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6- UA > 7- Diseases & Related Urine Findings > Flashcards

7- Diseases & Related Urine Findings Flashcards

1
Q

Congenital Anatomical Variations Affecting UT

A

– Duplicate sets of ureters

– Horseshoe kidney

– Vesicoureteral reflux (VUR)

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2
Q

Acquired Anatomical Variations Affecting UT

A

– Accidents and injuries can damage the kidneys or urinary tract

– Benign prostatic hyperplasia (BPH)

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3
Q

the most common renal congenital abnormality

A

Duplex Collecting System

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4
Q

Duplex Collecting System is characterized by

A

complete or incomplete duplications

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5
Q

Most common among

(what gender)

A

Females

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6
Q

Def: two separate pelvicalyceal systems draining a single renal parenchyma

A

duplex kidney

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7
Q

independent ureters that drain separately into the urinary or genital tract, and are seen in complete or incomplete duplication

A

double/duplicated ureters

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8
Q

describe partial (incomplete) duplications

A
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9
Q

Partial (incomplete) duplications can be associated with

A

ureteroureteral reflux and deformation of the ureter (ureterocele)

or

ureteropelvic junction obstruction of the lower pole of the kidney

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10
Q

define: Complete duplications of the ureters

A

the two ureters drain separately

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11
Q

describe how the Complete duplication ureters connect to the bladder

A

one ureter opens normally

the other opens in wrong place (ectopic)

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12
Q

Most duplicated systems are (symptomatic/asymptomatic)

A

asymptomatic

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13
Q

duplicated systems are important predisposing factor for the development of ___ in newborns or children

A

UTI

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14
Q

Def: a coindition that can be severe enough to result in flank discomfort or even a palpable mass

A

hydronephrosis

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15
Q

Hydronephrosis is a condition that typically occurs when the kidney

A

swells due to the failure of normal drainage to bladder

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16
Q

Is hydronephrosis a primary or secondary disease?

A

secondary

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17
Q

Def: is a congenital disorder affecting about 1 out of 400 people

(renal fusion or super kidney)

A

Horseshoe kidney

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18
Q

most common disorders seen with horseshoe kidney include

A
  • Turner syndrome (45,X0)
  • Trisomy 18 (47,xx)​
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19
Q

The fused part of the horseshoe kidney is the

A

isthmus

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20
Q

The isthmus is usually located at

A

L4/5 level between the aorta and inferior mesenteric artery

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21
Q

Horseshoe kidney is most common in

(gender)

A

men

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22
Q

what’s the symptoms of Horseshoe kidney?

A

none

it’s often asymptomatic

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23
Q

Horseshoe kidney increase risk for development of some disease as a result of

A

poor drainage of the urine

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24
Q

Def: an abnormal retrograde movement of urine from bladder into ureters

A

Vesicoureteral Reflux (VUR)

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25
Q

Define primary VUR

A

defect in development of the ureteral valve (short, ineffective flap valve) at the end of the ureter (only in children)

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26
Q

Define secondary VUR

A

occurs when an obstruction in the bladder or urethra causes urine to flow backward into the kidneys (at any age)

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27
Q

Urinary Tract Infection affects:

A
  • bladder (cystitis)
  • kidneys (pyelonephritis)
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28
Q

UTI Etiology

A
  • Bacteria ( 80-85% E. Coli)
  • Viral
  • Fungal (candidiasis)
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29
Q

UTI risk factors are

A
  • urinary tract obstruction:

In pregnancy urolithiasis prostate enlargement tumors etc.

  • catheterization
  • diabetes mellitus
  • congenital anatomical abnormalities
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30
Q

Acute Cystitis symptoms

A
  • dysuria (painful urination)
  • increased frequency of urination
  • increased urinary urgency
  • lower abdominal pain (discomfort in the pelvic area)
  • rarely causes systemic symptoms (fever, chills)
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31
Q

Pyelonephritis symptoms

A
  • causes systemic symptoms (fever, chills, nausea, vomiting)
  • flank pain
  • dysuria
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32
Q

Urinary tract infection urinalysis findings

A
  • cloudy urine
  • unusual urine color
  • pungent odor
  • specific gravity over 1.025

– increased count of leukocytes (neutrophils)

– positive leukocyte esterase

– presence of bacteria (not always)

– may have positive nitrite

– alkaline urine is found in presence of bacteria

– WBC, or bacteria casts may be present, they indicate only kidney infection

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33
Q

a common cause of upper urinary tract obstruction are

A

Kidney stones

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34
Q

Kidney stones aka

A

Urolithiasis

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35
Q

Kidney stones can cause severe pain in passage known as

A

ureteral (renal) colic

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36
Q

Kidney stones classic presentation includes severe pain originating in the

A

flank, or back

radiating inferiorly and anteriorly to groin

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37
Q

Does changing postion releave kidney stones pain?

A

No

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38
Q

At least 50% of kidney stones patients will also have

A
  • systemic symptoms (nausea, vomiting, tachycardia)
  • dysuria due to obstruction of the urinary tract
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39
Q

Hypertension results in damage of blood vessels of the kidney known as

A

benign nephrosclerosis

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40
Q

Define benign nephrosclerosis

A

hyaline accumulates in the wall of small arterioles causing hyaline arteriolosclerosis, which leads to ischemia

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41
Q

Diabetes mellitus is manifested by

A
  • polyuria
  • polydipsia
  • malaise
  • fatigue
  • microangiopathies (the small blood vessels of the body are injured)
  • diabetic nephropathy
  • peripheral neuropathy
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42
Q

Diabetic nephropathy is characterized by

A
  • glomerular lesions (diffuse glomerulosclerosis, Kimmelstiel-Wilson lesions)
  • renal angiopathy (hyaline arteriolosclerosis, atherosclerosis)
  • pyelonephritis
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43
Q

Diabetic nephropathy is often manifested by

A

nephrotic syndrome

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44
Q

Glomerular diseases present with

(what conditons)

A
  • nephritic syndrome
  • nephrotic syndrome
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45
Q

Define Nephritic Syndrome

A

increased permeability of the glomeruli for red blood cells, and reduced permeability for water

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46
Q

Nephritic Syndrome Signs and Symptoms

A

- hematuria with RBC casts

- oliguria

- azotemia

- hypertension

  • proteinuria < 3g/d
  • edema
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47
Q

Define Acute proliferative glomerulonephritis

A

Immune complexes become lodged in the mesangium and glomerular basement membrane below the podocyte foot processes

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48
Q

Complement activation leads to

A

destruction of the basement membrane

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49
Q

Changes in urine in acute proliferative (post-streptococcal, postinfectious) glomerulonephritis are typical for Nephritic syndrome are:

A
  • hematuria (gross- or micro-)
  • oliguria
  • edema (local, under the eyes)
  • cell casts (red blood, and renal epithelial)
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50
Q

Define: Rapidly Progressive (Crescentic) Glomerulonephritis

A

syndrome of the kidney disorders

rapid loss of renal function

acute renal failure

death within months.

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51
Q

Rapidly Progressive (Crescentic) Glomerulonephritis is clinically manifested by Nephritic syndrome

A
  • severe hematuria
  • dark, smoky colored urine
  • red blood cell casts

- oliguria, anuria

  • proteinuria < 3 g/d

- hypertension

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52
Q

Crescentic glomerulonephritis also demonstrates manifestations typical for Nephrotic syndrome:

A
  • heavy proteinuria (more than 3.5 g/day)
  • generalized edema
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53
Q

Define Goodpasture’s Syndrome

A

autoimmune

formation of autoantibodies against glomerular and alveolar basement membranes (Type 4 collagen)

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54
Q

Goodpasture’s Syndrome is a kidney pathology that’s associated with

A

Nephritic syndrome

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55
Q

Goodpasture’s syndrome symptoms in lungs

A
  • Hemoptysis
  • Dyspnea
  • Hypoxia of the tiss
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56
Q

Goodpasture’s syndrome symptoms in kidneys

A
  • Hematuria
  • RBC casts
  • Oliguria
  • Hypertension
  • Proteinuria
  • Azotemia
57
Q

Def: characterized by deposition of IgA and IgA immune complexes into mesangium (mesangial proliferation) with distraction of the GBM

A

Berger’s Disease

58
Q

Berger’s Disease aka

A

IgA nephropathy

59
Q

Berger’s Disease bigens within

(time line)

A

1-2 days

60
Q

Berger’s Disease begins 1–2 days within

(conditions)

A

acute respiratory

acute gastrointestinal

urinary tract infection

61
Q

Berger’s Disease d is manifested by

A

gross hematuria

Nephritic syndrom

62
Q

IgA nephropathy (Berger’s Disease) is the most common cause of ________ in the world

A

glomerulonephritis

63
Q

Def: a syndrome tha’s associated with increased permeability of the glomeruli for proteins, predominately albumins

A

Nephrotic Syndrome

64
Q

Nephrotic Syndrome Signs and Symptoms:

A

– heavy (massive) proteinuria <strong>(> 3.5 g/day)</strong> with foamy urine

– hypoalbuminemia

– generalized edema

– lipidemia and lipiduria

– urinary microscopic fat globules and fatty casts

65
Q

most common disease associated with Nephrotic syndrome in adults is

A

Mebranous Glomerulunephritis

66
Q

Mebranous Glomerulunephritis Is characterized by

A

diffuse thickening of the glomerular capillary wall

67
Q

In Mebranous Glomerulunephritis

There is deposition of immune complexes with their damage between

(what structures)

A

glomerular basement membrane

and

visceral epithelial cells

68
Q

Mebranous Glomerulunephritis Signs and Symptoms

A

– proteinuria (foamy urine)

– hematuria

– edema

– mild hypertension

– nocturia

69
Q

Membranoproliferative Glomerulunephritis (MPGN)

is usually presented by

A

Nephrotic syndrome

70
Q

Membranoproliferative Glomerulunephritis (MPGN)

in some cases it’s presented by presented by

A

combined Nephrotic-Nephritic syndromes

71
Q

MPGN Signs and Symptoms:

A

– proteinuria

– edema (including puffiness around eyes, weight gaining)

– hematuria (urine is of pink or red color)

– urine is darker than usually (like tea or cola)

– hypertension

– oliguria

72
Q

name the disease

benign disorder

most frequent cause of Nephrotic syndrome in children

A

Minimal Change Disease

73
Q

Minimal Change Disease aka

A

Lipoid Nephrosis

74
Q

Describe Minimal Change Disease (Lipoid Nephrosis)

A

by diffuse loss of foot processes of podocytes

can onlt be found by electron microscopy

75
Q

Minimal Change Disease (Lipoid Nephrosis)

signs and symptoms

A

- massive proteinuria (mostly albuminuria)

  • hypoalbuminemia

- generalized edema

- no hypertension (!)

- no hematuria (!)

76
Q

Minimal Change Disease (Lipoid Nephrosis) is treated with

A

Corticosteroid therapy

77
Q

Def: a lesion characterized by

sclerosis of some, but not all glomeruli

only a portion of the capillary tuft is involved

A

Focal Segmental Glomerulosclerosis

78
Q

Focal Segmental Glomerulosclerosis is acompanied with

A

Nephrotic syndrome

or

heavy proteinuria

79
Q

Focal Segmental Glomerulosclerosis

Electron microscopy shows

A
  • diffuse loss of foot processes podocytes

- focal detachment of the visceral epithelial cells with denudation of the underlying GBM

80
Q

Focal Segmental Glomerulosclerosis can affect

(what population)

A

Children and adults

81
Q

Focal Segmental Glomerulosclerosis

Urine and clinical findings are typical for:

A

Nephrotic syndrome

Hypertension

82
Q

Nephritc vs Nephrotic

(picture)

A
83
Q

Describe Chronic Glomerulonephritis

A

irreversible and progressive glomerular

and

tubulointerstitial fibrosis

84
Q

Chronic glomerulonephritis results in

A

chronic kidney disease (CKD)

and

end-stage renal disease (ESRD)

85
Q

chronic glomerulonephritis develops over the span of

(time)

A

years or possibly decades

86
Q

The progression of chronic renal failure developes within:

(time)

A

months to several years

87
Q

Chronic Renal Failure Signs and Symptoms:

A
  • oliguria
  • accumulation of toxic waste products affects virtually all organ & systems
  • anemia
  • fatigue and weakness
  • easy bruising
  • renal osteodystrophy
  • acidosis, hyperkalemia
  • edema
  • hypertension
88
Q

Define oliguria

A

decreased GFR)

89
Q

accumulation of toxic waste products includes which toxins?

A

uremic toxins

90
Q

easy bruising is due to

A

platelet dysfunction)

91
Q

renal osteodystrophy is due to

A

decreased production of vitamin D

92
Q

decreased production of vitamin D results in

A

hypocalcemia

secondary hyperparathyroidism

93
Q

Alport Syndrome Is a genetic condition, characterized by:

A

- kidney disease (glomerulonephritis, clinically manifested by Nephritic syndrome)

  • loss of hearing before age 30 y/o
  • eye abnormalities
94
Q

Acute Tubular Necrosis is a destruction and death of

A

tubular epithelial cells of the nephron

95
Q

Toxic ATN is characterized by

A

proximal tubular epithelium necrosis

due to a toxic substance

96
Q

in Toxic ATN, what causes acute kidney failure

A

Necrotic cells fall into the tubule lumen

97
Q

Ischemic ATN can be caused when

A

kidneys are not sufficiently perfused for a long period of time or during shock

98
Q

The proximal tubule and medullary thick ascending limb require

A

significant ATP

99
Q

The proximal tubule and medullary thick ascending limb are most susceptible to

A

ischemic damage

100
Q

Ischemic ATN specifically causes

A

skip lesions through the tubules

101
Q

Acute Tubular Necrosis lab findings

A

– reduced GFR

– increased blood levels of BUN and creatinine (azotemia)

– severe oliguria

– casts - epithelial renal cell casts (granular cast)

102
Q

Fanconi’s Syndrome is a disease that affect

(Strucutre)

A

proximal renal tubules

103
Q

Fanconi’s Syndrome effecet kidneys with inadequate reabsorption of:

A

– amino acids

– uric acid

– glucose

– phosphates

– bicarbonites

104
Q

Fanconi’s Syndrome may result in

A

renal tubular acidosis

105
Q

Renal Tubular Acidosis involves

A

1- decreased ability to secrete hydrogen ions in the distal tubules

2- decreased ability to reabsorb bicarbonate in the proximal tubule

106
Q

Define Nephrogenic Diabetes Insipidus

A

Kidney tubules defect

(distal convoluted tubules and collecting duct)

107
Q

central/neurogenic diabetes insipidus is caused by

A

insufficient levels of ADH

108
Q

In Nephrogenic Diabetes Insipidus, what’s the Pt’s urine volume and SG?

A

large volume

low specific gravity

109
Q

Renal Glycosuria Involves inadequate reabsorption of glucose due to

A

proximal tubular dysfunction

110
Q

In Renal Glycosuria, Renal histology is

A

normal

111
Q

Renal Glycosuria

Patients have increased urinary glucose with elevated specific gravity despite _____ blood glucose levels

A

normal or low

112
Q

In Renal Glycosuria Ketones are ____ present in the urine

A

never

113
Q

Acute Interstitial Nephritis affects

A

Interstitium of the kidneys surrounding the tubules

114
Q

In Acute Interstitial Nephritis, WBCs are increased in urine, especially

A

eosinophils

115
Q

Hepatorenal Failure (HRF) is an acute onset in patients with

A

severe liver diseases (cirrhosis)

116
Q

Hepatorenal Failure (HRF) is progressively intense ________which leads to oliguria, elevated BUN and creatinine, and renal failure

A

vasoconstriction

117
Q

In Hepatorenal Failure (HRF) urine, abnormal crystals can be found in addition to

A

hyaline casts or muddy-brown casts

118
Q

Phenylketonuria is due to

A

non-production of enzyme phenyalanine hydrolase

119
Q

Phenylketonuria (PKU) resutls in

A

several intermediates excretion in large amounts in urine and sweat phenylketons

120
Q

Phenylketonuria (PKU) excreted intermediates are

A
  • phenylpyruvic acid
  • phenyllactic acid
  • phenylacetic acid
121
Q

Phenylketonuria

Increased formation of phenylalanine metabolites resulting from

A

deficiency of phenylalanine hydroxylase

122
Q

In alkaptonuria there is lack of

A

homogentisic acid oxidase

in the tyrosine pathway

123
Q

homogentisic acid oxidase lack leads to accumulation of

A

homogentisic acid in tissues

124
Q

Accumulation of homogentisic acid in cartilage results in

A

the cartilage degeneration (ochronosis)

125
Q

Maple Syrup Urine Disease aka

A

branched-chain ketoaciduria

126
Q

Maple syrup urine disease (MSUD) etiology

A

inherited metabolic disorder

127
Q

Maple Syrup Urine Disease

Patients with this condition cannot break down:

A

leucine

isoleucine

valine

128
Q

Cystinuria etiology

A

inherited disease

129
Q

Cystinuria (cystinosis) is It is characterized by

A

inadequate reabsorption of amino acids in the proximal convoluted tubules

130
Q

Cystine Disorders patients are more likely to have in their urine?

A

cystine crystals and cystine renal stones

131
Q

Polycystic kidney disease (PKD) is

A

inherited disorder in which clusters of cysts develop primarily within kidneys

132
Q

what are the 2 types of PKD?

A
  • Autosomal dominant polycystic kidney disease
  • Autosomal recessive polycystic kidney disease
133
Q

Autosomal dominant PKD effects patiets at what age?

A

30’s and 40’s, but can happen in children

134
Q

in Autosomal dominant PKD, does both parents needs to carry the disease?

A

No

only one parent is needed to carry the disease

135
Q

Autosomal recessive PKD developes at what age?

A

shortly after birth

136
Q

Does Autosomal recessive PKD require both parents to have the disease?

A

Yes

137
Q

Which type of PKD is more common?

A

Autosomal dominant PKD

138
Q

Polycystic kidney disease symptoms may include

A
  • High blood pressure
  • Back or side pain
  • Headache
  • Increase in the size of abdomen
  • Blood in urine
  • Frequent urination
  • Kidney failure
  • Urinary tract infections

6- UA (9 decks)

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