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Renal Module > Urinary tract obstruction > Flashcards

Urinary tract obstruction Flashcards

1
Q

Where can the urinary collecting system become obstructed?

A

Anywhere from the PCT to urethral meatus.

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2
Q

What difference does the level of obstruction make?

A
  1. Above the Bladder the will be unilateral dysfunction

2. Below the bladder cause bilateral dysfunction

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3
Q

What are the mechanical ways that a hollow organ/structure can be obstructed?

A
  1. Intraluminal
    - Stone
  2. Intramural
    - stricture
  3. Extrinsic
    - Tumor
    - iatrogenic
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4
Q

What are the functional ways a hollow structure/organ can be affected?

A

Neurogenic bladder

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5
Q

What are some of the causes on urinary obstruction within the lumen?

A
  1. Calculus (stones)
  2. Blood Clots
  3. Sloughed papilla (diabetes, analgesic abuse, sickle cell trait)
  4. Tumor of renal pelvis
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6
Q

What are some of the causes of Urinary tract obstruction from within the wall

A
  1. neuropathis bladder

2. Urethral stricture

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7
Q

What are the extrinsic factors that are capable of causing urinary obstruction?

A
  1. Tumors

2. prostatic obstruction?

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8
Q

What are the symptoms of partial urinary obstruction? (one kidney)

A
  1. Polyuria
  2. Volume depletion
  3. Azotemia
  4. dRTA and hyperkalemia
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9
Q

What are the effects of acute unilateral obstruction?

A

The plasma creatinine concentration is usually normal or only slightly elevated (other nephrons begin hyperfiltration)

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10
Q

Is filtration normal in patients with acute unilateral obstruction?

A

No it may not be. GFR stays normal primarily dur to hypertrophy.

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11
Q

What is the Epidemiology of Hydronephrosis?

A
  1. In children usually congenital malformation e.g bladder neck obstruction or defective urethral valve
  2. In adults its usually acquired disese such as stone or prostatic hyperplasia
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12
Q

What are the causes of Hydronephrosis?

A
  1. Renal Stone (most common)
  2. Retroperitoneal fibrosis
  3. Cervical cancer, BPH
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13
Q

What are the physical findings of Hydronephrosis?

A
  1. Dilated ureter
  2. Dilated renal pelvis
  3. Compression atrophy of renal medulla and cortex
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14
Q

What are the factors that determine the symptoms seen with urinary tract obstruction?

A
  1. Time course
  2. Degree of obstruction
  3. Level of obstruction
  4. Development of secondary complications
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15
Q

What are the signs and symptoms of Urinary tract obstruction?

A
  1. History of difficulty in voiding, pain, infection, or change in urinary volume
  2. Signs of distension of the kidney or bladder upon palpation and percussion of the abdomen.
  3. Rectal exam revealing enlargenment and nodularity of the prostate, abnormal renal spinchter or a rectal pelvic mass
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16
Q

What is Anuria specific for?

A
  1. complete bilateral UTO

2. Shock

17
Q

What postvoid residual volume is suggestive of obstructive Uropathy?

A

100ml or more

18
Q

What are the treatments for Hydronephrosis?

A
  1. Catheter
  2. Nephrostomy tube
  3. Cytoscopy
19
Q

What are the mechanical ways that a hollow organ/structure can be obstructed?

A
  1. Intraluminal
    - Stone
  2. Intramural
    - stricture
  3. Extrinsic
    - Tumor
    - iatrogenic
20
Q

What are the functional ways a hollow structure/organ can be affected?

A

Neurogenic bladder

21
Q

What are some of the causes on urinary obstruction within the lumen?

A
  1. Calculus (stones)
  2. Blood Clots
  3. Sloughed papilla (diabetes, analgesic abuse, sickle cell trait)
  4. Tumor of renal pelvis
22
Q

What are some of the causes of Urinary tract obstruction from within the wall

A
  1. neuropathis bladder

2. Urethral stricture

23
Q

What are the extrinsic factors that are capable of causing urinary obstruction?

A
  1. Tumors

2. prostatic obstruction?

24
Q

What are the symptoms of partial urinary obstruction? (one kidney)

A
  1. Polyuria
  2. Volume depletion
  3. Azotemia
  4. dRTA and hyperkalemia
25
Q

What are the effects of acute unilateral obstruction?

A

The plasma creatinine concentration is usually normal or only slightly elevated (other nephrons begin hyperfiltration)

26
Q

Is filtration normal in patients with acute unilateral obstruction?

A

No it may not be. GFR stays normal primarily dur to hypertrophy.

27
Q

What is the Epidemiology of Hydronephrosis?

A
  1. In children usually congenital malformation e.g bladder neck obstruction or defective urethral valve
  2. In adults its usually acquired disese such as stone or prostatic hyperplasia
28
Q

What are the causes of Hydronephrosis?

A
  1. Renal Stone (most common)
  2. Retroperitoneal fibrosis
  3. Cervical cancer, BPH
29
Q

What are the physical findings of Hydronephrosis?

A
  1. Dilated ureter
  2. Dilated renal pelvis
  3. Compression atrophy of renal medulla and cortex
30
Q

What are the factors that determine the symptoms seen with urinary tract obstruction?

A
  1. Time course
  2. Degree of obstruction
  3. Level of obstruction
  4. Development of secondary complications
31
Q

What are the signs and symptoms of Urinary tract obstruction?

A
  1. History of difficulty in voiding, pain, infection, or change in urinary volume
  2. Signs of distension of the kidney or bladder upon palpation and percussion of the abdomen.
  3. Rectal exam revealing enlargenment and nodularity of the prostate, abnormal renal spinchter or a rectal pelvic mass
32
Q

What is Anuria specific for?

A
  1. complete bilateral UTO

2. Shock

33
Q

What postvoid residual volume is suggestive of obstructive Uropathy?

A

100ml or more

34
Q

What are the treatments for Hydronephrosis?

A
  1. Catheter
  2. Nephrostomy tube
  3. Cytoscopy

Renal Module (29 decks)

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