Exam 3 - urinary and reproductive Flashcards
Inflammation fo kidney
Nephritis
Inflammatory renal disease the arises in glomerulus
Glomerulonephritis
Inflammation of renal pelvis and kidney, most common in ascending urinary tract infections
Pyelonephritis
“Disease of kidney” refers to degenerative conditions of renal tubules
Nephrosis
An elevation in blood urea nitrogen (BUN) and creatinine related largely to reduced glomerular filtration rates (GFR).
Azotemia
Causes of azotemia
Glomerular disease, urinary obstruction or decreased renal perfusion
a clinical syndrome complex of renal failure
Uremia
Virtually complete reduction of urinary output; (<50ml urine/day)
Anuria
partial reduction of urinary output; <400ml urine/day
Oliguria
Blood in the urine “smoky” or “dusky” color
Hematuria
What is it called when you see packed “red cell casts” in urinary sediment?
Hematuria
Which one of these is associated with red cell casts in urinary sediment?
Azotemia Uremia Hematuria Nephritis Nephrosis
Hematuria
What is a symptom complex associated with ACUTE glomerular injury (glomerulonephritis, etc)
Nephritic syndrome
What is the symptom complex that makes up nephritic syndrome?
a) Hematuria (with red cell casts)
b) Azotemia and oliguria
c) Some degree of hypertension is common, etc.
In what case does the renal glomerulus become more permeable to plasma proteins
Nephrotic syndrome
What are features of Nephrotic syndrome
Renal glomerulus becomes more permeable to plasma proteins.
- Proteinuria > 3.5gm/day
- Hypoalbuminemia <3gm/dl
- Generalized edema
- Hyperlipidemia and lipiduria
Rapidly progressive oliguria or anuria of sudden onset
Acute renal failure
Causes of acute renal failure
- severe pyelonephritis (inflammation of renal pelvis and kidney)
- acute tubular necrosis
- urinary obstruction
- renal artery thrombosis
“End stage” of chronic renal disease and a common cause for morbidity and mortality
Chronic renal failure
Progressive stages of reduced functional activity in Chronic renal failure includes
- Progressive diminished renal reserve
- Renal insufficiency
- Azotemia
- Total renal failure
Most common causes of Chronic renal failure include
- Chronic glomerulonephritis
- Chronic pyelonephritis
Manifestations of Chronic renal failure
- early stages symptoms are vague
- long term effects: HTN, polyuria, anemia, bone loss
Inflammation of glomerulus
Glomerulonephritis (GN)
Goodpasture’s syndrome is associated with what condition
Glomerulonephritis
Goodpasture’s syndrome is associated with auto-reactive antibodies directed against glomerular basement membranes
Name the (5) types of glomerulonephritis (GN) and the prognosis or significant feature
- post streptococcal GN, “acute” | good in children & fair in adults
- rapidly progressive GN | poor prognosis
- membranous GN | thickened glomerular basement membrane, nephrotic syndrome
- lipoid nephrosis “minimal change” | good in children, less good in adults
- chronic GN | end stage, leads to chronic renal failure
Infection of kidney (renal pelvis and parenchyma)
Pyelonephritis
Acute and chronic patterns are differentiated by clinical course, symptoms and prognosis.
Acute pyelonephritis vs chronic pyelonephritis
Acute: sudden onset of fever, malaise, pain in costal-vertebral region
Chronic: major cause of chronic renal failure, affected kidneys become strophic and deformed by scarring
Pyelonephritis
Kidney infection
What are two malformations of the kidney?
Horseshoe kidney Ectopic kidney (lies inferior to normal position)
What happens during development in congenital polycystic diseases?
Cystic structures appear and contribute to obstruction. Multiple cysts appear and may resemble tumors
What are “simple” or acquired cysts?
In the process of aging, people may end up with single or multiple cysts that may look like tumors.
Contributing conditions include scaring, abscesses, or infarcts.
What contributes to hydronephrosis?
Total obstruction of urinary tract
hydronephrosis
Dilation of renal pelvis and calyces with pressure atrophy of parenchyma
What causes obstruction of the ureters?
Kidney stones
Scars and strictures
Tumors and hyperplastic lesions
Pregnancy
What is a calculi / urolithiasis
Kidney stone
4 types of calculi. What is the most common composition? Which one is most commonly associated with gout?
- Calcium oxalate ** in US
- Urates **50% are associated with gout
- Triple
- Cystine
Usually urolithiasis are mixed
Causes of urolithiasis?
Altered urinary pH
Dehydration
Hypercalcemia and hypercalcuria
What causes renal vascular disease?
HTN
Nephrosclerosis (due to HTN)
What is the most common renal cancer in adults?
Renal cell carcinoma (hypernephroma)
Triad features typical with renal cell carcinoma?
Hematuria
Costovertebral pain
Palpable mass
What is the embryonic “mixed” malignant renal tumor of children?
Wilm’s tumor - nephroblastoma
What is nephroblastoma and hypernephroma?
Nephroblastoma is associated with “mixed” tumor cancer in children
Hypernephroma is renal cell carcinoma, the most common renal center in adults
What systemic diseases do renal diseases affect the most?
Diabetes
Systemic lupus erythematosus
How does renal disease affect Diabetes?
Renal failure is 2nd to MI as cause of death.
Vascular problems, glomeruli sclerosis, pyelonephritis is more common
What nodular sclerosis lesions of the glomeruli do you see in diabetics with renal problems?
Kimmelstiel-Wilson lesions
How does renal disease affect SLE?
Deposition of DNA-anti-DNA immune complexes within glomeruli
Glomerulonephritis is common
What kind of reproductive cancer is most common in young males and cause about 10% of cancer-associated deaths?
Testicular cancer
15-34 years old
What is varicocele
Enlarged pampiniform plexus
*swelling, pain, infertility
What is hematocele
Blood in tunica vaginalis
*uncommon, likely caused by trauma, neoplasm, torsion of spermatic cord
What is hyrocele
Fluid in tunica vaginalis
Contributing causes: infection, neoplasm, incomplete closure of canals
What is chylocele
Accumulation of lymph in tunica vaginalis associated with lymph obstruction
What kind of disease contributes to enlargement and increased incidence for urinary obstruction in males?
Prostate diseases
What is more common: acute or chronic bacterial prostatitis?
Chronic bacterial prostatitis
What is the most common form of prostatitis reported by clinicians?
Chronic abacterial prostatitis (idiopathic)
What is nodular hyperplasia?
Benign prostatic hypertrophy “BPH”
*hyperplasia is increased # of cells, not increased cell size
What region of the prostate is most affected?
Central / median
Where does prostate carcinoma typically arise?
Posterior location: outer subcapsular zone
Where does prostate cancer metastasize?
Skeleton — osteoplastic lesions are nearly diagnostic for prostate cancer
Inflammatory reactions (cervicitis) contribute to scarring and obstruction of cervical glands which give rise to what kind of cyst?
Nabothian cysts
What are some risk factors that may cause tumors of the cervix?
HPV is the major cause for squamous cell carcinoma
Multiple sex partners
Cervical dysplasia can cause “frank” invasive carcinoma
Where does frank/invasive carcinoma spread?
Regional lymph and adjacent organs
What is endometriosis?
Mass of endometrial tissue that appears outside the body of the uterus
What is adenomyosis
Endometrial glands extend deep into myometrium
What is a common problem of the endometrium that specifically affects multiparous (more than 1 child)
adenomyosis
What is endometritis? Contributing causes?
Inflammation of endometrium
- chronic pelvic inflammatory disease
- retained placental fragments
- IUD
- TB
- idiopathic
What is a myometrium fibroid called?
Leiomyoma
What are cysts of the ovaries that are less than 6 cm in diameter?
Non-neoplastic or “physiologic” cysts
What are 3 types of Non-neoplastic or “physiologic” cysts of the ovaries?
Follicular - follicles that fail to rupture or seal up after ovulation
Luteal - focal masses of hyperplastic corpus luteum
Polycystic ovary - anovulatory
Polycystic ovary is also what syndrome
Stein-Leventhal syndrome
4 kinds/origin of tumors in the ovaries
Surface epithelium
Germ cell origin
Ovarian stroma and “sex-cord” tumors
Kruckenberg tumor
What is the most common tumor of the ovaries?
Surface epithelium
In the ovaries, what type of tumor is associated with teratomas?
Germ cell origin
Kruckenberg tumor in the ovaries is characterized by mucus secreting adenocarcinoma cells that come chiefly from what origin?
Stomach
Seen in 10% women with gastric cancer
What is infection of uterine tube with risk for mucosal adhesions and scars that contribute to infertility and increased incidence of ectopic pregnancy?
Salpingitis
What is an abscess of uterine tube?
Pyosalpinx
What is watery fluid, usually occurs when fallopian tubal lumen has been obstructed by inflammation in women
Hydrosalpinx
What is hemorrhage of ovarian/Fallopian tubes called
Hematosalpinx
90% of ectopic pregnancies are _____
Tubal
What is pre-eclampsia (characterized by 3 things)
HTN
Albuminuria
Edema
24th week of gestation or later
What is eclampsia
Endstage pre-eclampsia. Disseminated intravascular coagulation (DIC) with risk for organ infarcts, convulsions, coma
fatal if left untreated
What is a disorder of pregnancy where there is torphoblast but no fetus/fetal heart sounds
Hydatidiform mole
Mole = “shapeless mass”
Basically, its a non-cancerous tumor that forms after a non-viable implantation.
What is choriocarcinoma
Fast growing cancerous mass that forms from (50% of cases) complete hydatidiform mole
What is hydrops fetalis
Sever fetal edema, congestive heart failure, hepatosplenomegaly, etc. Fetal edema because of decreased synthesis of plasma proteins.
E.g. Rh factor incompatibility
