Incontinence
UTI
Patho/etiology
May result from bacterial, fungal, or parasitic infections; chemical irritants; foreign bodies; or trauma. Bacteria is normally cleared from the bladder by the flushing and dilutional effects of voiding. The high urea with high osmolarity along with the low pH of urine, acts as a natural barrier to pathogens. Escherichia coli is responsible for 85fl of community cases of bacterial cystitis. Less common in men but can be caused by an STI or immunosuppression.
Involuntary urine loss Requires both physiologic and cognitive capabilities. Requires functional nervous system and intact bladder and urethral function. Cognitive ability to react to bladder urges and be motivated to be continent. Neuron demyelination can cause a loss in message to the bladder
Diagnostic tests
Urinalysis* Residual urine measurement Filling cystometry studies Pressure flow studies during voiding
Clean-catch urine specimen and simple nitrite and leukocyte esterase dipstick test
Clinical manifestations Remember the different types of (signs and symptoms) incontinence
Acute onset of frequency, urgency, and dysuria Suprapubic pain Pink or cloudy urine
Involuntary leakage of urine.
Older adults may also show signs of delirium and new-onset incontinence.
Autosomal recessive Autosomal dominant polycystic Acute pyelonephritis Chronic pyelonephritis Polycystic kidney disease kidney disease Identified in the neonatal Most common hereditary cystic Obstruction or ureteral reflux that Chronic reflux of infected urine period, and when kidney disease involving both allows contaminated urine to enter into the renal pelvis. accompanied by kidneys but can occur at different the kidney. pulmonary hypoplasia, may rates. Risks: renal calculi, neurogenic result in death. If survives Risk factors are diabetes mellitus, bladder, vesicoureteral reflux, or to adulthood, retain some Eventually results in end-stage anatomic abnormalities of the underlying intrarenal disease. renal function, but kidney disease. urinary tract, and obstructive progressive decline in liver causes. function The cysts multiply and expand, kidney size increases, and a Kidneys retain their shape decline is seen in the glomerular but are enlarged, and the filtration rate (GFR). collecting ducts are dilated. Cysts can move to other organs, most common liver
Patho/etiology
Diagnostic tests
Family history, genetic testing, liver biopsy, and imaging techniques
Urinalysis revealing significant amounts of bacteria and white blood cell (WBC) casts
Renal Ultrasound
Ultrasound, CT scan, MRI
Clinical In the neonatal period: manifestations (signs respiratory distress, and symptoms) palpable kidneys, and systemic hypertension.
Mainly seen in patients who are 40 to 59 years old.
Sudden onset of fever, chills, CVA tenderness (classic sign- flank pain), nausea, vomiting, anorexia, and fever-induced dehydration.
Symptoms may be vague, inconsistent, or similar to acute pyelonephritis.
Ability to concentrate urine is decreased, hypertension, Flank or abdominal pain, fever, Progressive decline in liver proteinuria, hematuria, pain from Complications: abscesses, sepsis, malaise, or anorexia. function bleeding within the kidney, acute respiratory distress movement of kidney stones, and syndrome, recurrent/chronic development of urinary tract pyelonephritis, and chronic kidney infections. disease.
Renal Calculi Stones formed in the kidneys Urolithiasis: Stones formed anywhere in the urinary tract Etiology and Pathogenesis:
Acute glomerulonephritis Abrupt onset of hematuria, proteinuria, oliguria, azotemia, edema, and hypert