Urinary Lecture

Question 1

Unilateral Renal Agenesis

Answer 1

usually asymptomatic

Question 2

Bilateral Renal Agenesis

Answer 2

Fatal, most common causes of potter syndrome. Leads to lack of urine (Oligohydramnios). Deficient amniotic fluids prevents lungs from developing. Stillbirth or death soon after birth due to pulmonary hypoplasia

Question 3

What is polycystic kidney disease?

Answer 3

Inherited disorder in which clusters of cysts develop in the kidney over time and interfere with filtration

Question 4

Autosomal Recessive PKD

Answer 4

Inherited mutation in PKHD1 gene from parents. Symptoms present before birth or during early childhood

Question 5

What are the findings of autosomal recessive PKD?

Answer 5

Multiple renal cysts and renal failure
Congenital hepatic fibrosis
Potter syndrome

Question 6

Autosomal Dominant PDK

Answer 6

Inherited mutation in PKD1 or PKD2 from one parent. Symptoms present between 30 and 40

Question 7

Findings in Autosomal dominant PKD

Answer 7

Progressive kidney cyst formation and CKD
Intracranial aneurysms

Question 8

Renal Stones

Answer 8

Known as nephrolithiasis. Large stones are usually asymptomatic, small ones cause most of the pain.

Question 9

Hydronephrosis

Answer 9

= water in kidney. Could be from a stone.

Question 10

Bladder Calculi

Answer 10

More common in older males. Develop when urine is concentrated causing minerals to crystallize

Question 11

Causes of bladder calculi

Answer 11

Enlarged prostates
Nerve damage
Recurring UTIs
Bladder diverticulum or cystocele

Question 12

Bladder Cancer

Answer 12

Almost all cases are urothelial carcinoma
More common in men

Question 13

What are the symptoms of bladder cancer?

Answer 13

Initially asymptomatic
Earliest symptom is painless hematuria (hematuria in men needs to be worked up)
As it grows, patients start experiencing frequency, urgency and dysuria

Question 14

Characteristics of urothelial carcinoma

Answer 14

Tend to have multiple tumors at the same time or over different periods of time. Can be anywhere. Carcinogenic substance is in urine, so all urothelium is at risk

Question 15

What is atozemia?

Answer 15

Abnormally high nitrogen compounds measurable inn the blood (BUN, Creatinine etc)

Question 16

What is uremia?

Answer 16

Severe azotemia with clinical manifestations

Question 17

Nephrotic Syndrome

Answer 17

Remember, O and O in proteinuria.
Caused by dysfunction or damage of the glomerulus that allows large amounts of protein to pass into the urine
Fidnings:
Proteinuria, edema (starts in face)

Question 18

Nephrotic Syndrome

Answer 18

Characterized by damage of the glomerular capillaries by immune mediated inflammation.
Findings include: hematuria, red blood casts (RBC casts presence indicates that source of hematuria was within the kidney)

Question 19

Post Streptococcal Glomerulonephritis

Answer 19

Formed after streptococcal skin or pharynx infection. Typically an acute, transient process

Question 20

Rapidly Progressive Glomerulonephritis

Answer 20

Excessive damage to the glomerulus leads to leakage of procoagulants into urinary space. Leading to formation of glomerular crescents which “squeeze” the glomerulus and shut it down quickly

Question 21

Minimal Change Disease

Answer 21

Common in children.
Minimal or no change in glomeruli by light microscopy.
Fusions of glomeruli podocytes by electron microscopy

Question 22

Focal Segmental Glomerulosclerosis

Answer 22

Most common in adults.
Secondary causes: HIV, drugs, sickle cell
Leads to fibrosis of the glomeruli

Question 23

Membranous Nephropathy

Answer 23

2nd common causes of nephrotic syndrome in adults
Secondary causes: drugs, infections, lupus, solid tumors
Most don’t develop CKD