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8 PATH 2 > LAB 2 > Flashcards

LAB 2 Flashcards

1
Q

Why can Pregnancy (pressure atrophy) cause stone formation?

A

Fetus compresses the ureter, meaning fluid cant reach the bladder. This causes an accumulation of fluid in the ureter/kidney. This can lead to increased fluid in the kidney, leading to pressure atrophy and possible death of kidney (3 weeks min)

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2
Q

What issue is caused by Pregnancy (pressure atrophy)?

A

Hydronephrosis (most commonly caused by kidney stones)

  • “Proud Posture” can also form due to hyperlordosis
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3
Q

What can develop from “Proud Posture” ?

A

The pressure in the post aspect of IVD moves the nucleus purposes forward into the annulus fibrosis, causing pressure in the annulus fibrosis.

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4
Q

How do you distinguish between regular LBP and irregular LBP?

A

Punch sign

  • An increase of hydrostatic pressure in an area that already has increased hydrostatic pressure
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5
Q

What are the 5 different types of Urinary Obstruction associated with predisposing factors that cause stone formation?

A
  1. Enlarged prostate
  2. Pregnancy (pressure atrophy)
  3. Tumor
  4. Diverticulum
  5. Nephroptosis
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6
Q

Where can tumors be formed that would affect the kidney?

A

Within kidney, ureters, etc or outside of kidney, ureters, etc. -> prevents urine flow

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7
Q

What is Diverticulum?

A

Defined as “Pouching” of wall of an empty organ

  • Pouching of the bladder out of the bladder wall (rare) More common in Large Instestine
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8
Q

What is Nephroptosis?

A

When the kidney falls down, there is a kink in the ureter -> urine cannot flow down naturally -> Pressure has to increase to force the urine up the kink and then flows down like natural urine flow to low gravity

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9
Q

After the kink is developed in Nephroptosis, what forces the urine out?

A

Increased renal hydrostatic pressure -> Increased pressure of the kidney pelvis

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10
Q

The small dropping down of the kidney from Nephroptosis _______

A

Forces an increase of pressure within the kidney if the drop of the kidney is more dramatic, have to force the urine up even more in order to force the urine up

  • Done by increasing the hydrostatic pressure, not only on the fluid, but to the kidney pelvis and kidney tissue
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11
Q

When there is increased renal hydrostatic pressure what can happen?

A

Retention of urine begins to happen, thus increasing bacteria in the urinary tract

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12
Q

Replication of bacteria in the urine leads to _____

A

Pyelonephritis

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13
Q

What is the second way Nephroptosis can occur?

A

Kidney is surrounded by fat, protects it from temp. If you lose weight, the fat pad thins around the kidney allowing the kidney to fall down

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14
Q

What are the Predisposing factors that can cause Stone formation?

A
  1. Urinary Obstruction
  2. Epithelial Injury
  3. Changes in Urine
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15
Q

How can Epithelial Injury cause formation of kidney stones?

A

Increased rate of sloughing of epithelial cells (different cells have different lifespans — increased metabolism 5->20 days)

  • Forms Nidus
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16
Q

What is a Nidus in relation to Epithelial Injury?

A

Challenges of organic materials

  • Organic Core
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17
Q

What are the 3 subcategories of Epithelial Injury?

A
  1. Infection
  2. Vitamin A and B6 Deficiency
  3. Ischemia
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18
Q

Infection of Epithelial Injury promotes _____

A

Sloughing of epithelial cells and the bacteria themselves can be the Nidus

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19
Q

Which vitamins are associated with Epithelial Injury?

A

Vitamin A and B6

  • Increased sloughing rate = Nidus
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20
Q

Ischemia in Epithelial Injury =

A

Necrosis

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21
Q

What are the “Changes in Urine” than can cause Stone Formation?

A
  • Dehydration
  • Hypercalcemia
  • Hyperphosphaturia
  • Oxaluria (dietary or metabolic defect)
  • Uric Acid & Orate excess
  • Gout
  • Leukemia

** Can take any type of stone

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22
Q

What are Staghorn Calculus?

A

Stone that block the ENTIRE kidney pelvis

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23
Q

What are Staghorn Calculus made out of?

A

99% of renal calculus made of magnesium - ammonium phosphate **

1% made of cysteine ** QUIZ

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24
Q

What happens to the kidney when a Staghorn Calculus is inside?

A

Cortex of the kidney is basically gone due to stone blocking normal evacuation of fluid from the kidneys - retention of urine increases the hydrostatic pressure and DESTROYS normal functioning tissue of kidney

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25
Q

What condition happens with Staghorn Calculus?

A

Hydronephrosis

(Distention of the kidney pelvis with accompanying atrophy of the kidney parenchyma due to obstruction of the urine outflow)

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26
Q

How is kidney tissue lost in the case of Staghorn Calculus?

A

Pressure goes against the kidney parenchyma = loss of the kidney tissue

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27
Q

Can the kidney die in Staghorn Calculus?

A

YES *** kidney can die within 3 weeks if complete obstruction of urine flow

  • Incomplete obstruction of urine flow takes 3-4 months
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28
Q

Does a patient feel pain with Staghorn Calculus?

A

YES, this is due to kidney capsule distension, and this would create a positive Murphy’s punch

  • Punch can indicate inflammation of kidney, among others
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29
Q

What is the MC cause of kidney obstruction in medical office ?

A

Moving kidney stone

Renal/Urethral Colic ** QUIZ

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30
Q

What is Colic? **

A

Severe pain due to spasm of an empty organ = prick by needle

31
Q

What is an example of Colic?

A

Bile colic = spasm of the bile duct —> causes severe pain

32
Q

What is the pathway of the Renal/Urethral Colic?

A

Kidney stones move wide area (kidney pelvis) to narrow area -> goes into ureter and gets stuck in the entrance of the ureter due to shape, size, edges (smoothness) -> irritates the wall -> leads to spasm of the wall -> severe back pain (hard to identify)

33
Q

What is the identifying factor to help diagnose Uretrhal Colic?

A

Specific manifestations of pain.

  • Originates from the kidney and goes through flank area to the ipsilateral genitals** (testicles, etc.) and inner surface of the proximal thigh —> Irritation of the ureter
34
Q

What is a common symptom of Renal/Urethral Colic?

A

Hermaturia * while stone is moving, it damages the walls of the ureter and urethra which leads to blood in the urine (could be true hematuria, more commonly micro hematuria)

35
Q

What is the treatment of Renal/Urethral Colic?

A

Spasmolytics (injection - relaxation of muscle cells) and pain medication (narcotics)

36
Q

How does the treatment of Spasmolytics for Renal/Urethral colic help ?

A

Allows stone to pass through the ureter with aid of increased hydrostatic pressure

  • Wait until stone is in bladder and can be removed easily from there (can also be removed surgically from kidney)
37
Q

When would you start to think there’s a real problem with Renal/Urethral Colic?

A

Inability to remove the stone within 7** days will require surgery to remove the stone

  • If that isn’t done, LOSS OF KIDNEY is guaranteed to happen
38
Q

What is another way to eliminate kidney stone with Renal/Urethral Colic?

A

Can use ultrasound to break up stones only if in the kidney

39
Q

Vesicular Calculus aka

A

Bladder Stones

40
Q

Can the bladder have stones similar to the kidneys?

A

Yes! It is more common in males, may be different sizes, shapes, etc.

41
Q

What are the type of stones seen in the bladder (Vesical Calculi) ?

A

Multiple small stones, jack stone calculus, very large calculus

42
Q

Vesical Calculi (bladder stones) are eliminated how?

A

Bladder stone grasped and crushed by lithorite, preparatory to transurethral removal (called lithotripsy)

43
Q

What happens to the stones Bladder stones after being crushed by lithorite (lithotripsy)?

A

Normal urination will remove the stones in a natural way - -

  • Anesthesia not allowed because you do not know where you are in the urethra -> Can possibly tear the urethra typically less painful for women since urethra is shorter
44
Q

What is Acute Cystitis?

A

Acute inflammation of urinary bladder

45
Q

Who is acute cystitis more common in?

A

Common in females (rare in males)

46
Q

What is the first step to the development of Pyelonephritis ?

A

Acute Cystitis: Acute inflammation of Urinary Bladder

47
Q

What is Acute Cystitis characterized by?

A

One of the worst disorders of the kidneys, infectious inflammation of the bladder

48
Q

What bacteria is present with Acute Cystitis?

A

E. Coli, then other Gr-bacillus (staph and strep) as well, and normal gut flora

49
Q

What can cause Acute Cystitis?

A

STD’s, gonorrhea, chlamydia (most common infection of lower urinary tract), trichomoniasis (Protozoa that leads to inflammation/diseases of female genitals)

50
Q

Yeast infection aka

A

Candida albicans (candidiasis or candidosis) AKA Monilia (moniliasis)

51
Q

How does Candidiosis commonly live?

A

Lives in our body in inactive status - kept inactive by gut flora

52
Q

How does Gut Flora help prevent Yeast Infection?

A

If gut flora is suppressed, Candidosis occurs in women results in vaginal, cheese-like discharge — common among females

53
Q

What is a symptom in Yeast Infection that would signify it is actually yeast infection?

A

Cheese like discharge indicates active candidosis if prolonged or if in men

  • Discharge of the mouth = THRUSH **
54
Q

What can yeast infection aka Candida Albicans lead to?

A

Disorders of the urogenital and gastrointestinal problems

  • It is common due to gut flora depression due to antibiotics, both through administered through doctors as well as in the food (meat)
55
Q

Why is Yeast Infection aka Candida Albicans so common?

A

Physicians prescribe antibiotics regularly

56
Q

What is the treatment for Yeast Infection aka Candida Albicans?

A

Fight as soon as possible with anti-candida drugs or use different sources to promote gut flora

  • This will kill/suppress candida the natural way
57
Q

What is the major leading cause of acute pyelonephritis?

A

Acute cystitis

58
Q

What are the 2 predisposing factors to Yeast Infection aka Candida Albicans

A

Exposure of female pelvic organs to the cold

Inserting a catheter

59
Q

What is the most common predisposing factor for Acute Cystitis?

A

Exposure of female pelvic organs to the cold (sitting on cement benches)

  • Leads to infection problems with organs, ovarian inflammation and acute cystitis
60
Q

How does a catheter cause Acute Cystitis?

A

Catheterized bladder should be sterilized, when you pull out have another inflammation of urethra. This allows for replication and growth of bacteria (good temp and lots of food)

  • Procrastination of urination as well
61
Q

How does Procrastination of urine cause acute cystitis?

A

As more and more urine accumulates, this leads to increased elastic fiber destruction, and you’re unable to push everything out

  • Infection hides behind tumor or foreign objects (various objects)
62
Q

Where would you see different objects in the bladder of patients?

A

Women, distance is much shorter in women. It is common to see swelling of bladder wall due to inflammation, bulbous edema, Hemorrhagic cystitis , and ulcerative cystitis

63
Q

What is Acute Cystitis manifested by?

A

1) . Dysuria
2) . Increased frequency of urination
3. Lower abdominal pain

***** QUIZ

64
Q

What is dysuria?

A

Painful urination

65
Q

What type of “Lower Abdominal Pain” associated with Acute Cystitis?

A

Pain underneath the level of the umbilicus, caused by:

  • Appendicits, crohn’s/ ulcerative colitis, ovary inflammation, cystitis, subluxation of pelvic bones
66
Q

What 3 signs will Acute Cystitis have?

A

1) Dysuria
2) Increased frequency of urination

  • Increased attendance to the restroom to release just a couple drops of urine (increased sensitivity of bladder wall to urine)
    3) Lower abdominal pain
67
Q

What is another manifestation of acute cystitis? (Not a permanent / mandatory finding)

A

HEMATURIA**

68
Q

What is the treatment for acute cystitis?

A

Antibacterial medication for at least 7 days, 10 preferred (NOT cranberry juice) -> specific name is: UROBIOTICS

69
Q

When do symptoms go away in Acute Cystitis after giving treatment?

A

In a day and then patients stop taking the medication -> only weakened the bacteria and DID NOT kill them

70
Q

Can acute cystitis come back after treatment?

A

It can come back in 7 days and the bacteria become resistant to the medication (if pt is on these antibiotics, make sure they follow MD recommendation)

71
Q

If Acute Cystitis is left untreated, what would happen?

A

It can lead to chronic cystitis or acute pyelonephritis, this results in a small bladder (increased frequency)

72
Q

How does chronic cystitis also occur?

A

From the constant stop and go of antibiotics if pt doesn’t follow through with them as prescribed

73
Q

Exposure of pelvic area to cold _______

A

Can promote the development of acute cystitis and acute ovarian inflammation (cold is PREDISPOSING FACTOR)

8 PATH 2 (10 decks)

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