Pathology Chpt.10-11 cont.

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Section 1

Question Answer
A simple way to promote urinary system health is to _______ ?Stay hydrated
If you are well hydrated, what will your kidneys do?Excrete extra water in the urine.
What happens as urine flows regularly?It flushes microorganism from the bladder and urethra, preventing UTIs.
What does good hydration reduce the risk of developing?Kidney and bladder stones.
Why is the best drink in most circumstances plain water?It adds no salt, sugar, calories, or caffeine to the diet.
After years of diabetes mellitus, mature adults have a risk for developing ?Diabetic nephropathy.
What is the best way to reduce the risk for diabetic nephropathy?Manage diabetes mellitus from the first day it is diagnosed.
Kidney damage of diabetic nephropathy is cumulative and _____, so it is much better to prevent this disease than to deal with its consequences.irreversible
End-stage renal disease (ESRD) is a ________ of kidney functioning and ends in _______.complete failure - death.
What measures can reduce the risk for ESRD?Control blood pressure and blood sugar levels - If diabetic or hypertensive, monitor total urine protein levels - If at high risk for ESRD, reduce dietary protein - Do not smoke.
Chronic kidney disease if a life-threatening and potentially preventable. A number of lifestyle choices reduce the risk for developing CKD. What behaviors reduce the risk for atherosclerosis and heart disease?Do not smoke - Reduce or eliminate alcohol use - Control weight - Reduce dietary fat, sodium, and sugar - Control blood pressure - Control diabetes.
How does atherosclerosis contribute to kidney disease?As renal arteries and their small branches within the kidneys narrow, systemic blood pressure increases. The decreased blood to kidney causes them to release renin, which converts the plasma protein antiotensin into antiotensin I. In the liver and lungs, angiotensin I is converted to angiotensin II, which triggers vasoconstriciton and aldosterone secretion, resulting in hypertension.
What are signs and symptoms of Hypertensive kidney disease caused by atherosclerosis?Systemic hypertension symptoms such as headache, heart palpitations and tachycardia, light-headedness, and anxiety. Damage to retina can be observed.
What does sustained hypertension elevate the risk for?Heart failure, myocardial infaction, and stroke.

Section 2

Question Answer
Diagnosis of hypertensive kidney disease begins with a patient history. What tests can be done to determine which kidney is affected and where the problems lie?Ultrasound and renal arteriography permit visualization of blood flow and obstruction. The blood in the renal veins can be tested for elevated renin to determine which kidney is affected.
Why do dietary factors affect kidney health?Controlling weight, blood lipids, sodium intake, sugar levels, and engaging in regular exercise may help control progression of renal disease.
When should women begin to perform monthly brease self-examinations?In their 20's
When should women perform breast self-examinations each month?If still menstrating a few days after your period has ended. In not menstruating on the same day each month.
What is step 1 for a breast self-examination?Begin by looking at your breast in the mirror with your shoulders straight and your arms on your hips. What you should look for: Breats that are their usualy size, shape, and color. - Breasts that are evenly shaped without visible distortion or swelling.
During steps 1 & 2 of breast self-examination if you see these changes you should bring them to your doctor's attention.Dimpling, puckering, or bluging of the skin - A nipple that has changed position or an inverted nipple (pushed inward insteat of sticking out) - Redness, soarness, rash, or swelling.
What is step 2 for a breast self-examination?Raise your arms and look for the same changes as in step 1.
What is step 3 for a breast self-examination?While you're at the mirror, look for any signs of fluid coming out of one or both nipples (this could be watery, milkey, or yellow fluid or blood). Feel your breast while lying down, using your right hand to feel your left breast and then your left hand to feel your right breast
What is step 4 for a breast self-examination?Feel your breast while lying down, using your right hand to feel your left breast and then your left hand to feel your right breast. Use a firm, smooth touch with the first few finger pads of your hand, keeping the fingers flat and together. Use a cirucular motion, about the size of a quarter.Cover the entire breast from top to bottom, side to side - from your collarbone to the top of your abdomen, and from your armpit to your cleavage. Be sure to feel all the tissue from the front to the back of your breasts. For the skin and tissue just beneath, use light pressure; use medium pressure for tissue in the middle of your breasts; use firm pressure for the deep tissue in the back. When you've reached the deep tissue, you should be able to feel down to your ribcage.
What is step 5 for a breast self-examination?Feel your breast while you are standing or sitting. Many women find that the easiest way to feel their breast is when their skin is wet and slippery, so they like to do this step in the shower. Cover your entire breast, using the same hand movements described in Step 4.
How often should women have a clinical breast examination?For women in their 20s and 30s every 3 years. After age 40, every year. After age 50 a mammogram should be done every year.

Section 3

Question Answer
With age comes less control over urination as what muscles lose tone?Urethral sphincter
The total number of functions nephron units declines with age. As much as _____ of the nephrons may degenerate between ages ____ and _____.30% to 40% , 25 and 85.
Kidney loses sensitivity to ___.ADH
Reduction of _______, and therefore _________ activity, causes a lack of salt and water retention, allowing more _____ to be released by the kidney.rennin , aldosterone , urine
Urinary retention may also occur because ?The urinary bladder loses muscle tone and cannot empty completely.
________ exacerbates urine retention and is common in men because of _________.Obstruction , prostate enlargement.
Urinary retention increases the risk for ?Urinary tract infections and stone development.
Kidney cancer increases significantly after age ______, and incidence of bladder cancer increases after ago _____.60 , 70
What is menapause and when does it usually occur?Not a disease, but a physical change related to aging. Usually takes place between 45 and 55 years of age. As a woman ages the ovaries produce less estrogen and progesterone. Ovulation and menstration ceases.
What are the common signs and symptoms of menopause and how is it diagnosed?Hot flashes, night sweats, trouble sleeping, mood swings, trouble focusing, hair loss or thinning, facial hair growth, and vaginal dryness. It is diagnosed by syns and symptoms, elevated FSH, and low estrogen.
What is Uterine prolapse?Falling or sliding of the uterus from its normal position in the pelvic cavity into the vaginal canal. Prevalence is not known.
What are the risk factors and signs and symptoms for Uterine Prolapse and how is it diagnosed?Age, one or more vaginal births, and giving birth to a large baby. Signs and symptoms may include feelings of heaviness in the pelvic area, urinary difficulties, and a feeling like you are sitting on a small ball. Diagnosis may include pelvic examination, ultrasound, and MRI.
What causes Uterine Prolapse and what is the treatment?Trauma to the fascia, muscle and pelvic ligaments during pregnancy and delivery or atrophy of the pelvic floor muscles with age. Ligaments and muscels become overstretched and can no longer hold the uterus in place. Treatment consists of strengthening the pelvic floor muscles (Kegel exercises), inserting a pessary (removable device placed in the vagina designed to support areas of pelvic organ prolapse) into the vagina to support the uterus, or surgery. Uterine prolapse is not preventable.

Section 4

Question Answer
What is cystocele and what is the etiology of cystocele?A downward displacement of the urinary bladder into the vagina. (A bladder hernia) Etiology is trauma to the fascia, muscle, and pelvic ligaments during pregnancy and delivery.
What are the sins and symptoms of cystocele, how is it diagnosed and what is the treatment?Pelvic pressure, urinary urgency and frequency, and incontinence. Diagnosis is made by pelvic examination. Treatment includes Kegel exercises, vaginal pessary, or surgery.
What is Rectocele and what is the etiology of Rectocele?Bulging of the front wall of the rectum into the vagina. Etiology is trauma to the fascia, muscle , and pelvic ligaments during pregnancy and delivery, or atrophy of the pelvic floor muscels with age.
What are the risk factors, signs and symptoms, how is it diagnosed, and what is the treatment for Rectocele?Aging, one or more vaginal births, and obesity. Signs and symptoms include discomfort, constipation, and fecal incontinence. Diagnosis may include pelvic examination, MRI, and x-rays. Treatment includes Kegel exercises, vaginal pessary, and surgery.
Enlargement of the prostate gland, or benign prostatic hyperplasia (BPH) is so common that it is estimated that it affects ____ of men in the ____ and ____ of men in ther ___ and ___. What is the cause of BPH?60% - 60's , 80-90% - 70's & 80's. The cause is idiopathic and it is probably a normal part of the aging process in men. Dihydrotestosterone (DHT) is a metabolite of testosterone. BPH is directly dependent on DHT.
What are the risk factors, and signs and symptoms of BPH?Risk factors include age and a family history of enlarged prostate. Less than half of all men with BPH are symptomatic; signs and symptoms may include dribbling at the end of urinating, inability to urinate, incomplete emptying of the bladder, incontinence, needing to urinate two or more times per night, pain with urination, bloddy urine, slowed or delayed start of the urinary stream, straining to urinate, strong and sudden urge to urinate, and weak urine stream.
How is BPH diagnosed and what is the treatment?Diagnosis may include medical history, DRE, urine analysis, culture, PSA blood test, ultrasound, urodynamic testing, and cystocscopy. Treatment options include watchful waiting, medications such as an alpha blocker to relax smooth muscle in the prostate and increase urinary flow, hormone therapy to block the conversion of testosterone to DHT, and surgery.
The number of older people living with HIV?AIDS has increased over the years, partly because of the effectiveness of _______ therapy that permits people with HIV/AIDS to live longer. Recently ___ of all new HIV/AIDS cases have occurred among people age ___ . Overall, about ___ in ___ people living with HIV/AIDS are age ___ and older.antiretroviral. 15% - 50 and older. 1 in 4 - 59 and older.
What are the best ways to prevent STIs. (Sexually transmitted infections)?Don't have sex - Be monogamous - Use condoms - Know that birth control pills, shots, implats, spermicides, or diaphragms will not protect you from STIs. - Talk with your sex partner(s) about STIs and using condoms. - Don't abuse drugs or alcohol - Get tested for STIs - Have regular pelvic examinations.
STIs are infections spread by sexual contact. Sexual contact includes what type of unprotected intercourse? STIs are cause by what? What are the risk factors for STIs?Oral, anal or vaginal. - Bacteria, viruses, and protozoans. - Unprotected six, multiple sex partners, a history of STIs, being under the age of 25, and sexual contact while under the influence of drugs or alcohol.
WHO estimates how many new cases or curable STIs (syphilis, gonorrhoea, chlamydia, and trichomoniasis) occur annually throughout the world in adults of what ages?448 million - 15 to 49.
The CDC estimates how many new STIs occur each year in the U.S., almost half of them among people of what ages? STs cost the U.S. health care system an estimated _____ annually.20 million - 15 to 24. - $16 million.
Some STIs cause no or relatively minor signs and symptoms, but undetected infections can have serious consequences, including what?Infertility, PID (Pelvic Inflammatory Disease), cervical cancer, and adverse pregnancy outcomes.

Section 5

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