Urological Disorders Flashcards
What two problems can arise from filtration failure?
Haematuria and proteinuria
or accumulation of waste substances
How is the presence of waste products in the urine detected?
By measuring the serum concentrations of Urea and Creatinine
How is haematouria detected?
Through a urine dipstick
Why might the blood pressure of patient with a urological condition be high?
Due to salt and water retention in the blood which increases blood volume, and therefore leads to high blood pressure
Why might the blood pressure of patients with a urological condition be low?
Some patients who have dehydration or low in vascular volume because unable to make concentrated urine, or losing too much sodium in urine or dehydration due to vomiting
What hormonal problems might urological conditions lead to?
Reduced EPO and Secondary Hyperparathyroidism
What is the consequence of reduced EPO with kidney disease?
Reduction in erythropoiesis, leading to anaemia
How does vitamin D synthesis get affected by kidney disease?
The kidneys are responsible for the activation of Vitamin D through the 1-alpha-hydroxylation of Vitamin D - in kidney disease this might not occur
Why is PTH raised in patients with kidney disease?
Kidney disease = no 1-alpha-hydroxylation of Vitamin D
Therefore Vitamin D defiency
Therefore less Ca2+ absorbed
With Less Ca2+ absorbed, PTH levels rise
What are the most common pathogens for kidney infections in immunocompromised patients?
Fungi and virus
What are the most common pathogens for a kidney problem?
Bacteria
What is an infection of the bladder called?
Bladder - cystitis
What is an infection of the kidney called?
Pylonephritis
What are three other factors which could contribute to an infection of the urinary system?
Stones, obstructions and prostatic hypertrophy
What are signs and symptoms of a UTI?
Blood in urine, high temperature, soft and tender abdomen, especially over the suprapubic area
What is commonly found on a urine dip stick of a patient with a UTI?
High leucocytes, high nitrite and traces of blood
How are UTIs treated?
Broad Spectrum antibiotics initally, and then once culture has been completed prescribe specific antibiotics for the type of bacteria
What two ways can the immune system damage the kidneys?
Antibodies
Inflammatory cells - Neutrophils, macrophages and T cells
What is glomerulonephritis?
inflammation of the microscopic filtering units of the kidney
What are three clinical presentations of glomerulonephritis?
Nephritic syndrome
Proteinurin
Nephrotic Syndrome
What are the three patterns of organ involvement?
Kidney, Kidney and Lung, Whole organs and Other Tissues
What is seen in an immunostaining slide of a patient with glomerulonephritis?
brown stains indicate the presence of monocyte and macrophages that have invaded the glomeruli
What are the steps involved in the diagnostic approach to reaching a conclusion about a patients condition?
- History
- Physical Examination
- Urine dip stick
- Urine microscopy
- Urine protein to creatinine ration
- Blood tests
What is nephritic syndrome?
A condition comprising of signs of nephritis, which is kidney disease involving inflammation, and often occurs in the glomeruli
What are some symptoms of nephritis?
Blood in urine, variable protein in urine - increased urea and creatinine, may have hypertension,
Patient presents with a sore throat, high blood pressure and blood in their urine. What urological disease do they have?
Nephritis
What might a blood test show in a patient with nephritis?
- High serum urea and creatinine
2. Low GFR
What is IgA Nephropathy?
Deposition of IgA antibody in the kidney causing inflammation and scarring
How can IgA Nephropathy be detected?
Immunohistochemistry
How is IgA Nephropathy treated?
Supportive treatment to reduce hypertension eg ACEi or ARBs, and reduce sodium intake
How can IgA nephropathy be treated with immunotherapy?
Renal Replacement Therapy - Transplantation or dialysis
What two features are seem on a histological slide of a kidney with IgA nephropathy?
inflammation and scarring
What disease affects the kidneys and lungs?
Goodpasture’s Disease
What might a smoker with goodpasture’s disease experience?
Kidney failure, and coughing up blood
What is the pathophysiology behind Goodpastures disease?
it is anti-glomerular basement membrane antibody mediated
How does Goodpasture’s disease affect the lung and the kidney?
There is a shared common antigen - alpha3 chain of type 4 collagen