Module 11 Part 1

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Dysuria & Incontinence
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1

Pt w/ frequent urination, hematuria, no pain during urination, negative bacteria culture

What does the pt most likely have?

Interstitial Cystitis (IC)

2

Interstitial Cystitis (IC): What is it?

Damaged urothelium (bladder lining)

3

Antiproliferative Factor (APF): What does it do?

**ON EXAM**

Blocks normal growth of cells in bladder

- seen in som IC patients

4

Interstitial Cystitis(IC): Hemorrhagic ulcers

Hunner's Ulcers

5

Interstitial Cystitis(IC): S/s

**ON EXAM** "w/o what?"

-S/s as UTI w/o bacteria

-Increase urinary frequency

-Irritation of bladder wall: Bleeding/pain, inflamation-fibrosis

6

Interstitial Cystitis(IC): S/s

What is a Hemorrhagic Ulcer called?

**ON EXAM**

Hunner's Ulcer

7

Benign Prostatic Hyperplasia(BPH): What is it?

*Enlargment of prostate --> too many cells*

8

Benign Prostatic Hyperplasia(BPH): Causes

-FH, Obese w/ central fat distribution (chronic inflammatory state)

- increase 5 alpha-Reductase enzyme activity

- decrease testosterone, increase DHT

- Decrease androgen(male hormone), increase estrogen(femal hormone)

9

Benign Prostatic Hyperplasia(BPH): What does 5 alphe-reductase do?

It converts testosterone into (DHT) dihydrotestosterone

10

Benign Prostatic Hyperplasia(BPH): S/s

-Hesitant, interrupted, weak stream

urgency, frequency, nocturia, leaky/dripping (bc incomplete emptying)

11

Benign Prostatic Hyperplasia(BPH): Late stage

Hematuria, bladder/kidney infections, hydronephrosis

12

Benign Prostatic Hyperplasia(BPH):

___beer --> ___estrogen = _________

increase beer --> increase estrogen = Boobs (Gynecamastia)

13

Urine Incontinence: Stress incontinence; describe

- <60 yrs/o

- decrease pelvic floor muscles

14

Urine Incontinence: What is the muscle called that constricts the bladder?

Detrusor muscle

15

Urine Incontinence: Urge Incontinence; describe

-in older adults

- Over active nerves controlling bladder(detrusor muscle)

- neurological disorders: parkinsons, MS, CNS, Peripheral nerve damage

16

Urine Incontinence: S/s

-Same S/s as UTI

17

Urine Incontinence: Testing

-Clincal

- Pelvic US

R/o UTI

18

Diarrhea: Acute

duration

more then 3 loose/watery stools w/in 24hrs lasting les than 2 wks

19

Diarrhea: Persistent

duration

2-4 wks

20

Diarrhea: Chronic

Duration

>4wks

21

Diarrhea: Osmotic Diarrhea

Artificial sweeteners - Sorbitol

ex. Haribo Gummy Bears

22

Diarrhea: Secretory diarrhea(large volume)

viral, bacterial or perisitic

23

Diarrhea: Secretory diarrhea(small volume)

UC, cronh's,

24

Diarrhea: Motility diarrhea

(decrease transit time)

SI resection, IBS, Laxative abuse

25

Diarrhea: S/s

dehydration

26

Diarrhea: Testing

-culture

- ova & parasite (o&p) test

-CT

- Rectal exam

27

Diarrhea: Tx

BRAT

-Antimotility agent , Treat underlying cause

bannana

Rice

Apple sauce

Toast

28

Diverticulitis: What is it?

*Caused by diverticulosis(herniation) out pouching of GI tract. Can become inflamed/infected*

29

Diverticulitis: What kind of problem?

Large Intestine problem

30

Diverticulitis: Where is it MC?

Where is it rare in?

Sigmoid colon

Rare in SI (small intestine)

31

Diverticulitis: Causes

-Elderly, Genetic predisposition, obesity, Smoking

- low fiber fiet, low physical exercise

- Aspirin & other NSAIDS

32

Diverticulitis: S/s

What can it lead to?

-Abdominal pain, cramping, N/V, Leukocytosis

- Can lead to: abscess, perforations, bleeding, peritonitis, scaring - blockage, fistula - sticks to other organs

33

Diverticulitis: Testing

-Routine colonoscopy

-CT, abdominal US

34

Diverticulitis: BRBPR

Bright, Red, Blood, Per, Rectum

35

Diverticulitis: Tx

-High fiber (soft stools decrease pressure iside intestines

-surgery if severe complications