Urinary Flashcards
Do urinary procedures need CM?
Yes, typically.
What does VCUG stand for
Voiding cystourethrogram
What is a high BUN indicative of
Kidneys may not be working well
What is a high creatinine indicative of
kidney not filtering well
What is a low eGFR indicative of
loss of kidney function
Ectopic kidney
Abnormally positioned kidney
Are ectopic kidneys functional
usually yes
Horseshoe kidney
Both poles are mal-rotated and joined resembling a horseshoe
Duplication/Duplex collecting system
anomaly where multiple collecting systems form. Bifid: 2 collecting systems to one renal pelvis and ureter
complete double pelvis/duplex: 2 renal pelvis and ureters per kidney
What does VUR stand for
Vesicoureteral Reflux
What is Vesicoureteral Reflux (VUR)
An abnormal flow or urine from the bladder back into ureters DUE to failure of the vesico-urethral valve
Is VUR typically in adults or children
Usually a congenital condition in children
Is VUR congenital or traumatic
Typically congenital but can be from nerve damage or urethral blockage
What is a common complication of VUR
UTI
Ureterocele
Stenosis of distal ureter…leads to prolapsed bladder
How will Uretocele affect the bladder
It will prolapse and subsequently become abnormally dilated
What does Uretocele commonly lead to
hydronephrosis
What is something to look for radiographically for Uretocele
Cobra Head sign
Pyelonephritis
Inflammation of the kidney (acute or chronic)
What is often the cause of Pyelonephritis
Urinary tract obstruction
Pyuria
Pus in urine
What can happen with unresolved Pyelonephritis when a patient is diabetic
May become emphysematous pyelonephritis which is a necrotizing infection that can permanently damage or destroy a kidney
How does pyelonephritis look on an xray
There can be an abscess, hydronephrosis(enlarged kidney), or gas bubbles if it is emphysematous
Cystitis
Inflammation of urinary bladder
Is Cystitis more common in male or female anatomy
Female anatomy due to the shorter urethra
What are some possible causes of Cystitis
Bacterial infection, Instrumentation, Catheterization, or sexual intercourse
How can you help prevent cystitis in a patient with a catheter
keep the bag lower than the bladder to prevent backflow
Dysuria
Painful urination
Renal Calculi
Kidney Stones
What can Renal Calculi be made of
Calcium, uric acid, cystine, struvite
What percentage of renal stones are radioopaque
~80%
Phleboliths
Calcified clots within a vein
What is commonly mistaken for kidney stones
Phleboliths
Where are phleboliths most commonly located
Lower part of pelvis
Renal Colic
Severe pain presenting suddenly
What is usually the cause of Renal Colic
stones stuck in kidney, renal pelvis or ureters. Pain is from dilation and stretching/spasm of the ureter
What is a symptom of Renal Colic (besides pain)
Hematuria (blood in urine)
Hydronephrosis
Dilation/distention of renal pelvis and calyces (due to trapped urine)
What commonly causes Hydronephrosis
Obstructions
What is bilateral hydronephrosis indicative of
an obstruction at the base of the urinary bladder or urethra (affecting both ureters)
What is the main concern with hydronephrosis
It can lead to a completely and PERMANENTLY destroyed kidney functionally
Hydroureter
Dilated ureters
What are some treatments for Renal Calculi
Hydrate and wait
Lithotripsy (ultrasound shock waves to destroy stone)
Laster Lithotripsy (laser to destroy)
Chemolysis (medication to break them)
Surgical removal
Percutaneous nephrolithotomy/lithotripsy
Through small incision a tube is used to visualize the stone, then remove/break it. Follow up in fluoro
Cystoscopic retrieval can be 2 methods. These are
Basket extraction and Stent insertion
Are renal cysts usually malignant or benign
benign
Septations
Septums between portions of a cyst
Are renal cysts always unifocal
no, can be unifocal or bilateral
What may you need to do to definitively diagnose renal cysts
a biopsy
Polycystic kidney disease
Inherited disorder: cysts lobulate on the kidneys
Adenocarcinoma
Any malignancy involving glandular tissue in epithelium
Renal cell adenocarcinoma
Most common cancer of kidneys (RCC)
What is another name for RCC (renal cell carcinoma)
Hypernephroma
What is often the only symptom of RCC
Painless hematuria
Bladder carcinoma
Bladder tumor from epithelium
Who is most susceptible to bladder carcinoma
Males over 50
What is the most common symptom of bladder carcinoma
painless hematuria
ACUTE Renal Failure
quick onset and sudden damage. Rapid deterioration means nitrogen containing waste accumulates in the blood.
CHRONIC Renal Failure
Slow progression (over months)
Renal Hypertension
Also called renovascular hypertension.
Elevated blood pressure CAUSED by narrowing arteries that deliver blood to kidney
What are the symptoms of Renal hypertension
usually ASYMPPTOMATIC aside from really high BP
How is Renal hypertension usually managed
Using BP medication
What is a more severe treatment for renal hypertension
Angioplasty. Stenting or surgery.
