Dobson Renal Path #7

Question 1

What do obstructions of the urinary tract lead to an increased risk of?

Answer 1

• infection
• stone formation
• untreated leads to permanent renal atrophy

Question 2

Urinary tract obstruction presentation?

Answer 2

• sudden onset or insidious
• Partial or complete
• Unilateral or bilateral and can occur at any level of urinary tract
• Caused by intrinsic or extrinsic lesions

Question 3

What is the earliest manifestation in bilateral partial obstruction?

Answer 3

inability to concentnarte urine (hyposthenuria) seen ias polyruia and nocturia

Question 4

Complete bilateral obstructiion signs?

Answer 4

• oliguria or anuria
• incompatible with life if not fixed
• after relief of obstruction post obsturctive diuresis occurs
  
  • this is massive volumes of urine produced
  • leading to sodium loss

Question 5

Urolithiasis?

Answer 5

• Stones that usually arise from the kidney
• M>F between 20-30

Question 6

What are the most common type of kidney stones?

Answer 6

Calcium stones composed of calcium oxalate or calcium oxalate mixed with calcium phosphate

Question 7

What type of stone forms after an infection with Proteus Psuedomonas or Klebsiella?

Answer 7

These are urea splitting bacteria that convert urea to ammonia leading to formation of magnesium ammonium phosphate stones

Question 8

what type of stones are common in people with hyperuricemia?

Answer 8

• Uric acid stones
• Oddly though, ½ of patients with these stones don’t have hyperuricemia or increased excretion of uric acid, they just have a tendency to have a lower pH urine which predisposes them to these stones

Question 9

Clinical features of urolithiasis?

Answer 9

• May be asx
• Can have severe renal colic and abdominal pain
• Significant renal damage
• Hematuria with large stones
• Predisposition to infection