uterus

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The most common site for an EP is a:

fallopian tube AKA tubal pregnancy

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Causes of Eps:

salpinitis associated with STDs causing fallopian adhesion's, endometriosis

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Signs/symptoms of an EP usually appear w/in 2 months include:

unilateral abdominal pain, vaginal bleeding, vertigo, weakness/syncope, N+V

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Tx for an EP includes:

Termination of pregnancy with methotrexate or laparoscopic salpingostomy.

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A spontaneous abortion is AKA

a misscarriage

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A spontaneous abortion during the first trimester is often caused by a

fetal gentic abnormality

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A spontaneous abortion usually occurs between the:

7th and 12th weeks of gestation (pregnancy).

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Causes of a misscarriage include:

infection, drugs ETOH smoking and cafferine, poor nutrition, toxins, radiation

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The surgical procedure performed to scrape the endometrium if placental tissue remains after a miscarriage is called a:

D+C

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Toxemia is AKA:

preeclampsia

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Preeclampsia only occurs during

pregnancy

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The principal signs of preeclampsia include:

PIH, Albuminuria, edema, unusual WT gain

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If seizures develop, the condition is called

eclampsia

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Prevention for preeclampsia include:

prenantal care, proper nutrition

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Prostatitis is an inflammation of the prostate commonly caused by:

e.coli or GC

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Signs and symptoms of prostatitis include:

urgency, frequency, dysuria, hematuria, painful ejaculation

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Prostatitis usually responds well to

anibiotic therapy

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BPH

nonmalignant enlargement of the prostate,Benign prostatic hypertrophy (BPH) is more common after the age of 50.

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The enlarged prostate can frequently be palpated by:

DRE

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The enlarged prostate squeezes the urethra and the patient will complain of:

dysuria and urinary retention

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Untreated urinary retention can cause :

hydronephrosis

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Tx for BPH includes:

Avodart/Flomax, cystoscopy and TURP

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A prostatic carcinoma may be small and initially:

asymptomatic

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Signs and symptoms of a prostatic carcinoma include:

dysuria, hematuria, anorexia and WT loss, nocturia, urinary incontinence AKA enuresis

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The blood test to detect a predisposition for prostatic carcinoma is :

PSA

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Prostatic carcinoma can metastasize to the:

rectums, lymph, and bone

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A good Px depends on

early dection

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Tx for prostatic carcinoma include:

chemo, bilateral orchiectomy, radiation and prostatectomy

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Cryptorchidism refers to an

undescended testicle

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Cryptorchidism can eventually cause

sterility

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Tx for cryptorchidism includes

orchiopexy or orchiectomy

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Impotence is the inability to achieve or maintain an erection AKA

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Causes of ED:

atherosclerosis, stress, DM, complications of prostatectomy, trauma, side effects, drug/ETOH abuse

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Tx for ED:

Viagra, Levitra, Cialis, penile implant

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STD AKA

STIs

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Methods to reduce incidence of STIs include:

abstinence, monogamy, barriers

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Chlamydia is the most common STD and the number one cause of

PID

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Signs and symptoms of chlamydia for women may include:

dysuria, pungent discharge, dyspareunia, dysmenorrhea, abdominal pain, vaginal pruritus

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Signs and symptoms of chlamydia for men may include:

dysuria, balanorrhea, testis edema

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Gonorrhea is caused by:

GC; the 2nd most common STD

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Gonorrhea transmitted to a fetus during delivery can cause:

blindness/death

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Signs and symptoms of gonorrhea usually appear

2-10 days after exposure

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Signs and symptoms of gonorrhea for women may include:

green/yellowish discharge, abdonminal/pelvic pain, pharynigitis, dysuria

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Signs and symptoms of gonorrhea for men may include:

green/yellow balanorrhea, dysuria, pharynigitis, testis edema

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The primary stage of syphilis is characterized by one or more painless ulcers that appear on the penis, labia, lips, tongue, or anus called

chancers

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A chancre will develop within a

10-90 days after sexual contact, tx with PCN (penicillin)

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`If primary syphilis is left untreated the secondary stage begins within :

6 weeks to 6 months after exposure and usually lasts 1 to 3 months.

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The secondary stage is characterized by

non prutic rash typically on palms and soles

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The secondary stage is treatable with

PCN (penicillin)

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The tertiary stage can occur:

years after primary infection

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The tertiary stage occurs in approximately :

30% of ppl infected w/syphilis

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Complications of the tertiary stage include

heart disease, blindness, mental illness, and death.

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Blood tests for syphilis:

VDLR, RPR, EIA

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Genital herpes is an extremely painful chronic viral disease caused by the

HSV II

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Symptoms of HSVII generally occur within

3 weeks of exposure

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Signs and symptoms of HSV II include:

multiple painful pruritic vesicles that appear on the genitalia, buttocks, and thighs, dysuria, discjarge

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The active lesions appear when the

immune system is compromised

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This disease is more easily transmitted when the lesions are

active

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Outbreaks of genital herpes can be treated with

antiviral drugs (there is no cure)

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HPV lesions commonly appear on the:

penis and scrotum in men and on the perineum in women

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The primary symptoms of the HPV are

pruritus and pain

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Uncircumcised men are

three times more likely to be infected with the HPV

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A vaccine is available for these four types of the HPV called

Gardasil, approved for males and females ages 9-26

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Tx for HPV:

antiviral meds, electrocautery, cryosygery

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