Renal Pathology and Pharmacology Flashcards
What are the 4 symptoms of Urinary Obstruction?
- Anuria
- Polyuria
- Bladder distention
- Sometimes asymptomatic
What are the 4 symptoms of Renal/ureter stones?
- Renal colic
- Hematuria
- Pyelonephritis
- Sometimes asymptomatic
What is Pyelonephritis?
Kidney infection
What are 4 consequences of Pyelonephritis?
- Flank pain
- Fever
- 10-20% chronic renal failure
- Kidney scarring
What are 4 groups of people are at risk for Renal cell carcinomas?
- More common in males >40 yrs
- Smokers
- Analgesic users (NSAIDS)
- Obesity
What are 5 symptoms of Renal cell carcinomas?
- Hematuria
- Dull flank pain
- Fever
- Fatigue
- Often asymptomatic
Renal cell carcinomas most likely metastize to what two parts of the body?
Lungs or bones
What age are Wilms tumors most common?
First 3 years
What is the most common congenital renal tumor?
Wilms tumor
What are 4 contributing factors to bacterial cystitis in the bladder?
- Stones
- Catheters
- Short female urethras
- Obstructions
What are 3 features of urothelial carcinomas?
- Most often in males >50 years old
- Most common urothelial malignancy
- Associated with smoking, carcinogens (e.g., dyes, paint etc.)
What are 3 features of prostatitis?
- Most common in older men
- Often caused by bacteria responsible for cystitis
- Causes enlarged and tender prostate can cause obstruction
95% of cases of benign prostatic hyperplasia happen in men over what age?
75
What percent of benign prostatic hyperplasia cases must be relieved with surgery?
10%
What is the cause of benign prostatic hyperplasia?
Not well known; perhaps has to do with androgens or even estrogens
(T/F) Urinary obstruction is uncommon in benign prostatic hyperplasia patients.
False
Prostatic adenocarcinoma is most common malignancy (except skin cancers) in what demographic?
Older men; 60% of men >80 years old
How is prostatic adenocarcinoma most often detected?
Rectal exams
What does a rapidly increasing PSA (prostate specific antigen) mean?
High risk for cancer
How much PSA (prostate specific antigen) is abnormal?
> 4-6 mg/ml
(T/F) PSA (prostate specific antigen) is higher with age
True
The more PSA bound to ______________, the higher the risk of cancer.
alpha-1-antichymotrypsin (inflammatory protein)
How many American adults have chronic kidney disease?
26 Million
How many American adults are on dialysis?
½ million
What are 3 main causes of Chronic Renal disease?
- Diabetes
- Hypertension
- Chronic glomerulonephritis
What is the most common primary glomerulonephritis?
IgA nephropathy—triggered by a viral infection
5 things CRD patients can have:
- Platelet dysfunctions (bleeding)
- Gingival hyperplasia
- bone abnormalities (slow bone healing after oral surgery)
- Premature bone loss (osteoporosis)
- Infectious complications (due to immunosuppression)
4 common symptoms of CRD
- Heavy proteinuria (excessive protein in urine indicates renal cell death)
- Hematuria
- Inflammatory injury to kidneys (e.g., immune deposits in glomeruli block normal blood filtration and reabsorption)
- Glomeruli scarring and damaged functioning-could be sclerotic types
What are 4 common treatments (and analgesic) for small (<1 cm) kidney stones?
- Drink considerable water
- Dietary changes
- OTC analgesics (ibuprofen, Naprosyn)
- Tamusolin (Flomax)—relaxes ureter muscle (often have spasm due to irritation of the stone)
What are 3 treatments (and analgesic) for larger kidney stones?
- Lithotripsy (shock wave treatment)-break up stones
- Surgical removal
- Opioid analgesics for pain
What is the most common type of kidney stone? What percentage?
Calcium/oxylate excess in urine (~80% of stones)
What type of kidney stone is often associated with urinary infections? What Percentage?
Struvite (~10% of stones)-magnesium ammonium phosphate crystals
What is the only treatment for struvite kidney stones?
Acidify urine
Which type of kidney stone is often associated with gout?
Uric acid
In treatment of kidney stones, what is Hydrochlorothiazide for?
Thiazide diuretic—reduces calcium in urine
In treatment of kidney stones, what is Sodium bicarbonate for?
Alkalinizes urine
In treatment of kidney stones, what is Allopurinol for?
Reduces uric acid excretion—also used for gout
What bacteria are UTI’s often caused by?
E. Coli
What are 3 common treatments for UTIs?
- Trimethoprim-sulfamethoxazole
- Amoxicillin + clavulanic acid (resistant bacteria a problem)
- Ciprofloxacin (expensive)
What drug is used for hypertension in hemodialysis patients?
Atenolol and/or captopril
What drug is used to prevent clotting in blood passed through dialysis machine?
Heparin
What potent diuretic reduces fluid retention and the amount of fluid that needs to be removed by dialysis?
Furosemide
What drug has a high rate of infection in hemodialysis patients?
Prophylactic antibiotics
Renal cell carcinomas account for what percentage of total renal malignancies?
80-90% of renal malignancies
