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Biomedicine (Semester II) > 11. Urinary System - Pathologies > Flashcards

11. Urinary System - Pathologies Flashcards

1
Q

Urinary Tract Infection (UTI): definition

A

Infection and inflammation of the urinary tract

Often bacterial

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2
Q

Who’s more likely to suffer with a UTI?

A

More common in women

Increases with age

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3
Q

Urinary Tract Infection (UTI): signs and symptoms

A 
Dysuria
Frequent urination
Nocturia
Cloudy, smelly urine
Suprapubic pain
Haematuria
Nausea
Confusion
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4
Q

Urinary Tract Infection (UTI): diagnostics

A

Dipstick: nitrites, leukocytes, erythrocytes

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5
Q

Cystitis: definition

A

Infection of the bladder

Can be acute or chronic

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6
Q

Who’s more likely to suffer from cystitis?

A

More common in women

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7
Q

Cystitis: aetiology

A

75%+ caused by bacteria (E. coli) from intestinal flora
Wiping back to front
Catheterisation (repeated use)
Post-menopausal (thinned lining)
Diabetes mellitus
Enlarged prostrate (chronic cystitis common in older men)

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8
Q

Cystitis: signs and symptoms

A 
Pain in loin (lower back/abdomen)
Dysuria
Frequent urination but only passing small amounts
Dark, smelly, cloudy urine
Malaise, nausea, fever
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9
Q

Cystitis: diagnostics

A

Dipstick: nitrites, leukocytes, erythrocytes

Urine microscopy: significant bacteriuria

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10
Q

Cystitis: allopathic treatment

A

Antibiotics

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11
Q

Pyelonephritis: definition

A

Infection of the kidneys

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12
Q

Pyelonephritis: pathophysiology

A

Bacteria spreading from bladder to kidneys

In rare occasions it can spread from the blood

Renal pelvis and calyces fill with purulent exudate

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13
Q

Pyelonephritis: aetiology

A 
Infection spreading up from bladder
Diabetes mellitus
Immunocompromised patients
Obstructed flow of urine (due to enlarged prostate, kidney stones)
Pregnancy
Gout
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14
Q

Pyelonephritis: signs and symptoms

A

Loin pain and tenderness (often unilateral)
Dysuria
Frequent urination
Haematuria
Cloudy, smelly urine
Malaise, nausea, fever, vomiting, fatigue

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15
Q

Pyelonephritis: diagnostics

A

Dipstick: nitrites, leukocytes, erythrocytes, proteins

Urine microscopy: bacteria, casts, blood cells, protein

Blood test: inflammatory markers and WBCs

Imaging: Ultrasound

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16
Q

Pyelonephritis: complications

A

Repeated episodes of acute pyelonephritis are common and can lead to chronic pyelonephritis
Chronic pyelonephritis can lead to the necrosis and scarring of renal tissue = kidney disease and renal failure

Septicaemia
Renal abscess
Secondary hypertension

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17
Q

Pyelonephritis: allopathic treatment

A

Large quantities of water/herbal teas (>2l/day)
Strict bed rest
Warm packs
Antibiotics

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18
Q

Glomerulonephritis: definition

A

Autoimmune disease that causes glomerular inflammation

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19
Q

Glomerulonephritis: pathophysiology

A

Autoimmune reaction (type III hypersensitivity)

Antigen-antibody immune complexes are formed in response to any infection

These immune complexes are deposited in the glomeruli where they trigger an immune response

This leads to leaky capillaries and leukocyte proliferation, allowing proteins and erythrocytes to escape into urine

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20
Q

Glomerulonephritis: aetiology

A

Primary - no associated disease elsewhere

Secondary - part of a systemic disease (e.g. SLE - lupus)

Autoimmune - often occurs 1-3 wks after a bacterial infection (often from upper respiratory tract). Common in children

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21
Q

Glomerulonephritis: signs and symptoms

A

Asymptomatic haematuria and/or proteinuria
Cloudy/frothy urine
Back pain (due to glomerular inflammation)
Fluid retention - peripheral and facial oedema
Oliguria
Hypertension (due to glomerulosclerosis. Scarring and fibrosis reduces renal flow and GFR resulting in an increase in renin)
Fatigue, headaches, fever, nausea

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22
Q

Glomerulonephritis: diagnostics

A

Urinalysis: erythrocytes, proteins

Blood test: inflammatory markers, low GFR, low serum albumin, elevated urea/antibodies

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23
Q

Glomerulonephritis: allopathic treatment

A

Corticosteroids
Antibiotics
Diuretics

24
Q

Nephrotic Syndrome: definition

A

Collection of signs and symptoms associated with increased glomerular permeability (leaking) and heavy proteinuria

25
Q

Nephrotic Syndrome: pathophysiology

A

Loss of plasma proteins leads to low plasma osmotic pressure (hypoalbuminaemia), so fluid moves out of capillaries into tissues = oedema

26
Q

Nephrotic Syndrome: aetiology

A

Glomerulonephritis, diabetic glomerulosclerosis
Systemic Lupus Erythematosus (SLE)
Infections - HIV, malaria, hepatitis
Drugs - NSAIDs

27
Q

Diabetic Kidney (Nephropathy): definition

A

Deterioration of kidney function

28
Q

What percentage of diabetics are likely to develop nephropathy?

A

40%

29
Q

Diabetic Kidney (Nephropathy): pathophysiology

A

Diabetes mellitus elevates blood pressure

Glomerulosclerosis occurs as a result of the increased glomerular pressure

The kidneys become enlarged (different to other pathologies)

Glomeruli become damaged and proteins leak

30
Q

Diabetic Kidney (Nephropathy): signs and symptoms

A

Initially none
Fatigue, nausea, vomiting
Pallor
Oedema

31
Q

Renal calculi: definition

A

Kidney stones
Most commonly made up of calcium oxalate and phosphate (80%)
2% of population have kidney stones
Men more commonly affected (3:1)

32
Q

Renal calculi: pathophysiology

A

Stones may stay in position and obstruct urine flow

They may migrate down the urinary tract, producing symptoms en route

33
Q

Renal calculi: aetiology

A

Dehydration (increased solute concentration)
Hypercalcaemia e.g. hyperparathyroidism
Gout (hyperuricaemia)
Renal anatomical anomalies

34
Q

Renal calculi: signs and symptoms

A

Often asymptomatic
Severe loin pain radiating to the groin (ureteric colic)
Trace of blood in urine (dipstick test)
Nausea, vomiting, fever

35
Q

Renal calculi: allopathic treatment

A 
NSAIDs
Increase fluid intake
Shockwave therapy
Surgery (if bigger than 6mm)
Avoid intake of oxalate rich food - rhubarb, spinach, cocoa
Avoid calcium
36
Q

What are diuretics?

A

Medications which increase loss of sodium and water from the kidneys

37
Q

What are diuretics used to treat?

A

Oedema

Hypertension

38
Q

What are the types of diuretics?

A

Thiazide diuretics
Loop diuretics
Potassium sparing diuretics

39
Q

What do thiazide diuretics do?

A

Act on the DCT

40
Q

What do loop diuretics do?

A

Act on the Loop of Henle

41
Q

What do potassium sparing diuretics do?

A

Act on the collecting ducts

42
Q

What do diuretics cause excess secretion of?

A

Potassium
Magnesium
Sodium
Chloride

*Need to replace to keep muscle/nervous system function

43
Q

Which foods act as diuretics?

A

Celery

Dandelion

44
Q

What does renal dialysis do?

A

Mimics the excretory function of kidneys to remove wastes/balance electrolytes

45
Q

Who needs renal dialysis?

A

Patients in renal failure

46
Q

Types of renal dialysis

A

Haemodialysis

Peritoneal dialysis

47
Q

What does renal dialysis increase the risk of?

A

Infection so often antibiotics are given

48
Q

What is haemodialysis?

A

Removing waste products (urea, creatinine) and water from blood

49
Q

Where is haemodialysis used?

A

Usually in hospital but can be out-patient

50
Q

How often is haemodialysis used?

A

Usually 3 times a week

3-4 hours each session

51
Q

What is peritoneal dialysis?

A

Uses the peritoneum’s structure as a highly semi-permeable membrane to allow for the diffusion of fluids and dissolved substances

52
Q

How does peritoneal dialysis work?

A

A tube is inserted into the abdomen which administers dialysis fluid through which waste products diffuse into

Removal occurs via a shunt

53
Q

Where is peritoneal dialysis used?

A

Often administered at home

54
Q

How long does peritoneal dialysis take?

A

Longer than haemodialysis but often more comfortable

55
Q

What does peritoneal dialysis increase risk of?

A

Peritonitis at site of tube exit

Biomedicine (Semester II) (20 decks)

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