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Pathology 2210 > Urinary System > Flashcards

Urinary System Flashcards

1
Q

What are the functions of the kidney?

A

Filter blood
Remove waste products
Retain solutes of nutritional
Balance water volume, ion concentration and manage blood pressure

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2
Q

Podocytes have __________ that filter blood based on _____

A

Processes

Size

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3
Q

What is renal failure?

A

Is a condition where the kidney fails to filtered wastes out of the blood adequately

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4
Q

What is chronic renal failure ?

A

Progressive loss of kidney function over a period of months - years

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5
Q

What is acute renal failure?

A

Abrupt loss of kidney function over a period of days, usually caused by critical illness

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6
Q

What are the symptoms of renal failure?

A

Loss of blood components :
Haematuria - Blood cells in urine
Proteinuria - Proteins in urine

Failure to remove wastes (Azotemia) - things like high levels of urea and creatinine

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7
Q

Break down of the ___________________ will cause larger substances and cells to enter the filtrate

A

Glomerular Filtration Membrane

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8
Q

What is End-Stage Renal Disease (ESRD)?

A

It is a condition caused by wastes reaching toxic levels in the blood, it is fatal if left untreated

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9
Q

What are the symptoms of ESRD?

A

Weakness
High BP
Weight gain
Increased salt and fluid retention

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10
Q

Give a brief overview of Haemodialysis:

A

It is the filtration of blood with an artificial membrane
Chronic Treatment - 3 times a week 3-4 hours
Acute treatment - temporary renal replacement therapy

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11
Q

What is peritoneal dialysis?

A

Dialysis using the patients peritoneal membrane as a filter, fluid is pumped into the abdomen and allowed to equilibrate

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12
Q

How do we diagnose renal failure?

A
  • Clearance rates
  • Screening for proteinuria
  • Screening for haematuria
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13
Q

How do we do a blood and urine test?

A

[urine] / [plasma] x 24hr urine volume

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14
Q

What are clearance rates?

A

Clearance rates: measure the rate at which a marker (usually creatinine) is excreted

  • Creatinine has a clearance rate of 100ml/min
  • Requires a blood and urine test
  • Low clearance rate = decline in renal function
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15
Q

_________ is the most abundant protein in the proteinuric urine

A

Albumin

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16
Q

Glomerular diseases may be characterised by:

A 
Inflammation
Scarring
Membrane thickening
Podocytes disorganisation
Minimal change disease
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17
Q

Glomerular diseases are _________ in nature, glomerular tissue ________________

A

Progressive

Cannot regenerate

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18
Q

What is Glomerularnephritis?

A

A inflammatory disease of the glomerulus characterised by the presence of lots of cells including leukocytes in the glomerulus

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19
Q

What are the clinical features of glomerularnephritis?

A

Blocking of urine flow (Oliguria)

Podocyte damage can cause Proteinuria and/or Haematuria

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20
Q

What is Glomerulosclerosis?

A

A disease caused by damage to the glomerulus being repaired by laying down of collagen and other fibres. This affects the filtration membrane

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21
Q

Scarring of the glomerulus can be due to __________ or a secondary response to other diseases e.g. _______

A

Inflammation

Diabetes

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22
Q

What is Membranous Glomerulopathy?

A

A disease caused by the thickening of the capillary walls often with antibody deposits

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23
Q

The cause of membranous glomerulopathy is ________, it is linked to ________

A

Unknown

Diabetes

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24
Q

What is podocyte disruption?

A

It is the disruption of the regular structure, can be caused by flattening or detachment of podocytes

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25
Q

Tubular necrosis is caused by ______, ______ and _________. It is often _______ in nature requires _______ dialysis treatment

A

Ischaemia, Toxins and Chemicals
Acute
Temporary dialysis

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26
Q

Tubules can _______ after several weeks

A

Regenerate

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27
Q

Tubule necrosis causes tubules to _____________. There is loss of the _____________ meaning that solutes can not be absorbed as readily

A

Collapse on themselves

Brush-border

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28
Q

The concentration of electrolytes are measured in ___________, 1 _____ = 1 __________

A

Equivalents

1 charge = 1 equivalent

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29
Q

Most reabsorption occurs in the _____

A

PCT

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30
Q

What is reabsorbed in the PCT?

A 
NaCl
K
Ca
HCO3-,
Glucose and AAs
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31
Q

What is secreted in the PCT?

A

H+

NH3

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32
Q

What is reabsorbed in the LoH?

A

H20
NaCl
Mg in the ascending limb

33
Q

What is reabsorbed in the DCT?

A

NaCl

34
Q

What is secreted in the DCT?

A

K+

35
Q

What is reabsorbed in the collecting duct?

A

NaCl
H2O
Urea

36
Q

What are diuretics?

A

Substances that promote water loss

37
Q

What causes fluid disturbances?

A

Defective aquaporins (Diabetes Insipedus)
Vomiting - loss of water and electrolytes
Diarrhoea - loss of water and electrolytes

38
Q

Electrolyte disturbances can be caused by:

A

Retention of electrolytes
Redistribution of electrolytes - movement to balance charges causes issues with transport and other processes
Defective transporters

39
Q

Bicarbonate is reabsorbed in the ____

A

PCT

40
Q

What causes Respiratory Acidosis?

A

Inefficient CO2 removal, pulmonary disease

41
Q

What causes Respiratory Alkalosis?

A

Hyperventilation, too much CO2 removal

Anxiety and drugs

42
Q

What causes Metabolic Acidosis?

A

Excess H+

Renal failure

43
Q

What causes Metabolic Alkalosis?

A

Excess HCO3-

Ingestion of antacids

44
Q

How does the body respond to Respiratory Acidosis?

A

Kidneys reabsorb more HCO3 in the PCT

45
Q

How does the body respond to Respiratory Alkalosis?

A

Kidneys don’t reabsorb HCO3 in the PCT

46
Q

How does the body respond to Metabolic Acidosis?

A

Lungs blow off more CO2

Kidneys reabsorb more HCO3 in the PCT

47
Q

How does the body respond to Metabolic Alkalosis?

A

Lungs blow off less CO2

Kidneys don’t reabsorb HCO3 in the PCT

48
Q

What is the worst pH related disorder and why?

A

Metabolic Alkalosis because the body’s response is usually inadequate, to reduce CO2 we have to reduce O2 gain

49
Q

Give a brief description of kidney formation:

A

Kidneys start off as buds off of the bladder and ascend into position in the embryo

50
Q

What is agenesis of the kidney?

A

1 kidney fails to form

The kidney that is left is often enlarged to cope with the extra load

51
Q

One of the kidneys may fail to ________ this doesn’t causes issues unless there is _______ of the ureter

A

Ascend

Kinking

52
Q

______ of the kidneys can occur if they fail to ascend, this this doesn’t causes issues unless there is _______ of the ureter. Most common type is ________

A

Fusion
Kinking
Horseshoe

53
Q

There can be ____________________ of the ureter, these patients may be predisposed towards _______ if drainage doesn’t occur properly

A

Full or partial duplication of the ureter

Infection

54
Q

What is a simple cyst?

A

A thin epithelial layer enclosing a clear fluid

55
Q

Simple cysts often _____________

A

Go undetected

56
Q

How do cysts occur?

A

Mutation causes cell proliferation and fluid secretion into the space in between cells due to mutation in fluid transporters

57
Q

What is polycystic kidney disease?

A

A progressive genetic disease
Function declines as nephrons are destroyed and flow is impacted
Can be asymptomatic or painful

58
Q

What are the 2 different types of Polycystic kidney disease?

A

Childhood - Autosomal recessive

  • Cysts at birth
  • Death in early infancy

Adult - Autosomal dominant

  • Can be asymptomatic until 40-50s
  • Relatively common
59
Q

What are medullary cysts?

A

Cysts that occur in the medulla

Can seriously impact flow

60
Q

What are acquired cysts?

A

Cysts that develop in long term dialysis patients

61
Q

What causes urinary obstructuction?

A 
Congenital anomalies
Calculi (Stones)
Prostatic Hypertrophy
Tumours
Inflammation
Inflammation
62
Q

What is Hydronephrosis and Hydroureter?

A

Blockage causes backwards pressure that causes dilation of the renal pelvis and medulla or ureter

63
Q

What are renal calculi?

A

Stones formed from the precipitation of salts like uric acid and calcium in the urine

64
Q

What encourages renal calculi?

A
  • High salt concentrations
  • Urine stagnation
  • Infection
65
Q

What is a staghorn calculus?

A

A renal calculi that is shaped like the renal pelvis

66
Q

Stones may cause _______ or _______ the ureter lining and thus cause _______

A

Blockage or Tearing

Haematuria

67
Q

What is Lithotripsy?

A

A surgery to remove stones by ultrasonic waves that shatter them into small particles that can be excreted

68
Q

Micro-organisms in the urinary system are usually ________________

A

Flushed out with urine

69
Q

When can infection can occur?

A

When urine is stagnant (Flow obstruction)
Ureter lining is damaged
Patient has a catheter

70
Q

What is cystitis?

A

Infection of the bladder

71
Q

What is pyelonephritis?

A

Infection in the kidney

72
Q

Organisms that cause urinary infections are usually __________________

A

The patients enteric flora

73
Q

Where can pyelonephritis originate from?

A 
The blood (Haematogenous)
Backwards flow from the bladder
74
Q

How do we treat UTIs?

A

Treatment with antibiotics is usually successful if underlying cause is corrected as well

75
Q

Recurrent Pyelonephritis can lead to _________ of renal tissue and therefore _____________

A

A decrease in function

76
Q

Summarise benign kidney tumours:

A

Frequently found in the cortex
Usually not harmful
If in medulla can cause blockage and be a breeding ground for infection

77
Q

Summarise features of the main malignant kidney tumour in adults:

A

Renal cell carcinoma

  • Can invade the calyces, pelvis, renal vein, and ureter
  • Can cause bleeding .’. we get Haematuria
  • Prognosis is bad because the by the time it’s identified it’s already metastasised
78
Q

What are Wilms tumours?

A

A highly malignant tumour in children that occurs from spontaneous genetic abnormalities

It causes a swollen abdomen and Haematuria

79
Q

How do we treat Wilms tumours?

A

Nephrectomy
Radiotherapy
Prognosis is generally favourable

Pathology 2210 (20 decks)

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