Urinary Tract Pathology Flashcards
What does the Upper Urinary Tract comprise of?
Kidney, renal pelvis, ureter
What does the Lower Urinary Tract comprise of?
Bladder, prostate, urethra, genitalia
State five functions of the kidneys
Production of urine Blood pressure regulation Calcium homeostasis Water balance RBC production
State one function of the ureter
Conduit for urine
State two functions of bladder
Storage of urine
Excretion of urine
State the function of the prostate and seminal vesicles
Semen
State the function of the urethra
Conduit for urine (and ejaculate)
State the function of the gentalia
Spermatogenesis and reproduction
How long is the average female urethra?
4 cm
How long is the average male urethra?
24 - 26 cm
Give 5 examples of common urinary tract symptoms
- Changes in urine
- Pain
- Altered micturition
- Incontinence
- Sexual dysfunction
Give three examples of congenital abnormalities affecting the kidneys
- Renal duplication
- Horse-shoe kidney
- Absent kidney
In duplex ureters, the Weigert-Meyer rule applies. What is the Weigert-Meyer rule?
Of the two ureters from the kidneys, the upper part of the duplex kidney’s ureter will always enter the bladder lower and more medially to the counterpart ureter
In duplex ureters, why is the upper ureter more likely to become nephrotic?
The upper ureter opens up into the bladder at an angle at an abnormal place, it allows urine to reflux (vesicoureteral reflux (VUR)) up to the kidney and can become nephrotic, hence this ureter appears more baggy
What is bladder extrophy?
Protrusion of the urinary bladder through a defect in the abdominal wall
What is patent urachus?
An opening between the bladder and the belly button (navel), which usually closes before birth
What is vesicoureteral reflux (VUR)?
Urine flows retrograde, or backward, from the bladder into the ureters/kidneys
What is hypospadias and epispadias?
Hypospadias: opening of urethra on under-side of penis
Epidpasias: opening of urethra on upper-side of penis
What is phimoses?
The inability to retract the skin (foreskin or prepuce) covering the glans of the penis
What is cryporchidism?
The absence of one or both testes from the scrotum
What is Benign Prostatic Hyperplasia?
BPH refers to the histological changes of stromal-glandular hyperplasia seen within the prostate
BPH is a normal phenomenon is all males, but when does it become clinically significant?
When this overgrowth of benign tissue is associated bothersome lower urinary tract symptoms
BPH regulated by which hormone?
By the hormone testosterone and its potent metabolite, DHT, from the testes
What is the pathophysiology of BPH
Stromal and epithelial cells are sensitive to testosterone via their Androgen receptors, but DHT produced in the stromal cells can also affect the stromal cell it is made in (autocrine effect) as well as adjacent epithelial cells (paracrine effect)
Reiter’s syndrome is a triad of..?
- Conjunctivitis
- Urethritis
- Arthritis
What is the most common pathogen responsible for UTIs?
Escherichia coli
An ascending UTI is also known as…?
Pyelonephritis
Pyelonephritis has a clinical triad of..?
Renal angle pain & tenderness
Fever >39C
Raised WCC
What are the pathogens responsible for Epididymo-orchitis?
Gonorrhoea / chylamydia
Escherichia coli
Why is referred pain common up to the renal angle in UTIs?
Because the pelvic organs are supplied by a plexus of nerves, not one single nerve
What is mumps orchitis?
Testicular inflammation and atrophy following onset of mumps infection
Chemical cystitis in the bladder can be caused by..?
Ketamine, BCG, Mitomycin
What is Urolithiasis?
Formation of stony concretions in the bladder or urinary tract.
What are the risk factors for Urolithiasis?
Male, dehydration, dietary components, genetics
What types of Urolithiasis stones are there?
- Calcium stones (oxalate & phosphate)
- Uric acid
- Struvite (magnesium ammonium phosphate)
Urolithiasis is formed by supersaturation of urine, but how?
Nucleation -> Aggregation -> Growth
What is the most common kidney cancer subtype?
Renal cell carcinoma
What are the three types of Bladder / Ureter / Renal pelvic cancers?
- Transitional cell carcinoma (TCC) - most common
- Squamous cell carcinoma
- Adenocarcinoma
What is the most common subtype of Prostate cancer?
Adenocarcinoma
What is the most common subtype of Penile cancer?
Squamous cell carcinoma
