1. By: Maria R. Garcia Presentation: 9 Medical Terminology Anatomy and physiology of the urinary system: abbreviations-ARF: Acute renal failure-CC: clean catch urine specimen-ESRD: end-stage renal disease-cysto: cystoscopy-UTI: Urinary tract infection

2. ARF: Acute Renal Failure An abrupt or rapid decline in renal filtration function, kidneys have stopped working Also known as acute kidney injury (AKI) Can lead to build up of waste, fluids and electrolytes in the body Condition starts with rise in serum creatinine concentration or by azotemia

3. What causes acute renal failure ? A drop in blood flow to the kidneys, heavy blood loss, dehydration or an infection called sepsis. Medicines can also cause damage such as: antibiotics, pain medicine, blood pressure medication and dyes from x-ray tests Blockage from urine flowing out of the kidneys , kidney stones, tumor, injury or an enlarged prostate

4. Who is at risk and what are the symptoms of ARF? If you are an older adult Long term health problems with your kidney, have liver disease, diabetic, have high blood pressure, heart failure and obese SYMPTOMS Little or no urine when you urinate Swelling, especially in your legs and feet. Loss of appetite Nausea and vomiting Feeling confused, anxious and restless, or sleepy Pain in the back just below the rib cage

5. How is ARF treated? A kidney specialist will look into what is causing your kidneys to fail A doctor may restore blood flow and stop any medicines you may be taking Your doctor may recommend dialysis if waste is building up in your body Your doctor may put you on antibiotics to help with the infection Some may have permanent kidney damage that can lead to a chronic disease

6. CC: Clean Catch Urine Specimen A clean catch urine specimen is a sample of urine that is collected in a special way Clean catch means your first clean yourself with the disinfectant towelette and then you urinate directly in a cup For example one would receive a CC if you had an infection in your urinary tract A doctor would test your urine using a CC that would help keep out the bacteria that is on your skin but not in your urinary tract

7. How does one collect a CC? First you health care provider will give you a cup to urinate in Second, before you urinate in the cup make sure to wash your hands Third, remove the lid with clean hands without touching the inside of the cup Fourth, gently wipe your vagina or penis with a packaged disinfectant wipe Fifth, start urinating in toilet and place cup under the stream of urine. You will only need 2 tablespoons of the urine. Once complete place back lid and wash your hands

8. What are the results of a CC? Depending on the type of test your doctor ordered one could have normal or abnormal If the urine test was sent for urinalysis then abnormal results would mean a presence of white blood cells, red blood cells or large amounts of protein If the urine test was sent for urine culture then abnormal results may indicate bacteria, urinary tract infection or a bladder infection

9. ESRD: End-stage kidney disease End-stage kidney disease occurs when the kidneys no longer can function day to day. ESRD occurs when a persons chronic kidney disease has worsened and which the kidney can no longer function and is less that 10% normal A person with chronic kidney disease gradually worsens for 10-20 years and progresses to end-stage kidney disease People who reach to ESRD will need dialysis or a kidney transplant

10. Causes and symptoms of ESRD The most common cause of ESRD are diabetes and high blood pressure Symptoms of ESRD: -Fatigue - Breath odor -Itching and dry skin - Excessive thirst -Headaches - Swelling of feet and hands -Increase weight loss without trying - Bone pain -Loss of appetite - Brain and nervous system symptoms -Nausea - Easy bruising and nose bleeds

11. Exams and tests for ESRD If one has high blood pressure a brain and nervous system test will be ordered to examine the signs of nerve damage A doctor would listen for abnormal heart rate or lung sounds with a stethoscope A patient with ESRD will make less urine or most likely stop so many tests will need to be run

12. Treatment for ESRD For now the only treatment for ESRD is dialysis or a kidney transplant Other treatments could include: extra calcium and vitamin D , special medicines called phosphate binders, to help prevent phosphorous levels from becoming too high, treatment for anemia, iron pills, special shots of a medicine called erythropoietin, and blood transfusions. Without dialysis or a kidney transplant or other treatments one would die from the buildup of fluids and waste in the body

13. Cysto: Cystoscopy Test that is used to look at the inside of the bladder and the urethra using a thin instrument with lighting called a cystoscope A doctor would use a cystoscope when an x-ray does not show up well. Thus a cystoscope is inserted in the urethra and then into the bladder for better viewing If a doctor finds suspicious growths with a cystoscope they will be removed to avoid future surgery

14. Why would one need a Cysto? Blood in urine Painful urination Urinary frequency Inability to pass urine Repeated urinary tract infections Blockage in urethra Stones or growths Bleeding in bladder Remove tumors

15. How is the cystoscopy done? Is done by a Urologist Cystoscopy generally is a very safe test You will be given a sedative to relax You will lie on your back on a special table with your knees bent and legs apart A well-lubricated cystoscope is inserted into your urethra and slowly advanced into your bladder The cystoscope is usually in your bladder for only 2 to 10 minutes. Common side effect are temporary swelling of the urethra, which may make it difficult to urinate. A catheter inserted in your bladder can help drain the urine until the swelling goes awayand bleeding sometimes occurs

16. Cystoscopy results: Normal – the urethra, bladder and uretersappear normal, no polyps or other abnormal tissues, swelling, bleeding, narrow areas (strictures), or structural abnormalities. Abnormal -There is swelling or narrowing of the urethra, there are tumors, polyps, ulcers and inflammation and pelvic organ prolapse

17. UTI: Urinary Tract Infection Is an infection in your urinary system such as the kidneys , ureters, bladder and urethra Women are at greater risk of contracting a UTI UTI can spread to your kidney and can become painful if untreated Antibiotics are usually given to medicate UTI

18. UTI: Symptoms Persistent urge to urinate Burning sensation when urinating Passing small amounts of urine Urine that appears cloudy Urine that appears bright pink or cola colored which is a sign of blood in the urine Strong-smelling urine Pelvic painor Rectal pain

19. UTI: Causes If in the bladder it is usually caused by E. Coli and sexual intercourse If in the urethra it is caused by gastrointestinal bacteria spreading from the anus to the urethra, sexually transmitted diseases (STDs), such as herpes, gonorrhea and chlamydia

20. UTI: Tests and Diagnosis Taking a urine sample in a cup by first wiping the area clean. The urine is then tested to look for pus, red blood cells or bacteria Urine culture can be taken to grow bacteria in a lab. This test allows your doctor to see what bacteria is causing your infection and which medications will be helpful A CT scan may be ordered or a scope to see the inside of your bladder

21. UTI: Treatment and Drugs Antibiotics are usually given to treat UTI Antibiotics commonly used to treat UTI are: Sulfamethoxazole-trimethoprim,Amoxicillin (Larotid, Moxatag), Nitrofurantoin(Furadantin, Macrodantin), Ampicillin,Ciprofloxacin(Cipro) and Levofloxacin(Levaquin If the medication is taken properly, symptoms should clear up in a few days