Renal 1 Flashcards
- Relatively common (1 in 800)
- Pt usually unaware
- Usually only one kidney
- Both kidneys is rare/incompatible w/ life
Unilateral agenesis (one kidney does not form)
What are the 4 diseases of the kidney we learned about?
- Unilateral agenesis
- Renal Hypoplasia
- Horseshoe Kidney
- Renal Cystic Dysplasia
- Kidneys do not develop to normal size
- More often affects 1 kidney
- When both kidneys involved, results in renal failure (will need dialysis)
Renal Hypoplasia
What are the 2 most common causes of Renal Hypoplasia?
- HTN
- DM
- Fusion of kidney at midline
- Occurs in 1 in 600
- No issues, unless defect favors obstruction to renal flow
Horseshoe Kidney
What vessel blocks a horseshoe kidney?
Inferior Mesenteric Artery (IMA)
- Most common renal development disorder
- Results from abnormal differentiation of the renal structures during embryonic period along w/ cyst formation
- Usually unilateral
Renal Cystic Dysplasia
- Histologically, tube like structures enclosed by mesenchyme, foci of cartilage, and immature glomeruli and tubules
- ***NO association w/ malignancy***
Renal Cystic Dysplasia
- 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
Adult Polycystic Kidney Disease
- # 1 disorder that needs dialysis
- Develops by age 30 or 40
- BUN and Creatnine are increased
- Kidneys are size of liver!
Adult Polycystic Kidney Disease
- 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
Adult Polycystic Kidney Disease
- Results in hematuria w/ “red frank blood”
- May lead to ischemic atrophy of intervening parenchyma leading to: hemorrhage, infection, and HTN
Adult Polycystic Kidney Disease
- The most common congenital kidney disease that people go on dialysis for
Adult Polycystic Kidney Disease
3 things common in people w/ Adult Polycystic Kidney Disease
- HTN w/ varying severity occurs in 75%
- Saccular berry aneurysms present in 10-30% of patients
- End stage renal failure occurs about age 50
- 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
Childhood Polycystic Kidney Disease
- Which disease is “obstructed tubules?”
- Which disease is “cyst appear to originate from epithelium of collecting ducts?”
- Tubules: Adult Polycystic Kidney Disease
- Ducts: Childhood Polycystic Kidney Disease
Infection of kidney
Pyelonephritis
Infection of urinary bladder
Cystitis
- Are pyelonephritis and cystitis acute or chronic infections?
Either
Most common cause of UTIs?
(Bacterial, viral, or fungal)
Bacterial (E. coli) : Gram negative rod in GI tract
What are 2 ways that bacteria reach the urinary tract and which is most common?
- From blood (hematogenous infection)
- Ascending infection (most common)
What causes a woman’s urethra to be more open; making them more prone to contracting UTIs?
Estrogen
Besides E. coli, what are 3 other less common bacterias causing UTIs?
- Candida
- Staph aureus
- Staph epidermidis
What is the 2nd most common bacteria of the stool?
Ameroides Nigelis
Pathologic finding on kidney with acute pyelonephritis
Petechia on surface of kidney
Primary infection which leads to hematogenous infection is typically located in which 3 areas?
- Endocardium
- Lungs
- GI tract
Ascensing infection of UTIs are usually from which 3 things?
- Sexual intercourse (honeymoon cystitis)
- After urinary catheterization
- Following surgical procedures (removal of bladder tumor)
Why are UTIs more common in women? (3)
- 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)
What are other 5 conditions which can lead to UTIs?
- Urinary stones
- Tumors
- BPH
- DM
- Immunosuppression
***What is the most common cause of UTIs in men?***
BPH
Which bacteria is most common cause of Acute Pyelonephritis?
E. coli (gram negative rod)
What are the 2 uncommon bacterial causes of Acute Pyelonephritis?
Staph and Strept (faecalis)
- Suppurative infection of kidneys
- Grossly contains foci of pus and focal abscesses
- Severe cases: pus may permeate entire kidney and fill renal pelvis
Acute Pyelonephritis
- Round, yellow, raised abscesses are present on renal surface surrounded by areas of congestion
Acute Pyelonephritis
- Onset of sudden, sharp pain in the _____ ____, along w/ fever, chills, & malaise.
- UA: pyuria, bacteriuria, & leukocytosis
- Costovertebral angle
- Acute Pyelonephritis
Tx for acute pyelonephritis
Abx may be used, but if patient is immunocompetent the infection subsides on its own (usually)
Older women, especially with DM, fever, sxs of dehydration, and disorientation probably have what??
UTI –> acute pyelonephritis
Connective tissues between blood vessels, tubules, and glomeruli
Interstitium
Will acute pyelonephritis have PMNs/neutrophils?
Yes
