9 - Urinary Tract and Male Reproductive System Flashcards
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
Name the 5 main glomerular disease syndromes
Nephritic syndrome
Nephrotic syndrome
Acute renal failure
Chronic renal failure
Isolated urinary abnormalities
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)
What are the nephritic syndrome findings (hint: PHARAOH)
Proteinuria & Edema
Hematuria
Azotemia
RBC Casts
Anti-strep titers
Oliguria
Hypertension
What is one acute and one chronic cause of nephritic syndrome
Acute: post-strep glomerulonephritis
Chronic: SLE
What are the three characteristics of nephrotic syndrome
- Proteinuria
- Hyperlipidemia (increased lipid in blood)
- Lipiduria (lipid in urine)
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
What is membranous nephropathy characterized by?
Membranous thickening of glomerular basement membrane due to immune complex deposition (HSR III)
What is minimal change disease characterized by
lipid nephrosis, most common cause of nephrotic syndrome in children
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
Which nephrotic syndrome diseases are most common in children? In adults?
Children: minimal change disease
Adult: FSGS
What is diabetes mellitus characterized by?
Hyperglycemia which can develop into kidney dmg
What are the 4 pathologic findings of diabetes mellitus
- glomerulosclerosis
- arteriosclerosis
- papillary necrosis
- pyelonephritis
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
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)
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?
-
Calcium stones: hypercalcemia
2.** Struvite** stones: UTIs -
Uric acid stones: hyperuricemia
4.** Cystine** stones: inborn metabolic errors
What are the four ways renal stones can be treated?
- pain management
- kidney muscle relaxation drugs
- small stones can be voided/urinated
- 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
