HLTH 2501: disorders of the urinary system Flashcards
2 lower urinary tract infections
cystitis and urethritis
an upper tract urinary infection
pyelonephritis
where do most UTIs come from?
most are ascending, arising from organisms in the perineal area and travelling along the continuous mucosa
common causative organism of UTIs
E coli
how does E coli enter the urinary tract?
it adheres to the mucosa of the bladder by fimbriae or pili, therefore is not washed out when emptying
why are women more susceptible to UTIs?
shorter urethra, closer proximity to the anus, and frequent irritation to the tissues
why may men develop UTIs?
prostatic hypertrophy and retention of urine
why are the elderly at risk for UTIs?
tendency towards incomplete emptying, reduced fluid intake, impaired blood supply to the bladder, and immobility
what may contribute to UTIs?
pregnancy, scar tissue, and renal calculi (kidney stones)
what does cystitis and urethritis cause the urinary tract to appear as?
inflamed, red, swollen, and ulcerated
cystitis causes
bacterial infection, reaction to drugs, radiation therapy, or irritants like feminine hygiene products or catheter
urethritis causes
STI, injury from an instrument like a catheter, or exposure to an irritating chemical like a spermicide
2 categories of urethritis
gonococcal and nongonococcal
gonococcal urethritis causative organism
neisseria gonorrhoeae (transmitted sexually)
nongonococcal urethritis causative organism
infectious agents other than N. gonorrhoeae, often being chlamydia trachomatis
signs of lower tract UTIs
pain in lower abdomen, dysuria (painful urination), urgency, and nocturia, systemic signs like fever, malaise, and nausea, reactive arthritis, conjunctivitis, and cloudy urine
dysuria
painful urination
complications of UTIs
prostatitis, pelvic inflammatory disease, cervicitis, or infertility
treatment for UTIs
antibiotics, pain management, sometimes NSAIDs, increased fluid intake, and cranberry juice as a prophylactic measure
pyelonephritis
infects one or both kidneys through infection extending from the ureter, causing purulent exudate to pool and caused inflammation of the medulla
how do the kidneys appear during pyelonephritis?
abscesses and necrosis can be seen in the medulla and may extend through the cortex to the surface of the capsule
complications of pyelonephritis
the exudate can compress the renal artery and vein and can obstruct urine flow to the ureter, causing acute renal failure; recurrent infections can also lead to fibrous scar tissue forming over a calyx, leading to loss of tubule function and hydronephrosis
signs of pyelonephritis
normal lower tract symptoms such as dysuria, but also a dull aching pain in the lower back and more marked systemic signs
urinalysis for lower tract UTIS
will indicate bacteriuria, pyuria, and microscopic hematuria
urinalysis for upper tract UTI
will indicate bacteriuria, pyuria, and microscopic hematuria, but also urinary casts consisting of leukocyte or renal epithelial cells
types of antibiotics for UTIs
trimethoprim-sulfamethoxazole, nitrofurantoin, and amoxicillin
function of cranberry juice for UTIs?
it reduces the capability of E coli to adhere to the bladder mucosa
glomerulonephritis main type
acute poststreptococcal glomerulonephritis
acute poststreptococcal glomerulonephritis
follows streptococcal infection with certain strains of group A beta-hemolytic streptococcus which usually originate as upper respiratory infections
who is most commonly affected by APSGN?
young boys (3-7)
how does APSGN develop?
the antistreptococcal antibodies create an antigen-antibody complex (type III reaction) that lodges in the glomerular capillaries and activates the complement system to cause an inflammatory response in the glomeruli of both kidneys
serum levels in APSGN
immunoglobulin G and C3 are present in glomerular tissue and serum C3 is reduced
complications of APSGN
decreased GFR can cause acute renal failure, renin secretion can be triggered, increased BP and causing edema, and scarring of the kidneys may occur
signs of APSGN
dark and cloudy urine, facial and periorbital edema, elevated BP, back pain, inflammation signs, and decreased urine output
diagnostic tests for APSGN
blood tests showing elevated urea and creatine, anti-Dnase B, streptococcal antibodies, ASO, ASK, decreased complement levels, and decreased HCO3 due to metabolic acidosis; urinalysis will also be used to confirm the presence of proteinuria, gross hematuria, and erythrocyte casts
treatment for APSGN
reduced sodium, fluid, and protein intake, glucocorticoids for inflammation, and antihypertensives for BP; however, recovery is usually self occuring and is sufficient
nephrotic syndrome other name
nephrosis
nephrotic syndrome
is often secondary to other diseases (ex. lupus or exposure to drugs)
how does nephrotic syndrome develop
increased permeability os the glomerular capillaries allows large amounts of plasma proteins like albumin to escape into the filtrate, causing decreased osmotic pressure and low BP as a result; this activates aldosterone secretion, leading to edema
lipoid nephrosis
is a type of nephrotic syndrome common in young children
blood levels in nephrotic syndrome
hypoalbuminemia and high cholesterol
urinalysis of nephrotic syndrome
indicates proteinuria, lipiduria, and casts that are fatty, epithelial, and hyaline; urine is often frothy
signs of nephrotic syndrome
massive edema (anasarca), weight gain, pallor, causing impaired appetite, respiration, and activity levels; skin breakdown may also occur
treatment for nephrotic syndrome
glucocorticoids like prednisone, ACE inhibitors, antihypertensive therapy, and increased protein intake and reduced sodium
treatment for recurrent nephrotic syndrome
cytotoxic therapies such as cyclophosphamide
