HLTH 2501: disorders of the urinary system

Question 1

2 lower urinary tract infections

Answer 1

cystitis and urethritis

Question 2

an upper tract urinary infection

Answer 2

pyelonephritis

Question 3

where do most UTIs come from?

Answer 3

most are ascending, arising from organisms in the perineal area and travelling along the continuous mucosa

Question 4

common causative organism of UTIs

Answer 4

E coli

Question 5

how does E coli enter the urinary tract?

Answer 5

it adheres to the mucosa of the bladder by fimbriae or pili, therefore is not washed out when emptying

Question 6

why are women more susceptible to UTIs?

Answer 6

shorter urethra, closer proximity to the anus, and frequent irritation to the tissues

Question 7

why may men develop UTIs?

Answer 7

prostatic hypertrophy and retention of urine

Question 8

why are the elderly at risk for UTIs?

Answer 8

tendency towards incomplete emptying, reduced fluid intake, impaired blood supply to the bladder, and immobility

Question 9

what may contribute to UTIs?

Answer 9

pregnancy, scar tissue, and renal calculi (kidney stones)

Question 10

what does cystitis and urethritis cause the urinary tract to appear as?

Answer 10

inflamed, red, swollen, and ulcerated

Question 11

cystitis causes

Answer 11

bacterial infection, reaction to drugs, radiation therapy, or irritants like feminine hygiene products or catheter

Question 12

urethritis causes

Answer 12

STI, injury from an instrument like a catheter, or exposure to an irritating chemical like a spermicide

Question 13

2 categories of urethritis

Answer 13

gonococcal and nongonococcal

Question 14

gonococcal urethritis causative organism

Answer 14

neisseria gonorrhoeae (transmitted sexually)

Question 15

nongonococcal urethritis causative organism

Answer 15

infectious agents other than N. gonorrhoeae, often being chlamydia trachomatis

Question 16

signs of lower tract UTIs

Answer 16

pain in lower abdomen, dysuria (painful urination), urgency, and nocturia, systemic signs like fever, malaise, and nausea, reactive arthritis, conjunctivitis, and cloudy urine

Question 17

dysuria

Answer 17

painful urination

Question 18

complications of UTIs

Answer 18

prostatitis, pelvic inflammatory disease, cervicitis, or infertility

Question 19

treatment for UTIs

Answer 19

antibiotics, pain management, sometimes NSAIDs, increased fluid intake, and cranberry juice as a prophylactic measure

Question 20

pyelonephritis

Answer 20

infects one or both kidneys through infection extending from the ureter, causing purulent exudate to pool and caused inflammation of the medulla

Question 21

how do the kidneys appear during pyelonephritis?

Answer 21

abscesses and necrosis can be seen in the medulla and may extend through the cortex to the surface of the capsule

Question 22

complications of pyelonephritis

Answer 22

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

Question 23

signs of pyelonephritis

Answer 23

normal lower tract symptoms such as dysuria, but also a dull aching pain in the lower back and more marked systemic signs

Question 24

urinalysis for lower tract UTIS

Answer 24

will indicate bacteriuria, pyuria, and microscopic hematuria

Question 25

urinalysis for upper tract UTI

Answer 25

will indicate bacteriuria, pyuria, and microscopic hematuria, but also urinary casts consisting of leukocyte or renal epithelial cells

Question 26

types of antibiotics for UTIs

Answer 26

trimethoprim-sulfamethoxazole, nitrofurantoin, and amoxicillin

Question 27

function of cranberry juice for UTIs?

Answer 27

it reduces the capability of E coli to adhere to the bladder mucosa

Question 28

glomerulonephritis main type

Answer 28

acute poststreptococcal glomerulonephritis

Question 29

acute poststreptococcal glomerulonephritis

Answer 29

follows streptococcal infection with certain strains of group A beta-hemolytic streptococcus which usually originate as upper respiratory infections

Question 30

who is most commonly affected by APSGN?

Answer 30

young boys (3-7)

Question 31

how does APSGN develop?

Answer 31

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

Question 32

serum levels in APSGN

Answer 32

immunoglobulin G and C3 are present in glomerular tissue and serum C3 is reduced

Question 33

complications of APSGN

Answer 33

decreased GFR can cause acute renal failure, renin secretion can be triggered, increased BP and causing edema, and scarring of the kidneys may occur

Question 34

signs of APSGN

Answer 34

dark and cloudy urine, facial and periorbital edema, elevated BP, back pain, inflammation signs, and decreased urine output

Question 35

diagnostic tests for APSGN

Answer 35

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

Question 36

treatment for APSGN

Answer 36

reduced sodium, fluid, and protein intake, glucocorticoids for inflammation, and antihypertensives for BP; however, recovery is usually self occuring and is sufficient

Question 37

nephrotic syndrome other name

Answer 37

nephrosis

Question 38

nephrotic syndrome

Answer 38

is often secondary to other diseases (ex. lupus or exposure to drugs)

Question 39

how does nephrotic syndrome develop

Answer 39

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

Question 40

lipoid nephrosis

Answer 40

is a type of nephrotic syndrome common in young children

Question 41

blood levels in nephrotic syndrome

Answer 41

hypoalbuminemia and high cholesterol

Question 42

urinalysis of nephrotic syndrome

Answer 42

indicates proteinuria, lipiduria, and casts that are fatty, epithelial, and hyaline; urine is often frothy

Question 43

signs of nephrotic syndrome

Answer 43

massive edema (anasarca), weight gain, pallor, causing impaired appetite, respiration, and activity levels; skin breakdown may also occur

Question 44

treatment for nephrotic syndrome

Answer 44

glucocorticoids like prednisone, ACE inhibitors, antihypertensive therapy, and increased protein intake and reduced sodium

Question 45

treatment for recurrent nephrotic syndrome

Answer 45

cytotoxic therapies such as cyclophosphamide