LAB 1 Flashcards by Clint Eastwood

What is Urolithiasis refers to what?

A calculus (stone) formation at any level of the collecting urinary system (not only just in the kidneys) from Vit A deficiency

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How many people have Kidney stones?

35 million 10% of Americans (mostly men)

Hidden/undiagnosed urolithiasis (not manifested yet) # increases dramatically

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What is the Etiology of Urolithiasis?

Unknown

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What is the Pathogenesis of Urolithiasis?

Associated with increased concentration of the stones’ constituents in the urine so that it exceeds their solubility in the fluid - SUPERSATURATION ***

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What is an example of Supersaturation?

Sugar in coffee; too much added sugar is unable to be dissolved in the coffee

Prevented by drinking sufficient amounts of fluids to keep the fluid levels high enough to keep the constituents from forming stones

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Urine is typically _____

A weak acidic environment

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70-75% of the stones in the urinary are formed from ____

Calcium Oxalate or combination of calcium oxalate and phosphate

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Formation of stones in tract requires space (there is no excess space in the body), how is space made?

Space is made by removing/killing the original, functional kidney tissue

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Kidney stones obstruct the path that fluid flows from the kidney to bladder —>

Fluid is physically not compressible - causes an accumulation of fluid and increases hydrostatic/hydrolic pressure

(Increases with increased fluid in the closed/confined space) - the walls consist of proper kidney tissue

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How does pressure atrophy affect the kidney?

Destroys the kidney tissue -> IRREVERSIBLE (may result in kidney failure)

Stones and their fragments can then flow into the ureter that is much smaller than the rest of the system

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10-15% of the stones in the urinary tract are made of _____

Magnesium and Ammonium Phosphate

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Magnesium and Ammonium Phosphate aka:

Triple Stones or Struvite

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What is the normal environment of urine?

Weakly acidic to prevent bacterial growth (fights bacterial contamination of urine UTI)

This is a part of innate immunity - nonspecific resistance

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In what environment are Triple Stones made?

BASIC ENVIRONMENT

Normally, stones are formed in an acidic environment

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If you drink basic mineral water, different bacteria begins to develop, what are those bacteria?

Gram bacillus, E. Coil, Serratia, Psudomonia, etc

** Gram Bacillus infection infection is most likely cause for infection

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If a patient has basic urine, you’re thinking ______

UTI

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What is the most powerful converter of urine to a basic environment?

Proteus Vulgaris (Gr-bacillus)

6-23% of the stones in the urinary tract are made of ______

Uric acid salts

When are Uric acid salts typically seen?

Patients with Hyperuricemia (increased uric acid in the blood)

Pure uric acid stones are radiolucent and will NOT be seen on X ray

What makes salts radiopaque?

Calcium (Called calcium inclusions)

0.5 - 4% of the stones in the urinary tract are made of ______

Cystine ***

What is Cystine in urine due to?

Increased elimination of cystine from the kidneys (the excess cystine precipitates into stones)

What is urinary obstruction?

Slowing or stoppage of fluid flow in the system promotes precipitation of the solutes in the fluid (urine) and their sedimentation/deposit on the wall of the system

What does Urinary Obstruction result in?

The decrease/narrowing of the tube lumen of the system

What can narrowing of the lumen cause?

Decreased flow of the fluid (example: blocked pipes) - Any blockage/restriction of urine flow can cause the deposit of the solutes/sediment

T/F, and enlarged prostate can cause Urinary obstruction, thus causing stone formation?

TRUE

What is an “Enlarged Prostate?”

Any pathology of the prostate will cause an issue in urination — swelling of the gland can restrict the flow of urine

What are examples of Enlarged prostate?

Acute prostatitis , prostate tumors (MC**)

T/F, The prostate is single lobed?

FALSE, it has multiple lobes (lobes not found after fetus becomes baby)

Central zone =

Surrounds urethra

Transitional zone =

Around urethra

Periurethral zone =

Surrounds urethra

Peripheral Zone =

Outermost zone (surrounds others)

Tumor in any Zone, C, T, P, P will ______

Compress the urethral wall - results in reduced urination

Where does a tumor in the prostate usually grow into?

The lumen of the bladder (easiest way with least resistance) - This decreases the size/capacity of the bladder (100 -> 70) causes frequent urination

A tumor in any Zone can cause what to the urethra?

The tumor BLOCKS the urethra which can cause DRIBBLING** - By patient trying to push out the urine, this increases the intra abdominal pressure causing a possible hernia

What type of Herniation is common with blockage of the urethra by a prostate tumor?

Typically will cause an inguinal herniation = 3 ball disease - patient cannot urinate

Inability to begin urination =

Hesitancy

What zone will you see symptoms take the longest to develop?

The PERIPHERAL ZONE, farther from urethra than others, thus causing symptoms later than earlier

Benign prostatic hypertrophy/hyperplasia:

Adenoma (tumor arising from granular tissue - benign - begins in the lobes near the urethra CZ TZ PuZ) ***** - affects urinary system in short time

Prostate cancer carcinoma typically begins where ? ****

Peripheral zone (80%) - Eventually reaches entire prostate, grows slow and eventually reaches urethra (over years) unable to treat and inoperable

Most patients who have typical prostate cancer _____

Have no symptoms other than urination difficulty - With Prostate cancer (carcinoma), there will be nothing left of the prostate (20 % of cases the tumor can begin in other zones)