9 - Urinary Tract and Male Reproductive System Flashcards by Rachael Pan

Define the following terms: oliguria, anuria, polyuria, hematuria, proteinuria, azotemia, urinary casts

Oliguria: decreased urine production
Anuria: no urine production
Polyuria: increased urine production
hematuria: blood in urine
proteinuria: protein in urine
Azotemia: elevated blood urea nitrogen and creatinine
Urinary casts: particles found in urine, type helps determine cause of renal pathology

How well did you know this?

Not at all

Perfectly

Name the 5 main glomerular disease syndromes

Nephritic syndrome
Nephrotic syndrome
Acute renal failure
Chronic renal failure
Isolated urinary abnormalities

How well did you know this?

Not at all

Perfectly

Name the 4 primary and 2 secondary diseases/causes of glomerular diseases

Primary:
1. Focal Segmental glomerulosclerosis
2. Minimal change disease
3. membranous nephropathy
4. Acute post-streptococcal glomerulonephritis

Secondary:
1. immunologic disorders (SLE)
2. Metabolic disorders (diabetes mellitus)

How well did you know this?

Not at all

Perfectly

What are the nephritic syndrome findings (hint: PHARAOH)

Proteinuria & Edema
Hematuria
Azotemia
RBC Casts
Anti-strep titers
Oliguria
Hypertension

How well did you know this?

Not at all

Perfectly

What is one acute and one chronic cause of nephritic syndrome

Acute: post-strep glomerulonephritis
Chronic: SLE

How well did you know this?

Not at all

Perfectly

What are the three characteristics of nephrotic syndrome

Proteinuria
Hyperlipidemia (increased lipid in blood)
Lipiduria (lipid in urine)

How well did you know this?

Not at all

Perfectly

What are the acute and chronic causes of nephrotic syndrome (hint: the ones that are not for nephritic syndrome)

Acute:
- focal segmental glomerulosclerosis
- minimal change disease
- membranous nephropathy

Chronic: diabetes mellitus

How well did you know this?

Not at all

Perfectly

What is membranous nephropathy characterized by?

Membranous thickening of glomerular basement membrane due to immune complex deposition (HSR III)

How well did you know this?

Not at all

Perfectly

What is minimal change disease characterized by

lipid nephrosis, most common cause of nephrotic syndrome in children

How well did you know this?

Not at all

Perfectly

What is focal segmental glomerulosclerosis (FSGS) characterized by

by its name “some parts of the kidney filters are scarred,” the most common cause of nephrotic syndrome in adults

How well did you know this?

Not at all

Perfectly

Which nephrotic syndrome diseases are most common in children? In adults?

Children: minimal change disease
Adult: FSGS

How well did you know this?

Not at all

Perfectly

What is diabetes mellitus characterized by?

Hyperglycemia which can develop into kidney dmg

How well did you know this?

Not at all

Perfectly

What are the 4 pathologic findings of diabetes mellitus

glomerulosclerosis
arteriosclerosis
papillary necrosis
pyelonephritis

How well did you know this?

Not at all

Perfectly

What is acute renal failure characterized by? Describe the three main causes.

Characterized by decreased urine production (oliguria) and electrolyte disturbances. Usually reversible and if not requires dialysis or transplant

Prerenal -> decrease in renal perfusion
**Renal ** -> glomerulonephritis
**Postrenal ** -> ureteric obstruction due to stones

How well did you know this?

Not at all

Perfectly

What is chronic renal failure characterized by?

Insidious decrease in renal function due to kidney damage, requires dialysis or transplant. There are 5 stages, ranging from eGFR ≥ 90 (normal) to < 15 (end-stage renal disease)

How well did you know this?

Not at all

Perfectly

What is the difference betwenn autosomal dominant and recessive polycystic kidney diseases

AD: aka adult PKD. Characterized by large cysts and greatly enlarged kidney

AR: aka childhood PKD. Characterized by a large number of small cysts in kidneys

What is cystic renal dysplasia characterized by?

congenital disorder of kidney development usually unilateral and affects children (bilateral means death)

What are horseshoe kidneys characterized by?

asymptomatic congenital disorder that can increase the risk of UTI’s, stones, and renal tumors

What are the two main mechanisms of UTIs?

Hematogenous spread: sepsis, septic emboli
Ascending infections: urethra -> bladder

What is the term used for inflammation of bladder? Inflammation of kidney?

Cystitis
Pyelonephritis

What is cystitis characterized by? Name 4 causes and 3 symptoms

Characterized by inflammation of bladder caused by gram-neg bacteria, more common in females cuz shorter urethra

Causes:
- sexual intercourse
- indwelling catheter
- obstruction
- instrumentation

Symptoms:
- dysuria
- polyuria
- cloudy pee

What is pyelonephritis characterized by? What are the two main routes of infection?

inflammation due to bacterial infection

Ascending through urinary tract and via the bloodstream

What are the 4 pre-disposing factors of pyelonephritis? 3 signs/symptoms?

Pre-disposing factors:
- pregnancy
- bladder reflux
- bladder obstruction
- urinary stones

Signs/symptoms:
- flank pain
- fever
- costovertebral angle tenderness

What’s another name for renal stones? What is it characterized by?

Urolithiasis

characterized by renal colic, sudden onset of flank pain

What are the four types of renal stones and what are they associated with?

1. **Calcium** stones: hypercalcemia 2.** Struvite** stones: UTIs 3. **Uric acid** stones: hyperuricemia 4.** Cystine** stones: inborn metabolic errors

What are the four ways renal stones can be treated?

1. pain management 2. kidney muscle relaxation drugs 3. small stones can be voided/urinated 4. large stones require intervention (lithotripsy)

What is renal cell carcinoma characterized by? What are three signs and symptoms? What is a disease commonly associated with this?

Characterized by renal neoplasm in epithelial cells Signs/symptoms: - asymptomatic - flank pain, hematuria - hypercalcemia, paraneoplastic syndromes Von Hippel-Lindau disease

What is nephroblastoma? What is it characterized by?

Aka Wilson's Disease, characterized by mutation in WT- and WT-2 genes. More common in children, unilateral.

What is transitional (urothelial) cell carcinoma characterized by? Symptoms? Diagnosis? Risk factors? Treatment?

Characterized as most common urinary tract malignancy, involves transitional epithelium in bladder Hematuria, dysuria, pain cystocopy and biopsy smoking, aniline dyes, schistosomiasis surgery, chemotherapy, BCG

What is cryptorchidism characterized by

Fetal developmental disorder involving failure of testicles to descend into scrotum. Can be fixed using surgery

What is hypospadia characterized by?

pp hole is not through shaft but instead comes out before

Characterization and causes of the following: epididymitis/prostatitis/urethritis, orchitis, balanitis

**Epididymitis/prostatitis/urethritis**: - due to hematogenous spread or ascending infection - causes: sex, uropathogens **Orchitis**: - inflammation of testes, often combined with epididymitis - caused by syphilis bacteria and mumps virus **Balanitis**: - inflammation of glans penia - caused by syphilis bacteria and HSV virus

Cause and characterization of genital herpes? Signs and treatments?

**Cause**: HSV type II **Characterization**: vesicle rupture **Signs**: clear serous fluid, shallow painful ulcer **Treatment**: no cure, remains dormant in neural ganglion cells

Gonorrhea: cause, characterization, treatment, complications

**Cause**: Neisseria gonorrheae **Characterization**: purulent urethritis **Signs**: dysuria, yellow urethral discharge **Treatment**: antibiotics **Complications**: ascending infection (prostatitis, epididymitis), hematogenous spread (arthritis)

Chlamydia: cause, signs, treatment

**Cause**: chlamydia trachomatis **Signs**: asymptomatic, reactive arthritis (can't pee can't bend knee) **Treatment**: antibiotics

Syphilis: cause, characterization, treament

**Cause**: spirochete treponema pallidum **Characterization**: 1. primary = painless ulcer on glans penis 2. secondary = systemic infection, immune rxn 3. tertiary = affects CNS, granulomas, vasculitis **Treatment**: antibiotics

Compare and contrast the two main types of germ cell tumors

Both present as scrotal mass **Seminoma**: - most common, good prognosis (localized), no serologic tumor markers - treat with radiation, chemotherpy, surgery **Non-seminoma**: - poor prognosis (metastasizes), HCG and AFP markers - treat with chemotherapy and surgery - Examples: embryonal carcinoma, yolk sac, teratoma, choriocarcinoma

What are the two sex cord stromal tumors

leydig cell tumor sertoli cell tumor

Compare and contrast the benign and malignant prostatic neoplasms

Benign: **benign prostatic hyperplasia (BPH)** - occurs in *transition *zone - characterized by hypertrophy of prostate epithelum/stroma - symptoms: IPSS, urgency/frequency, nocturia Malignant: **prostatic carcinoma** - occurs in *peripheral* zone - characterized by glandular epithelium in prostate (most are adenocarcinomas) - most common cancer in males