HLTH 2501: urinary tract obstructions, vascular disorders, and congenital disorders Flashcards
what is the urinary tract often obstructed by in older men?
benign prostatic hypertrophy or prostatic cancer
common urinary tract obstructions
tumors, inflammation, scarring, stenosis, congenital defects, and renal calculi
kidney stones two other names
urolithiasis or renal calculi
kidney stones
can develop anywhere in the urinary tract and tend to form when there is an excessive amount of relatively insoluble salts in the filtrate or when fluid intake is insufficient; these can commonly cause infections
staghorn calculus
is a very large stone that forms in the renal pelvis and calyces in the shape of a deer’s antlers
how do kidneys stones develop?
once solid material forms, deposits continue to build up on this nidus, a form a larger mass along with cell debris
treatment for small kidney stones
increasing fluid intake
hydronephrosis
stretched or swollen kidneys that can develop from kidney stones, scar tissue, tumors, or untreated prostatic enlargement
what are kidney stones composed of?
calcium salts mainly, as well as small amounts of uric acid, struvite, or cystine
struvite
magnesium ammonium phosphate; found in kidney stones
calcium stones
consist of phosphate, oxalate, or carbonate and form when calcium levels in the urine and high because of hypercalcemia, perhaps because of a parathyroid tumor or metabolic disorder
when are calcium stones likely to form?
when the urine is highly alkaline, when there is inadequate fluid intake, and in those who are vegetarian
uric stones
develop due to hyperuricemia due to gout, high purine diets, or chemo, especially when the urine is acidic
signs of kidney stones
back pain, renal colic attack (pain in the back that radiates to the groin), nausea, vomiting, cool, moist skin, and rapid pulse
another name for back pain
flank pain
what confirms the diagnosis of kidney stones?
radiologic examination
treatment for kidney stones
small stones will pass on their own; larger stones may be treated with extracorporeal shockwave lithotripsy, laser lithotripsy, and sometimes surgery
extracorporeal shockwave lithotripsy
uses sound waves to break up the kidney stone
laser lithotripsy
uses a ureteroscope to located to stone and a scope-mounted laser to destroy it
surgical removal of kidney stones procedure
is called a percutaneous nephrolithotomy
what does continued buildup of urine cause?
necrosis of tissue and direct pressure and compression of the blood vessels
hydronephrosis signs
usually is asymptomatic but may be back pain
tumors in the urinary tract
are rare and are often malignant tumors of the bladder that occur in men over 50
most common type of urinary tract cancer
bladder cancer
renal cell carcinoma
is a primary tumor arising from the tubule epithelium, more often in the renal cortex
renal cell carcinoma spread
often metastases to the liver, lungs, bones, or CNS where it is diagnosed
who is renal cell carcinoma common in?
men and smokers over 45
signs of renal cell carcinoma
painless hematuria, dull, aching back pain, unexplained weight loss, anemia, and paraneoplastic syndromes such as hypercalcemia or cushing syndrome
treatment for renal cell carcinoma
removing the kidney, as the kidneys are not responsive to chemo or radiation
bladder cancer
are often malignant tumors in the transitional epithelium lining the bladder in the trigone area; it often develops as multiple tumors are tends to reccur
how is bladder cancer diagnosed?
urine cytology and biopsy
where does bladder cancer tend to metastasize to?
the pelvic lymph nodes, liver, and bone
bladder cancer signs
hematuria, infection, dysuria, and frequency
common population of those with bladder cancer
those working with chemicals such as dyes, rubber, or aluminum, cigarette smokers, and those taking lots of analgesics
treatment for bladder cancer
surgery, chemo, radiation, and photoradiation
photoradiation
is a combination of drug and laser treatment and has been successful for bladder cancer
nephrosclerosis
involves vascular changes similar to arteriosclerosis in the kidney that involves thickening and narrowing of the walls, causing occlusion of the lumina
result of nephrosclerosis
reduced blood supply to kidneys, causing ischemia and atrophy, increasing renin secretion, and increased blood pressure; destruction of the renal tissue and chronic renal failure may also occur
causes of nephrosclerosis
can be a lesion, secondary to hypertension, or diabetes mellitus
treatment for nephrosclerosis
antihypertensive agents, diuretics, ACE inhibitors, beta blockers, and decreased sodium intake
types of urinary system congenital disorders
vesicoureteral reflux, agenesis, hypoplasia, ectopic kidney, and fusion
vesicoureteral reflux
is caused by a defective valve in the bladde
agenesis
refers to a developmental failure of one kidney to develop and is asymptomatic
hypoplasia
is a failure of the kidneys to develop to normal size, and is often unilateral; can result from fibrosis
ectopic kidney
is a kidney and its ureter out of normal position, ex. lower in the abdominal or pelvic cavity; kidney function is normal but the ureter may become kinked, causing obstruction or infection
fusion of kidneys
can occur during developmental, resulting in a single horseshoe kidney with normal function
adult polycystic kidney most common form
is genetic and transmitted on an autosomal dominant gene on chromosome 16
adult polycystic kidney
manifestations usually don’t appear until around age 40 when chronic renal failure becomes symptomatic and dialysis is required
diagnosis for adult polycystic kidney
CT or MRI
what happens in adult polycystic kidney?
multiple cysts develop in both kidneys and and gradually expand over the years, resulting in compression and destroyment of the kidney tissue leading to chronic renal failure
what else may occur with adult polycystic kidney?
cysts can be found on other organs like the liver or cerebral aneurysms are found
polycystic disease in children
is transmitted as a recessive gene and manifests at birth
wilms tumor other name
nephroblastoma
wilms tumor
is a rare, usually unilateral, tumor in children that is associated with defects in tumor-suppressor genes on chromosome 11 and may occur in conjunction with some other congenital defects
signs of wilms tumor
around ages 3-4, clothes don’t fit or a unilateral bulge appears, high BP may also be apparent as well as pulmonary metastases
