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2 - CPR (renal) > 20-7 (Obstructive Uropathy) > Flashcards

20-7 (Obstructive Uropathy) Flashcards

1
Q

Obstructive lesions of the urinary tract increase your risk for what 2 things?

A

Infection

Stones

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2
Q

If the obstructive lesion in the urinary tract is unrelieved, what will occur?

A

Permanent renal atrophy

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3
Q

Dilation of the renal pelvis and calyces

A

Hydronephrosis

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4
Q

With an acute obstruction, what is the likely symptom?

A

Pain due to distention

– other symptoms based on cause

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5
Q

With a unilateral or partial obstruction, what is the likely symptom?

A

SILENT

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6
Q

With a bilateral partial obstruction, what is the likely symptom?

A

Inability to concentrate urine

=> polyuria and nocturia

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7
Q

With a bilateral complete obstruction, what is the likely symptom?

A

Oliguria or Anuria

– incompatible with life

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8
Q

If the bilateral complete obstruction is removed, what is the post-op symptom?

A

Diuresis – excreting lots of urine

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9
Q

Oliguria or Anuria is what type of obstruction?

A

Bilateral complete

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10
Q

Inability to concentrate urine (polyuria and nocturia) is what type of obstruction?

A

Bilateral partial

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11
Q

Silent (asymptomatic) is what type of obstruction?

A

Unilateral or partial

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12
Q

What population is more often affected by urolithiasis (stones) and where do most stones arise?

A

Men 20-30

– Arise in kidney

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13
Q

What are the 4 types of calculi (stones)?

A
  1. Calcium oxalate/phosphate
  2. Magnesium Ammonium phosphate
  3. Uric acid
  4. Cystine
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14
Q

What are the 4 types of calculi (stones)?

A
  1. Calcium oxalate/phosphate
  2. Magnesium ammonium phosphate
  3. Uric acid
  4. Cystine
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15
Q

What is the main mechanism for how stones arise?

A

Increased urinary concentration of the stones’ constituents such that it exceeds their solubility

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16
Q

What is the main mechanism for how stones arise?

A

Increased urinary concentration of the stones’ constituents such that it exceeds their solubility

17
Q

Besides supersaturation with stone contents, what are some other general causes of stones (4)?

A
  • Changes in urine pH
  • Decreased urine volume
  • Bacteria present
  • Decreased inhibitors of crystal formation in urine
18
Q

Calcium stones can be due to what types of molecular changes?

A 
Hypercalcemia diseases 
Hypercalciuria
Increased uric acid secretion
Hyperoxaluria
Hypocitraturia
19
Q

The main molecular cause of calcium stones is?

A

Hypercalciuria without hypercalcemia

– Increased intestinal absorption/renal tubular issue

20
Q

If Hypocitraturia is causing the calcium stones, what are the 2 signs?

A

Acidosis + diarrhea

21
Q

How do Magnesium Ammonium Phosphate stones form?

A

Formed after infections by urea splitting bacteria that convert urea –> ammonia

22
Q

How do Magnesium Ammonium Phosphate stones form?

A

Formed after infections by urea splitting bacteria that convert urea –> ammonia

23
Q

What bacteria are considered urea splitting bacteria?

A

Proteus
Pseudomonas
Klebsiella
Some Staphylococci

24
Q

Once bacteria convert urea to ammonia with struvite stones, what does that do to the urine?

A

Alkaline urine

25
Q

Describe the size of magnesium ammonium phosphate stones and what is a special kind?

A

LARGE

- Staghorn stones = occupy renal pelvis

26
Q

Uric acid stones are common in people with hyperuricemia (gout/leukemia). Although, a majority of people with uric acid stones do not have?

A

Do NOT have hyperuricemia or increased uric acid secretions!!! (weird)

27
Q

A majority of people with uric acid stones do NOT have?

A

Hyperuricemia or increased uric acid secretions

28
Q

How do the stones look when made of uric acid?

A

Radiolucent

29
Q

Defects in renal reabsorption of amino acids will cause what type of stones to form?

A

Cystine

30
Q

Calculi can be asymptomatic or cause pain/colic. What will larger stones cause and what are patients with stones at risk for?

A

Larger stones = hematuria

– Increased risk for superimposed infections

2 - CPR (renal) (27 decks)

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