Diseases of Kidneys and Urinary Tract

Question 1

What constitutes the UUT?

Answer 1

Anything above the bladder

Question 2

What constitutes the LUT?

Answer 2

Anything below the bladder

Question 3

Give examples of causes of renal diseases

Answer 3

Infection, inflammation, iatrogenic, neoplasm, trauma, vascular, hereditary

Question 4

How do renal diseases present?

Answer 4

Pain, pyrexia, haematuria, proteinuria, pyuria, mass on palpation

Question 5

What is the definition of proteinuria?

Answer 5

Urinary excretion >150mg/day

Question 6

Name the types of haematuria?

Answer 6

Microscopic
Dipstick Positive
Macroscopic

Question 7

What is phimosis?

Answer 7

Tightness of foreskin

• means foreskin cannot pull back
• can cause acute retention

Question 8

What is the definition of microscopic haematuria?

Answer 8

> 3RBC’s per high power field

Question 9

What is oliguria ?

Answer 9

Urine output <0.5ml/kg/hour

Question 10

What is anuria?

Answer 10

Absolute anuria - no urine output

Relative anuria - <100ml/24 hrs

Question 11

What is poluria?

Answer 11

Urine output >3l/24hours

Question 12

What is nocturia?

Answer 12

Waking at night >1 occasion to micturate

Question 13

What is nocturnal polyuria?

Answer 13

Nocturnal urine output >1/3 of total urine output in 24 hours

Question 14

What is AKI?

Answer 14

An abrupt and sustained decrease in kidney function

Question 15

How is AKI staged?

Answer 15

via RIFLE criteria

Question 16

What indicated AKI risk?

Answer 16

increase in serum creatitine and a decrease in GFR by 25% or U0<0.5ml/kg/h for 6 hours

Question 17

What indicates AKI injury?

Answer 17

Increase in serum creatinine, decrease in GFR by 50% or U0<0.5ml/kg/hour for 12 hours

Question 18

What do results show in ARF?

Answer 18

Increase in serum creatinine, decrease in GFR by 75%, anuria or U0 <0.3ML/KG/H

Question 19

What results in AKI loss?

Answer 19

Persistent ARF or loss of kidney function >4weeks

Question 20

What qualifies as End Stage Kidney Disease?

Answer 20

Complete loss of kidney function >3months

Question 21

How is body fluid homeostasis affected by CRF?

Answer 21

Fluid overload

Question 22

How is electrolyte homeostasis affected by CRF?Q

Answer 22

Hyperkalaemia, Hyperphosphataemia may occur

Question 23

How do bladder diseases present?

Answer 23

Pain, pyrexia, haematuria, recurrent UTIs, chronic retention, urinarly leak, pneumaturia (air from urethra), LUTS

Question 24

Describe LUTS?

Answer 24

Voiding, Storage and incontinence

Question 25

What is Epidiorchitis?

Answer 25

Infection of the testes

Question 26

What can cause epidorchitis?

Answer 26

STI and UTI

Question 27

What is the function of the Vesico-ureter junction?

Answer 27

Prevents backflow of urine

Question 28

What is the path of infection when it is caused by urine reflux?

Answer 28

Ascending infection

Question 29

What drugs can cause nephrotoxicity?

Answer 29

Gentamycin and NSAID's

Question 30

What controls micturition?

Answer 30

Cortical centre, pons, sacral segments (s2-s4), internal sphincter, external sphincter and detrusor muscle

Question 31

What are the two phases of the micturition cycle?

Answer 31

Storage phase and voiding phase

Question 32

How do NSAID's cause nephrotoxicity?

Answer 32

They inhibit prostaglandins which increases arteriole constriction - only affects those with poor renal reserves

Question 33

What is a TCC?

Answer 33

Transitional Cell Carcinoma

Question 34

What are causes of bladder outflow tract diseases?

Answer 34

Prostatitis, balantitis, pelvic floor damage, urethral damage, prostate or penile cancer, chronic pelvic pain syndrome, BPE, Urethral stricture, phimosis

Question 35

Define acute urinary retention?

Answer 35

Painful inability to void with a palpable and percussible bladder

Question 36

What is the main risk factor for acute urinary retention?

Answer 36

Benign Prostatic Obstruction

Question 37

What is the immediate treatment for acute urinary retention?

Answer 37

Immediate catheterisation

Question 38

Define Chronic Urinary retention?

Answer 38

Painless, palpable and percussible bladder after voiding

Question 39

What causes chronic urinary retention?

Answer 39

Detrusor underactivity

Question 40

What are uncomplicated UTI's?

Answer 40

UTI in sexually active females only with clear relation to sexual activity

Question 41

What organisms cause UTI's?

Answer 41

E.Coli, Staph. Saprophyticus, Klebsiella, Proteus, Pseudomonas, Staph Aureus

Question 42

Where can cystitis spread to if severe?

Answer 42

Prostate --> testes

Question 43

What can cause a colo-vesical fistula?

Answer 43

Diverticular disease, bowel disease