Renal 1

Question 1

• fRelatively common (1 in 800)
• Pt usually unaware
• Usually only one kidney
• Both kidneys is rare/incompatible w/ life

Answer 1

Unilateral agenesis (one kidney does not form)

Question 2

What are the 4 diseases of the kidney we learned about?

Answer 2

• Unilateral agenesis
• Renal Hypoplasia
• Horseshoe Kidney
• Renal Cystic Dysplasia

Question 3

• Kidneys do not develop to normal size
• More often affects 1 kidney
• When both kidneys involved, results in renal failure (will need dialysis)

Answer 3

Renal Hypoplasia

Question 4

What are the 2 most common causes of Renal Hypoplasia?

Answer 4

• HTN
• DM

Question 5

• Fusion of kidney at midline
• Occurs in 1 in 600
• No issues, unless defect favors obstruction to renal flow

Answer 5

Horseshoe Kidney

Question 6

What vessel blocks a horseshoe kidney?

Answer 6

Inferior Mesenteric Artery (IMA)

Question 7

• Most common renal development disorder
• Results from abnormal differentiation of the renal structures during embryonic period along w/ cyst formation
• Usually unilateral

Answer 7

Renal Cystic Dysplasia

Question 8

• Histologically, tube like structures enclosed by mesenchyme, foci of cartilage, and immature glomeruli and tubules
• ***NO association w/ malignancy***

Answer 8

Renal Cystic Dysplasia

Question 9

• Multiple, expanding serous or purulent filled cysts of both kidneys that destroys intervening parenchyma
• Autosomal Dominant disorder
• Cysts derivedm from obstructed tubules, but reason for obstruction is unknown

Answer 9

Adult Polycystic Kidney Disease

Question 10

• # 1 disorder that needs dialysis
• Develops by age 30 or 40
• BUN and Creatnine are increased
• Kidneys are size of liver!

Answer 10

Adult Polycystic Kidney Disease

Question 11

• Early sign is dull/aching pain in abdomen or back
• Tubules, vessels, glomeruli are all impinged upon
• Signs of renal failure in 3rd or 4th decades of life

Answer 11

Adult Polycystic Kidney Disease

Question 12

• Results in hematuria w/ “red frank blood”
• May lead to ischemic atrophy of intervening parenchyma leading to: hemorrhage, infection, and HTN

Answer 12

Adult Polycystic Kidney Disease

Question 13

• The most common disease that people go on dialysis for

Answer 13

Adult Polycystic Kidney Disease

Question 14

3 things common in people w/ Adult Polycystic Kidney Disease

Answer 14

• HTN w/ varying severity occurs in 75%
• Saccular berry aneurysms present in 10-30% of patients
• End stage renal failure occurs about age 50

Question 15

• As soon as umbilical cord is cut, baby goes into kidney failure
• Autosomal recessive disorder
• Enlarged bilateral kidneys which are non-functional at birth
• Resemble sponges

Answer 15

Childhood Polycystic Kidney Disease

Question 16

• Which disease is “obstructed tubules?”
• Which disease is “cyst appear to originate from epithelium of collecting ducts?”

Answer 16

• Tubules: Adult Polycystic Kidney Disease
• Ducts: Childhood Polycystic Kidney Disease

Question 17

Infection of kidney

Answer 17

Pyelonephritis

Question 18

Infection of urinary bladder

Answer 18

Cystitis

Question 19

• Are pyelonephritis and cystitis acute or chronic infections?

Answer 19

Either

Question 20

Most common cause of UTIs?

(Bacterial, viral, or fungal)

Answer 20

Bacterial (E. coli) : Gram negative rod in GI tract

Question 21

What are 2 ways that bacteria reach the urinary tract and which is most common?

Answer 21

• From blood (hematogenous infection)
• Ascending infection (most common)

Question 22

What causes a woman’s urethra to be more open; making them more prone to contracting UTIs?

Answer 22

Estrogen

Question 23

Besides E. coli, what are 3 other less common bacterias causing UTIs?

Answer 23

• Candida
• Staph aureus
• Staph epidermidis

Question 24

What is the 2nd most common bacteria of the stool?

Answer 24

Ameroides Nigelis

Question 25

Pathologic finding on kidney with acute pyelonephritis

Answer 25

Petechia on surface of kidney

Question 26

Primary infection of UTI which leads to hematogenous infection is typically located in which 3 areas?

Answer 26

• Endocardium
• Lungs
• GI tract

Question 27

Ascensing infection of UTIs are usually from which 3 things?

Answer 27

• Sexual intercourse (honeymoon cystitis)
• After urinary catheterization
• Following surgical procedures (removal of bladder tumor)

Question 28

Why are UTIs more common in women? (3)

Answer 28

• Estrogen/Progesterone have relaxing effect on urthera (opening it up to bacteria)
• Shorter urethra (easier to colonize bladder)
• Pregnancy (enlarged uterus has mechanical/ compressing effects on urinary bladder and ureters)

Question 29

What are other 5 conditions which can lead to UTIs?

Answer 29

• Urinary stones
• Tumors
• BPH
• DM
• Immunosuppression

Question 30

***What is the most common cause of UTIs in men?***

Answer 30

BPH

Question 31

Which bacteria is most common cause of Acute Pyelonephritis?

Answer 31

E. coli (gram negative rod)

Question 32

What are the 2 uncommon bacterial causes of Acute Pyelonephritis?

Answer 32

Staph and Strept (faecalis)

Question 33

• Suppurative infection of kidneys
• Grossly contains foci of pus and focal abscesses
• Severe cases: pus may permeate entire kidney and fill renal pelvis

Answer 33

Acute Pyelonephritis

Question 34

• Round, yellow, raised abscesses are present on renal surface surrounded by areas of congestion

Answer 34

Acute Pyelonephritis

Question 35

• Onset of sudden, sharp pain in the _____ ____, along w/ fever, chills, & malaise.
• UA: pyuria, bacteriuria, & leukocytosis

Answer 35

• Costovertebral angle
• Acute Pyelonephritis

Question 36

Tx for acute pyelonephritis

Answer 36

Abx may be used, but if patient is immunocompetent the infection subsides on its own (usually)

Question 37

Older women, especially with DM, fever, sxs of dehydration, and disorientation probably have what??

Answer 37

UTI –> acute pyelonephritis

Question 38

Connective tissues between blood vessels, tubules, and glomeruli

Answer 38

Interstitium

Question 39

Will acute pyelonephritis have PMNs/neutrophils?

Answer 39

Yes