Renal and Genitourinary Disorders

Renal and Genitourinary Disorders

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Renal and Genitourinary Disorders

Case Study

A 52 year old woman presented to the clinic for ongoing fatigue and weight loss during the last 6 weeks. She thinks she’s loss at least “10 pounds”. For the past week and a half she’s noted some progressing ‘muscle cramping’ tetany, as well as ‘tingling’ sensation around her mouth and lower extremities. She’s also noted some intermittent colicky abdominal pain. On your exam, you noted a positive Chvostek’s sign. PMH: 20 year history of Crohn’s disease. She also tells you that she is a practicing vegan.

List the primary diagnosis and rational
List at least 3 differential diagnosis with a brief rational
Describe the pertinent history required to rule in or rule out
Describe you physical exam findings or screening tools used
Discuss the treatment plan for the patient in your case study using this format

Prescriptions(s):

Interventions/ lifestyle changes:

Referrals:

Follow up:

Education:

(Minimum 2 references)

Overview of Genitourinary Disorders
What does genitourinary mean?

Genitourinary is a word that refers to the urinary and genital organs.

Urology is the branch of medicine concerned with the urinary tract in both genders and the genital tract of the reproductive system in males.

Nephrology is the branch of medicine concerned with the kidney.
What is the urinary tract?

The urinary tract includes the organ system primarily responsible for cleaning and filtering excess fluid and waste material from the blood. The urinary system is made up of the following:

Kidneys

Ureters

Bladder

Urethra

The kidneys also function as glands that produce hormones necessary for building red blood cells and regulating blood pressure.
What causes problems in the urinary system?

In children, problems of the urinary system include acute and chronic kidney failure, urinary tract infections, obstructions along the urinary tract, and abnormalities present at birth.

Diseases of the kidneys often produce temporary or permanent changes to the small functional structures and vessels inside the kidney. Frequent urinary tract infections can cause scarring to these structures leading to renal (kidney) failure. Some diseases that cause kidney damage include:

Glomerulonephritis

Hemolytic uremic syndrome

Polycystic kidney disease

Hydronephrosis

Urinary tract infections

Disorders of the urinary tract are often related to a blockage that prevents complete emptying of the bladder and often leads to reverse flow of urine. A urinary tract obstruction can cause damage to the urinary tract and kidneys because urine backs-up and pools in various areas along the tract. Pooling of urine in the bladder, ureters, or kidneys can lead to infection, scarring, and long-term kidney failure. Some disorders that cause obstruction of the urinary tract include:

Megaureter

Posterior urethral valves

Ureterocele or ureteral duplication

Vesicoureteral reflux

Neurogenic bladder

Several disorders of the urinary tract only affect males, which are largely related to the male anatomy as well as fetal development. Disorders that affect males may involve the penis, urethra, or testes. Some of the male urogenital disorders include:

Undescended testes or cryptorchidism

Hydrocele

Hypospadias

Inguinal hernia

Micropenis

Testicular torsion

Disorders of the genitourinary system in children are often detected by fetal ultrasound prior to birth. If not detected on fetal ultrasound, often children will develop a urinary tract infection that will prompt your child’s doctor to perform special diagnostic tests that may detect an abnormality. Some diseases of the kidney do not reveal themselves until later in life or after a child has a bacterial infection or an immune disorder.