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Pathology 3000 > Urinary Tract > Flashcards

Urinary Tract Flashcards

1
Q

Glomeruli

A

Bundle of capillaries for filtering blood

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2
Q

Primary function of urinary tract

A

Formation and excretion of urine

  1. Ultrafiltration of blood in the nephrons of the kidneys
  2. Urine then enters renal collecting system
  3. Through ureters to urinary bladder
  4. Discharged through urethra
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3
Q

Nephron

A

Basic functional unit of the kindey
Contains glomeruli, tubules and collecting ducts
~90% of fluid is reabsorbed
Conserves water, balances pH and ionic composition of blood

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4
Q

Hormones that kidneys synthesize (2)

A
  1. Renin

2. Erythropoietin

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5
Q

Renin

A

Raises blood pressure

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6
Q

Erythropoietin

A

Stimulates RBC production in the bone marrow

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7
Q

Hormones that regulate kidney function (3)

A
  1. Antidiuretic hormone
  2. Arterial natriuretic factor
  3. Aldosterone
    Imperative for normal kidney function
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8
Q

Antidiuretic hormone

A

Stimulates water uptake in the distal convoluted tubules

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9
Q

Arterial natriuretic hormone

A

Stimulates water loss

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10
Q

Aldosterone

A

Increases sodium reabsorption which increases body fluid volume

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11
Q

Juxtaglomerular apparatus

A

Senses pressure in distal tubule, and promotes production of renin

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12
Q

Developmental disorders (4)

A

Very common, mostly asymptomatic

  1. Renal agenesis
  2. Horseshoe kidney
  3. Polycystic kidney disease
  4. Multicystic renal dysplasia
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13
Q

Renal agenesis

A

Bilateral or unilaterial

No kidneys

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14
Q

Horseshoe kidney

A

Kidneys fuse at posterior section
Function usually not impaired
Accidental discovery

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15
Q

Polycystic kidney disease

A

Autosomal polycystic kidney disease - 85% due to mutation in polycystin-1
Kidneys lose function completely and need dialysis/donor (40-50yo)
Bilateral involvement, massive enlargement, almost complete parenchymal replacement by cysts, derived from blocked tubules
Cysts arise in nephron, epithelial lining, interstitial inflammation and fibrosis

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16
Q

Symptoms of autosomal dominant polycystic kidney disease

A

Hematuria, oliguria, flank pain

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17
Q

Cystic renal dysplasia

A

Sporadic, non-familial
Abnormal metanephric differentiation
Unilateral or bilateral kidney enlargement, multicystic
Immature ducts surrounded by undifferentiated mesenchyme
Often focal cartilage, abnormal lobar organization
Mostly associated with ureteropelvic obstruction, ureteral agenesis or atresia and other abnormalities of lower urinary tract

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18
Q

Local symptoms of kidney disease

A

Changes is urine volume - polyuria or oliguria

and composition - hematuria, glucosuria, pyuria

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19
Q

Pyuria

A

Pus formation in urine

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20
Q

Systemic symptoms of kidney disease

A

Fever
Malaise (infections)
Uremia

21
Q

Uremia

A

Accumulation of various metabolites in the blood

Creatinine, uric acid, ammonia

22
Q

Glomerular disease (4)

A
  1. Immunogenic diseases
  2. Metabolic
  3. Circulatory disturbances
  4. Multiple mechanisms
23
Q

Glomerulonephritis

A

Immunogenic disease of glomerulus

24
Q

Metabolic glomerular diseases (2)

A
  1. Diabetes

2. Amyloidosis

25
Q

Circulatory disturbances causing glomerular diseases (3)

A
  1. Hypertension
  2. Atherosclerosis
  3. Disseminated intravascular coagulation
26
Q

Symptoms of glomerular disease *** (4)

A
  1. Rapidly progressive glomerulonephritis
  2. Nephritic syndrome
  3. Nephrotic syndrome
  4. Isolated hematuria or proteinuria
27
Q

Nephrotic syndrome (7)

A
  1. Increased glomerular permeability
  2. Nephrotic range proteinuria
  3. Hypoalbuminemia
  4. Edema
  5. Hyperlipidemia (lipiduria)
  6. Thrombo-embolism
  7. Infection
28
Q

Nephritic syndrome (7)

A
  1. Hematuria
  2. RBC casts, dysmorphic/fragmented RBC in urine
  3. Oliguria
  4. Proteinuria
  5. Hypoalbuminemia
  6. Edema
  7. Hypertension
29
Q

Crescentic glomerulonephritis

A

Immune related
Severe glomerular injury
Formation of fibrinous exudate inside Bowman’s capsule
Usually in patients with anti-glomerular basement membrane disease (Goodpasture’s syndrome)
Anuria and acute renal failure

30
Q

Acute glomerulonephritis

A

Immune-mediated inflammation of the glomerulus, 1-2 weeks after acute infection
Nephritic syndrome
Glomeruli filled with inflammatory cells

31
Q

Poststreptococcal Acute Glomerulonephritis by EM (5)

A
  1. Deposition of immune complexes in glomerular basement membrane
  2. Glomeruli appear hypercellular, with increased mesangial cells and inflammatory cells
  3. Compression of capillaries causing renin release
  4. BM damage leads to hypoalbumemia
  5. Peripheral edemia
32
Q

Membranous nephropathy

A

Common cause of nephrotic syndrome in adults
Immune-mediated glomerulopathy
Thickening of BM secondary to massive deposition of immune complexes
Staining for Ig, C3 shows granular staining around capillary walls

33
Q

Lipoid nephrosis

A

Minimal change disease
Most common nephrotic syndrome in children
Nephrotic syndrome with hyperlipidemia and lipiduria
Fusion of foot processes by electron microscopy

34
Q

Chronic proliferative glomerulonephritic (4)

A
  1. IgA nephropathy
  2. Membranoproliferative GN
  3. Focal mesangial proliferative GN
  4. SLE
    (no effective treatments except SLE)
35
Q

Diabetic glomeruloscerlosis

A

Most prevalent metabolic disease affecting kidneys
Hyperglycemia causing changes in renal glomeruli, arterioles, interstitium
Thickening of BM and mesangial matrix (diffuse or nodular)
Proteinuria (10-20 years after onset)
Prone to bacterial infections, pyelonephritis

36
Q

End-stage glomerulopathy (4)

A
  1. Chronic renal failure
  2. Symmetrically shrunken, fine surface granularity caused by loss of renal tubules
  3. Patients develop progressive uremia
  4. Replacement of glomeruli by collagen
37
Q

Acute tubular necrosis

A

Sudden decrease in arterial pressure leads to acute hypoperfusion in the kidneys

38
Q

Nephroangiosclerosis

A

Decreased blood flow due to renal artery artherosclerosis

Leading to ischemic glomerulosclerosis

39
Q

Urinary stones (4)

A
  1. Calcium (75)
  2. Struvite (15)
  3. Uric acid (5)
  4. Cystine (1)
40
Q

Ascending UTI

A

Bacteria reach urinary tract through the urethra
More common
Women more susceptible
Predisposing conditions: nodular prostatic hyperplasia, urolithiasis, bladder catheterization, pregnancy

41
Q

Descending UTI

A

Bacteria reach urinary tract from the blood
Hematogenous infection
Usually preceded by sepsis or septic emboli

42
Q

Acute pyelonephritis

A

Suppurative infection of the kidneys
Appears swollen, pale
Microabsesses

43
Q

Chronic pyelonephritis

A

Develops from repeated bouts of acute pyelonephritis

Persistant infection leads to destruction of the renal parenchyma, affected kidneys become small and irregularly scarred

44
Q

Acute cystitis

A

Congestion and mucosal hemorrhage
Mucosa may be ulcerated or covered with pus
Fever, pain, hematuria, pyuria

45
Q

Chronic cystitis

A

Mucosa has considerable thickening, ulceration and hemorrhage

46
Q

Cystitis

A

Inflammation of the bladder wall

47
Q

Cystitis in elderly men

A

Complication of nodular prostatic hyperplasia

48
Q

Cystitis in women

A

Bacteria cystitis may be associated with sexual intercourse and pregnancy

Pathology 3000 (14 decks)

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