Renal System Flashcards
What is Meant by Obstructive Disorders?
Urinary obstruction can occur in people of any age, involve any level of the Urinary Tract from Urethra to pelvis.
Obstruction may be sudden or insidious, partial or complete, unilateral or bilateral.
Causative conditions include congenital abnormalies, urinary calculi (stones), pregnancy, benign prostatic hyperplasia, scar tissue resulting from injection and inflammation, tumours, neurologically disorders such as Spinal Cord Injury.
What is Pathogenesis of Renal Calculi?
Anatomical changes in Urinary Tracts Structures, Metabolic and Endocrine influences, Dietary Factors and Urinary Tract Infections. There are 4 basic types of Kidney Stones:
- Calcium
- Magnesium Ammonium Phosphate Stones
- Urine Acid Stones
- Cystine Stones
What are the Signs and Symptoms of Renal Calculi?
Major Manifestation is PAIN.
Two types of Pain accociated with stones - Renal Colic and Noncolicky renal pain.
1. Renal Colic - Term used to describe the colicky pain which accompanies stretching of collecting duct or ureter as stone is attempted to be passed.
Caused by Stones 1-5mm in Diameter, which can obstruct urine flow in the Ureter.
Acute, intermittent and Excruciating Pain in the Flank and upper outer Quadrant of the Abdomen on the Affected side.
Pain may radiate to the lower abdominal quadrant, bladder area, perineum or scrotum in a man.
Skin may be cool and clammy
Nausea and Vomiting are common.
2. Noncolicky Pain - caused by Pain that accompanies distension of structures within the Kidney,
Deep Dull ache in Flank can vary from Mild to Severe.
Pain often Exaggerated by Drinking large amounts of Fluid.
What is a Urinary Tract Infections?
A very common type of Bacterial infection seen in healthcare. There are Several Different forms:
- Asymptomatic Bacteriuria
- Symptomatic Infections
- Lower UTI’s such as Cystitis
- Upper UTI’s such as Pyelonephritis
Ability to cause renal damage, UTIS are considered to be more serious.
What is the Pathogenesis of Urinary Tract Infections?
Most UTIs are caused by Bacteria that enter via the Urethra. Can also be through Bloodstream, usually in Immunocompromised individuals and Neonates.
Increased risk of UTIs in people with Urinary Obstruction or Reflux, in people with Neurogenic Disorders that delay bladder emptying, in Women who are sexually active, post menopausal women, in men with diseases of the prostate and in Older Adults.
What are Disorders of Glomerular Function - Acute Pyelonephritis?
Represents an upper UTI
Risk factors are those which increase an individual susceptibility or reduce their response to infection e.g. individuals with Diabetes mellitus.
Occurs most often in debilitated, chronically ill people and those receiving immunosuppression treatment.
What are Symptoms of Acute Pyelonephritis?
Presents with an abrupt onset of Chills, pyrexia, or even hyper pyrexia and flank tenderness which may be unilateral or bilateral.
Nausea and Vomiting along with abdominal pain.
What are Malignant Tumours of the Kidney - Renal Carcinoma?
Kidney cancer is largely a silent disorder in the early stages, and symptoms usually present during advanced stages.
Haematuria, flank pain and presence of a palpable mass.
Tumour may reach considerable size before it is detected.
Often detected on scanning when looking for other conditions.
What is Dehydration?
A condition caused by the loss of too much Fluid from the Body. It can be Caused by:-
- Diarrhoea
- Vomiting
- Excessive Sweating
- Over Urinating
- Fever
- Not Drinking enough
Who are at Higher Risk of Dehydration?
Older Adults. Some evidence that the elderly may lose their sense of thirst, so they don’t drink
Infants and Younger Children, more likely to have Diarrhoea and Vomiting
People with Chronic illnesses that cause more Urination or Sweating - Diabetes, Cystic Fibrosis or Renal Problems
People who take Diuretics
People who work outdoors or exercise during hot weather.
What are Symptoms of Dehydration in Adults?
Feeling Thirsty
Dry Mouth
Less Urine and Sweat
Dark Coloured Urine
Dry Skin
Feeling Tired
Dizziness
Tenting of the Skin
What are the Symptoms of Dehydration in Infants and Young Children?
Dry Mouth
Crying without Tears
No Wet Nappies for 3hrs or More
Fever (HIGH)
Unusually Sleepy or Drowsy
Irritable
Sunken Eyes
Sunken Fontanelle
What is Meant by Urinary Retention?
The inability to Voluntarity Urinate.
Acute Retention is a Medical Emergency, Characterised the abrupt development of the Inability to pass urine (Over a Period of Hours)
Chronic Urinary Retention is the Gradual (over moths and Years) of the inability to empty the bladder completely, Characterised by a residual volume greater than 1 Litre or associated with the presence of a distended or palpable bladder.
May be due to Urethral blockage, effects of certain drugs, neurogenic causes, postpartum, postoperatively.
What is Acute Urinary Retention?
Painful and Required immediate treatment by Catheterisation.
Most common cause in men is benign prostatic hyperplasia (Increase in number of cells in a structure).
Usually Present with symptoms associated with obstruction (Acute or Chronic) urinary retention, frequency of urination, urgency or nocturia.
What is the Treatment for Urinary Retention?
Catheterisation to relive pain. Before Catheter is remover 2 days of drugs e.g. Alfuzosin Doxazosin to relax muscles.
Intermittent Catheterisation offered, before an indwelling catheter inserted.
Surgery recommended for men with some more severe symptoms that do not responds to drug therapy, or have complications, such as acute retention, haematuria, renal failure, bladder calculi or recurrent urinary tract infections.
