(U)- Obstructive Uropathy Flashcards

1
Q

What does pressure build-up cause when there is an obstruction?

A

Back-pressure

Areas proximal will swell with urine

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2
Q

What is hydronephrosis?

A

Swelling of the kidney due to accumulation of fluid

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3
Q

What is vesicoureteral reflux?

A

Urine refluxing from the bladder back into ureters

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4
Q

What is post-renal AKI?

A

Reduced kidney function due to obstructive uropathy

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5
Q

What is pre-renal AKI?

A

Reduced kidney function due to hypoperfusion of the kidneys

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6
Q

What can cause hypoperfusion of the kidneys?

A

Dehydration
Sepsis
Acute blood loss

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7
Q

What is renal AKI?

A

Damage within the kidney itself causing reduced kidney function

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8
Q

What can cause renal AKI?

A

Glomerulonephritis
Nephrotoxic medications

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9
Q

How do upper tract obstructions present? (in the ureters)

A

Loin to groin or flank pain

Reduced or no urine output

Vomiting

Impaired renal function on blood tests (raised creatinine)

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10
Q

How do lower tract obstructions present? (in the bladder or urethra)

A

Difficulty or inability to pass urine

Urine retention

Impaired renal function on blood tests

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11
Q

What imaging is used in diagnosing obstructive uropathy?

A

Ultrasound

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12
Q

What are the common causes of upper urinary tract obstruction?

A
  • Kidney stones
  • Tumours
  • Ureter strictures (scar tissue narrowing tube)
  • Retroperitoneal fibrosis (scar tissue in retroperitoneal space)
  • Bladder cancer
  • Ureterocele
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13
Q

What are the common causes of lower urinary tract obstruction?

A
  • BPH
  • Prostate cancer
  • Bladder cancer
  • Urethral strictures
  • Neurogenic bladder
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14
Q

What is neurogenic bladder?

A

Abnormal function of the nerves innervating the bladder and urethra

Leads to over/underactivity of the detrusor and sphincter muscles of the urethra

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15
Q

What are the key causes of neurogenic bladder?

A
  • MS
  • Diabetes
  • Stroke
  • Parkinson’s
  • Brain or spinal cord injury
  • Spina bifida
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16
Q

What problems can neurogenic bladder lead to?

A
  • Urge incontinence
  • Increased bladder pressure
  • Obstructive uropathy
17
Q

How is obstructive uropathy managed?

A

Removing or bypassing obstruction

Nephrostomy

Urethral/Suprapubic catheter

18
Q

What are the complications of obstructive uropathy?

A

Pain
AKI (post-renal)
CKD
Infection
Hydronephrosis
Urinary retention and bladder distention
Overflow incontinence of urine

19
Q

What happens in hydronephrosis?

A

Renal pelvis and calyces swell due to obstruction

20
Q

What causes idiopathic hydronephrosis?

A

Narrowing at the pelviureteric junction

Narrowing can be congenital or develop later

21
Q

How is idiopathic hydronephrosis treated?

A

Pyeloplasty

22
Q

What imaging is used for diagnosis of hydronephrosis?

A

Ultrasound
CT scan
Intravenous urogram

23
Q

How is hydronephrosis treated?

A

Treat underlying cause

Pressure can be relieved with:
- Percutaneous nephrostomy inserting tube into ureter, through skin then kidney
- Antegrade ureteric stent inserting catheter into ureter, through kidney