Urinary System Path (exam 5) Flashcards
What is the most common renal pathology?
Obstruction
What is an urinary tract obstruction?
What causes them?
Interference with the flow of urine at anywhere in urinary tract
Any anatomic or functional defect
What is hydroureter?
What typically causes it?
What can hydroureter cause?
To much water or fluid in the ureters
Usually due to a blockage at the entrance to the bladder
Can lead to hydronephrosis
What is hydronephrosis?
What does it lead to?
To much water or fluid in the kidneys
Can lead to increased pressure in kidneys or tubules, increasing CHP
Is hydroureter or hydronephrosis more pathologic?
Why?
Hydronephrosis due to the negative effects on kidneys
What is compensatory hypertrophy?
What leads to it?
Overcompensation by one kidney due to poor functioning of the other kidney
The healthy kidney hypertrophoes
From obstruction of 1 kidney, from a kidney removal, from pyelonephritis
What is post-obstructive diuresis?
High increase in urination frequency (increased kidney output) once a kidney obstruction is removed/ alleviated
What are renal calculi?
What are the classifications of renal calculi?
They are kidney stones, or urinary stones (once they enter the urinary system)
Calcium oxalate or calcium phosphate (most common)
Struvite stones (ammonia, magnesium stones)
Uric acid and cystine stones
What causes renal calculi?
What are the most common risk factors?
Most often percipitated and crystallized minerals, Supersaturation of one or more salts, precipitation of a salt from liquid to solid state
Risk factors most likely from changes in pH, also temperature and dehydration (changes in mineral concentration levels)
What are symptoms of renal calculi?
Renal Colic (intense but intermittent flank pain), hematuria, vomiting
What substance has the largest contribution to formation of renal calculi?
Calcium derived stones
How do you treat renal calculi?
High fluid intake, decreasing dietary intake of stone-forming substances, stone removal
Lithotripsy (ultrasound waves used to break up kidney stones into smaller pieces)
What is prostatitis?
Inflammation of prostate in males
Can block flow of urine and lead to weak urine flow and pain urinations (dysuria)
What is neurogenic bladder (detrusor dyssynergia)?
What are the types?
Loss of nervous control of the bladder
Detrusor hyperreflexia: urinary frequency increases
Detrusor areflexia: decreased urinary frequency
What are the types of renal tumors?
How do they differ?
Renal adenomas: typically benign growths
Renal cell carcinomas (RCC): highly malignant tumor growths
Who are bladder tumors more common in?
What is an important, distinguishing symptom?
Older malls (60 or older) who smoke and drink Massive amounts of gross, painless hematuria
What is an urinary tract infection?
Inflammation of the urinary epithelium usually caused by bacteria
What bacteria usually causes UTIs? What yeast (fungus)?
E coli (bacteria) Candida albicans (yeast)
Why are women more likely to get UTIs?
Length of urethra (women shorter)
Proximity to anus/ rectum (women closer)
Prostate (secretes antibiotics, antimicrobial secretions)
What is cystitis?
What are the types?
What do they present with?
Bladder inflammation/ infection
Noninfectious cystitis: not bacteria, its caused by yeast, virus, autoimmune or hypersensitivity
Present with cloudy urine, abdominal pain, dysuria, increased frequency, sometimes hematuria
What is pyelonephritis?
What do we usually see with it? Why?
What can it lead to?
Kidney inflammation/ infection that has crossed into the renal pelvis
Usually see compensatory hypertrophy because typically only 1 kidney affected
Leads to obstruction (lack of urine formation) because of lack of filtration
Differentiate the types of pyelonephritis?
Acute pyelonephritis: short term/ localized infection, no tissue change
Chronic pyelonephritis: recurring acute infections or stone formation that leads to permanent scarring
What do glomerular disorders affect?
Affect filtering at the glomerulus and disrupt the membrane functioning
Decreased glomerular filtration rate: reduced creatinine clearance
Elevated BUN
Loss of negative charge of glomerular filtration membrane, prtein in the urine: proteinuria
What do glomerular disorders result in?
Hypoalbuminemia which causes hypocalcemia
Edema
What is glomerulonephritis?
What causes it?
Inflammation of the glomerulus
Commonly due to hypersensitivity reactions: type 2- antibodies against the glomerular, type 3- depositions of antigen antibody complexes
From post-streptococcal infection, viral infection, diabetes
What does glomerulonephritis lead to?
Systemic disorder that affects BOTH kidneys
Most common cause of end-stage renal failure
Can lead to nephrotic syndrome
What is nephrotic syndrome?
Loss of 3.5 or more grams of protein per day in the urine
From increased glomerular permeability
Leads to hypoalbuminemia and then hypocalcemia, edema
Rapid onset but it is not kidney failure
What is acute kidney injury?
What causes it
Acute renal failure
Sudden (rapid onset) lack of renal function
Lack of blood flow (renal hypoperfusion) decreases filtration and lowers GFR
From impaired renal blood flow, generally from trauma or hemorrhage
Most common cause is glomerulonephritis
What is chronic renal failure?
What are some things it causes?
Irreversible loss of renal function (end stage failure)
Loss of kidney function affects homeostatic control mechanisms and negatively impacts multiple systems
Proteinuria and uremia: protein in urine, high urea in blood
Creatinine and urea clearance: goes down
Fluid and electrolyte balance disrupted
Acid-base balance disrupted
Anemia: because we don’t release EPO
Loss of bone density
Hypocalcemia: because of hypoalbuminemia
How does the renal system cause metabolic acidosis?
Increased filtration of bicarb (retain more hydrogen) Increased reabsorption of hydrogen Decreased reabsorption of bicarb (HCO3-) Decreased secretion of hydrogen Increased secretion of bicarb
How does the renal system cause metabolic alkylosis?
Increased filtration of hydrogen Increased reabsorption of bicarb Decreased reabsorption of hydrogen Increased secretion of hydrogen Decreased secretion of bicarb
