Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Urinary System > Presentation of Diseases of Kidney and Urinary Tract > Flashcards

Presentation of Diseases of Kidney and Urinary Tract Flashcards

1
Q

What does the upper urinary tract include?

A

Kidneys - parenchyma and pelvi-calyceal system
Ureters - pelvi-ureteric junction, ureter and vesico-ureteric junction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What does the lower urinary tract include?

A

Bladder
Bladder outflow tract - bladder neck, prostate, external urethral sphincter, urethra, urinary meatus, and foreskin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is the nature of renal diseases?

A

Infection, inflammation, iatrogenic (nephrotoxicity, PCNL), neoplasia (renal tumours and collecting system tumours), trauma, vascular and hereditary

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is infection in renal diseases called?

A

Pyelonephritis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are types of inflammation in renal diseases?

A

Glomerulonephritis and tubulointestinal nephritis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are vascular causes of renal disease?

A

Atherosclerosis, hypertension and diabetes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are hereditary causes of renal disease?

A

Polycystic kidney disease and nephrotic syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is included in the presentation of renal diseases?

A

pain, pyrexia, haematuria, proteinuria, pyuria (pus in urine due to infection), mass on palpation and renal failure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is the definition of proteinuria?

A

Urinary protein excretion of more than 150mg/day

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

In clinical practice, how many types of haematuria is there?

A

3 - visible (Frank), microscopic and dipstick

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is the definition of microscopic haematuria?

A

More than 3 red blood cells per high power field

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is oliguria?

A

When urine output is more than 0.5ml/kg/hour

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is anuria?

A

Absolute anuria - no urinary output
Relative anuria - less than 100ml/24hrs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is polyuria?

A

Urine output more than 3l/day

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is nocturia?

A

Waking up at night equal to or more than 1 occasion in the night

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is nocturnal polyuria?

A

Nocturnal urine output more than 1/3 of total urine output in 24hrs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is the definition of acute kidney injury in terms of staging?

A

Risk - increase in creatinine level x 1.5 or decrease in GFR by 25%
Injury - 2x and 50%
Failure - 3x and 75%
Loss - persistent AFR or complete loss of kidney function > 4 weeks
End stage kidney disease - complete loss of function more than 3 months

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What are the functions of the kidney?

A

Body fluid homeostasis - fluid overload
Electrolyte homeostasis - Na, K and Cl
Acid base homeostasis
Regulation of vascular tone - BP
Excretory functions - physiological waste and drugs
Endocrine functions - erythropreitin, Vit D and renin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What are some of the presentations of chronic renal failure?

A

Asymptomatic, tiredness, anaemia, oedema, high BP, bone pain, pruritus, N/V, dyspnoea, pericarditis, neuropathy and coma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is the nature of ureteric diseases?

A

Infection - ureteritis
Iatrogenic/ Trauma - cut or tied in hysterectomy or colon resection Neoplasia
Hereditary - PUJ obstruction and VUJ reflux
Obstruction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What are some types of neoplasia in ureteric diseases?

A

TCC of ureter, TCC of bladder obstructing VUJ, prostate cancer obstructing VUJ, pelvic malignancy, pelvic or para-aortic lymphadenopathy

22
Q

What are the types of obstruction in ureteric diseases?

A

Intra-luminal - stone or blood clot
Intra-mural - scar tissue and TCC
Extra-luminal - pelvic mass and lymph nodes

23
Q

What is the presentation of ureteric diseases?

A

Pain, pyrexia, haematuria, palpable mass, and renal failure is bilateral obstruction or single functioning kidney

24
Q

What is the nature of bladder diseases?

A

Infection - cystitis
Inflammation - interstitial cystitis and colo-vesical fistula
Iatrogenic
Neoplasia
Idiopathic - overreactive bladder syndrome
Degenerative - chronic urinary retention
Neurological - bladder dysfunction

25
Q

What iatrogenic/ trauma can cause bladder diseases?

A

Bladder rupture
Bladder injury from hysterectomy resulting in vesico-vaginal fistula

26
Q

What are the types of bladder neoplasia?

A

TCC of bladder making 90%
9% small cell carcinoma
1% adenocarcinoma

27
Q

What is the presentation of bladder diseases?

A

Pain (suprapubic region), pyrexia, haematuria, recurrent UTIs, chronic urinary retention, urinary leak from vagina and pneumaturia
Lower urinary tract symptoms (LUTS)

28
Q

What is included in lower urinary tract symptoms?

A

Storage LUTS (function) - frequency, nocturia, urgency, and urge incontinence
Voiding LUTS (obstruction) - poor flow, intermittency, and terminal dribbling
Incontinence

29
Q

What is the risk of bladder cancer in a patient with visible haematuria?

A

25-30%

30
Q

What is the risk of renal cancer in patient with frank haematuria?

A

0.5-1%

31
Q

What can cause lower urinary tract symptoms (LUTS)?

A

Bladder pathology - OAB, UTI, interstitial cystitis and bladder cancer
Bladder outflow obstruction
Pelvic floor dysfunction
Neurological causes
Systemic disorders

32
Q

What neurological disorders can cause LUTS?

A

Supra-pontine lesions - stroke, Alzheimer’s, and Parkinson’s
Infra-pontine supra-sacral lesions - spinal cord injury, disc prolapse and spina bifida
Infra-sacral - MS, diabetes, cauda equina compression and surgery

33
Q

Describe the control of micturition?

A

Cortical centre - bladder sensation and inhibition of micturition
Pons
Sacral segments - S2-4 micturition reflex
Micturition cycle - storage and voiding phase

34
Q

What is the nature of bladder outflow tract diseases?

A

Infection/ Inflammation - prostatitis and balanitis
Iatrogenic/ Trauma - pelvic floor damage or urethral injury from catheterisation
Neoplasia - prostate and penile
Idiopathic - chronic pelvic pain syndrome
Obstruction

35
Q

What can cause obstruction of bladder outflow tract?

A

Primary bladder neck obstruction, benign prostate enlargement, urethral stricture, meatal stenosis and phimosis

36
Q

What is the presentation of bladder outflow tract diseases?

A

Pain, (suprapubic or perineal), pyrexia, haematuria, LUTS, recurrent UTIs, acute urinary retention and chronic urinary retention

37
Q

What is the definition of acute urinary retention?

A

Painful inability to void with a palpable and percussible bladder
Residuals vary from 500ml to 1l
Main factor is benign prostatic obstruction (BPO)

38
Q

What is the initial treatment for acute urinary retention?

A

Catheterisation
Treat underlying trigger if present

39
Q

What is the definition of chronic urinary retention?

A

Painless, palpable, and percussible bladder after voiding
Often able to void but residual of 400mls to 2l
Main factor is detrusor muscle underactivity
Presents as LUTS or complications

40
Q

When does chronic urinary retention need treatment?

A

Asymptomatic with low residuals don’t necessarily need treatment
Patients with symptoms or complications need treatment

41
Q

What is the treatment for chronic urinary retention?

A

Catheterisation
If high pressure then physiological or pathological diuresis occurs
Long term urethral or suprapubic catheter, CISC, and TURP if benign prostatic obstruction

42
Q

What are some complications of chronic urinary retention?

A

UTI, post-decompression haematuria, pathological diuresis, electrolyte abnormalities, and persistent renal dysfunction

43
Q

Describe UTIs

A

Infection of urinary tract
Diagnosis of microbiological evidence and symptoms or signs
Two types - compilated (need investigated) and uncomplicated (young sexually active female)

44
Q

How is a diagnosis of a UTI made?

A

Diagnosis of microbiological evidence and symptoms or signs - bacterial count of 104 from MSSu culture
At least one - fever, loin/ flank pain, tenderness, subrapubic pin, urinary frequency, urinary urgency, and dysuria

45
Q

What are some factors to consider when differentiating between complicated and uncomplicated UTIs?

A

Age, sexual activity, gender, co-morbidities, abnormal renal tract, foreign body and type of organism

46
Q

What are some complications of UTIs?

A

Infection (sepsis), renal failure, bladder malignancy, acute renal retention, frank haematuria, bladder or renal stones

47
Q

What are the investigations for UTIs?

A

MSSU
Lower tract - flow studies, residual bladder scan and cystoscopy
Upper tract - USS kidneys,, IVU, MAg-3, DMSA scan

48
Q

What is the treatment for UTIs?

A

Appropriate antibiotic therapy
Treat complications and cause

49
Q

What are some emergencies related to UTIs?

A

Acute renal failure, sepsis, renal colic, severe haematuria causing haemorrhagic shock, metastatic disease, acute urinary retention, chronic high pressure urinary retention, testicular torsion and paraphimosis

50
Q

Which organisms are associated with UTIs?

A

E.coli
Klebsiella species
Proteus species
Pseudomonas aeruginosa

Urinary System (26 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions