Renal pathology

Question 1

Flow Interference anywhere along Urinary Tract

↑ Infection Risk + ↓ Renal Functions (↓ GFR)

Dilation of Distal Structures (ex. Hydronephrosis)

Excessive Fibrosis & Apoptosis → Kidney Damages

3-4 Weeks → Irreversible Damages & Loss of Function

Unilateral Obstruction → Compensatory Hypertrophy

Post obstructive Diuresis → Fluid/Electrolyte Imbalance

Answer 1

upper UTO

Question 2

Dilation of Ureter & Pelvicalyceal system

Answer 2

Ureterohydronephrosis:

Question 3

Dilation of Renal Pelvis & Calyces

Answer 3

Hydronephrosis:

Question 4

cause of UTO

most common composition : Calcium + Phosphate

↑ Risk of Chronic Kidney Disease & Myocardial Infarcts
Renal Colic = Moderate to Severe Pain
Often incapacitating + Nausea and Vomiting

Obstructions:
Posterior Flank Colic → Pelvis or Proximal Ureter
Lateral Flank Colic → Midureter
Urgency/Urge Incontinence → Lower Ureter

Answer 4

kidney stones

Question 5

decrease coordination between bladder and sphincter

Answer 5

dyssynergia

Question 6

automatic bladder emptying when full

Answer 6

hyperreflexia

Question 7

Automatic bladder emptying with sphincter contraction → Functional obstruction
lesion between S1 and C2

Answer 7

Overactive Bladder Syndrome

Question 8

Urine retention → Bladder distention

lesion below S1

Answer 8

Underactive Bladder Syndrome

Question 9

what are the manifestation of urine flow obstruction?

Answer 9

frequent voiding
nocturia, urgency and dysuria
weak and intermittent stream
feeling of full bladder despite urination.

Question 10

what bacteria are involved in acute cytitis?

Answer 10

E.coli and Staphylococcus S.

Question 11

what are the manifestation of acute cytitis?

Answer 11

common: Frequency + Urgency + Dysuria; Low Back Pain
Severe: Hematuria; Flank Pain; Foul-Smelling urine

Question 12

Renal Edema & Inflammation
Purulent (WBC) Urine
Medullary Abscesses
Classic UTI Sx (Frequency, Dysuria, etc)
Acute Systemic Sx (Fever & Flank Pain)

Answer 12

Acute Pyelonephritis

Question 13

Tubule & Pelvis Atrophy + Dilation
↓
Permanent Kidney Scarring

Answer 13

Chronic pyelonephritis

Question 14

Classic Sx → Hematuria & Proteinuria (by increased permeability)
Severe Cases: Edema + Hypertension + ↓ Renal Functions (by a decrease in GFR)

Answer 14

Acute Glomerulonephritis

Question 15

Chronic Hyperglycemia
↓
Metabolic + Microvascular + Inflammatory Damages
↓
Glomerular Membrane Fibrosis + Mesangial Proliferation
↓
Proteinuria & Chronic Kidney Disease

Answer 15

Diabetic nephropathy

Question 16

Complication of SLE → Autoimmune Complexes Deposition
↓
Complement Activation + Inflammatory Cascade
↓
Glomerular Membrane Fibrosis + Mesangial Proliferation

Answer 16

Lupus Nephritis

Question 17

Altered glomerular permeability and loss of negative change - protenuria
manifestations : edema and lipiduria
Protein Excretion ˃ 3g/day + Hypoalbuminemia + Edema
Cause = Glomerular Injuries

Answer 17

Nephrotic Syndrome

Question 18

Hematuria (RBC Casts) with mild Proteinuria

Cause = Glomerular Pores ˃ RBC

Answer 18

Nephritic Syndrome

Question 19

Chronic kidney diseas is associated with what systemic diseases?

Answer 19

Metabolic Syndrome; Diabetes; SLE; AKI or Chronic Glomerulonephritis

Question 20

↑ Angiotensin II: ↑ GFR & Permeability + Systemic HT

Proteinuria: ↑ Inflammation & Progressive Fibrosis

Answer 20

chronic kidney injury

Question 21

increases when GFR decreases

Answer 21

urea

Question 22

symptoms of hyponatremia

Answer 22

Vomiting; Diarrhea; ↑ Secretions & Filtration

Question 23

symptoms of hypernatremia

Answer 23

Excesssive Retention → HT + Edema + Heart Failure

Question 24

Which of the following is the least likely to lead to Urinary Tract Obstruction?
Prostate Cancer
Urethral Sphincter Atrophy
Pregnancy
Urethral Stenosis

Answer 24

Urethral Sphincter Atrophy

Question 25

What is the ultimate consequence of most acute kidney injuries (AKI)
No urine formation
Increased GFR
Acute Tubular Necrosis
Low urine output

Answer 25

Low urine output