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Renal Pathology > UT obstructions and congenital disorders > Flashcards

UT obstructions and congenital disorders Flashcards

1
Q

Symptoms and signs:
Asymptomatic (detected in imaging)
Symptomatic: renal colic, pain localized in the back, intensive increasing with no alleviating factors.

A

Urolithiasis

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2
Q

Extrinsic causes in upper urinary tract obstruction?

A

Cervix: carcinoma
Uterus: pregnancy or tumor
Prostate: invasive carcinoma

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3
Q

Pain or burning sensation during urination

A

Dysuria

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4
Q

Detects opaque calcareous or cystine stones. Wide availability and minimal radiation and low cost. But it has limited sensitivity and specificity

A

KUB (kidneys, ureters, and bladder) x-ray

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5
Q

Affects 5%-10% of the US people, nephrolithiasis, men are more affected, the age of predisposition is 20-30 years, heredity and errors in metabolism ((cystinuria (Ýconcentrations of cystine in urine) and primary hyperoxalurias)

A

Urolithiasis

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6
Q

Laboratory findings:

  • increased serum creatine: bilateral & unilateral obstruction
  • hematuria and pyuria: few RBC, but depending on obstruction hematuria will be present
A

Ureteral colic

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7
Q

70% most common stones in the US are composed of?

A

Calcium oxalate or calcium phosphate

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8
Q

Decreased pH urinalysis most likely describes what type of stones?

A

Uric acid stones or calcium oxalate stones

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9
Q

Obstruction below the vesicoureteral junction

A

Lower urinary tract obstruction

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10
Q

Highest sensitivity and specificity for kidney diagnosis, but the disadvantage: radiation exposure and high cost.

A

CT scan

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11
Q

patients with hyperuricemia, gout and leukemias has increased?

A

Uric acid

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12
Q

refers to dilation of the urinary tract, renal pelvis, and calyces with kidney atrophy

A

Hydronephrosis

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13
Q

Ureteral functional causes of lower UT obstruction?

A

Prostate: benign prostatic hypertrophy

Bladder: cancer

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14
Q

strong need to urinate.

A

Urinary urgency

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15
Q

Low grade obstruction is also known as?

A

Partial or incomplete obstruction

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16
Q
A

Agenesis of the kidney

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17
Q

Risk factors:

dietary: (animal protein, oxalate, Sodium, sucrose and fructose)

Non dietary: (age, race, obesity, lack access of water and medication table in pp, exercise)

urinary: increased urine vol.

Clinical presentation:
• Present or absence of pain, depends on site of obstruction and degrees.
• Pain, change in urine output, hypertension, hematuria and Ý serum creatine.

A

Urolithiasis

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18
Q

Bilateral agenesis is incompatible with life.
• The solitary kidney enlarges as a compensatory hypertrophy.
• Some develop glomerular sclerosis in the remaining kidney as a result of the adaptive changes in hypertrophied nephrons.

A

Agenesis of the kidney

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19
Q

Pathogenesis:
Stones occurs in urine that is supersaturated, this affects:
• Crystal components concentrations • Inhibitors(citrate)
• Urine pH

A

Urolithiasis

20
Q

Ureteral anatomic causes of lower urinary tract obstruction?

A

Post-instrumentation such as catheter

21
Q
A

Hypoplasia

22
Q

refers to the renal disease cause by impaired flow of urine or tubular fluid.

A

Obstructive nephropathy

23
Q

Pain is abrupt and intensifies over time, pain resolves with removal or passage.
Gross hematuria, urinary urgency, frequency nausea, and vomiting can occur.
When is in the bladders: urinary frequency, dysuria, suprapubic pain and urinary incontinency.

A

Ureteral colic

24
Q

75% most common stones in the Mediterranean and Middle East are composed of?

A

Uric acid

25
Q

Failure of the kidney develop a normal size
• This could occur bilaterally=renal failure in early childhood. More commonly unilateral defect.
• Is seen in low weigh birth infants

A

Hypoplasia

26
Q

Etiology: formation of stones by supersaturation of the compounds:
• magnesium ammonium phosphate
• calcium oxalate and phosphate association
with patients with hypercalcemia (increased Ca+2 in blood), hypercalciuria (increased Ca+2 in urine), hyperparathyroidism, diffuse in bone disease, sarcoidosis.

A

Urolithiasis

27
Q

Most frequent in males (in children’s)
• As a result of urethral valve or pelviureteral junction obstruction
• If the obstruction is in early development the kidney fails to develop but if is bilateral -> high mortality rates
• If is in later gestation and is unilateral hydronephrosis and nephron loss still occurs.
Epidemiology: 10% of the pIeople are born with malformation of the urinary system, hereditary.

A

Congenital urinary tract obstruction

28
Q

structural or functional changes in the urinary tract that impede normal urine flow.

A

Obstructive uropathy

29
Q
A

Ectopic kidney

30
Q

Physical findings: costovertebral angle tenderness. Is not consistent and intense as in pyelonephritis, abdominal examination negative, hypertension and tachycardia

A

Ureteral colic

31
Q

Can affect the upper or lower part of the urinary tract. It will be by intrinsic or extrinsic causes.

Causes:
• Urinary calculi
• Benning prostatic hypertrophy
• Tumors
• Malignant disease (carcinoma of the cervix or
uterus)
• Inflammation (prostatitis, ureterisis,
urethritis)

A

Acquired urinary tract obstruction

32
Q

Abnormally frequent urination

A

Urinary frequency

33
Q

Noninvasive, fast, low cost, but low sensitivity. Excellent in detecting: hydronephrosis and hydroureter.

A

Ultrasound

34
Q

The development of the metanephros into the kidney may occur in ectopic foci.
• This kidney lies above the pelvic brim or within the pelvis it can be small or normal size.
• Because of the abnormal position, the ureters may cause obstruction to the urinary flow.
-can lead to bacterial infections

A

Ectopic kidney

35
Q

Urinary tract calculi or stone

A

Urolithiasis

36
Q
A

Acquired urinary tract obstruction

37
Q

genetic defects in renal absorption of AA like cysteine -> cystinuria.

This stones form at low pH

A

Cysteine stones

38
Q

High grade obstruction is also known as?

A

Complete obstruction

39
Q

Obstruction above vesicoureteral junction

A

Upper urinary tract obstruction

40
Q
A

Horseshoe kidney

41
Q

If there’s hematuria in the urinalysis most likely there is?

A

Active stone disease

42
Q

Fusion of the upper or lower poles of the kidney and is continues across the midline anterior to the great vessels.
• Found in 1 in 500 to 1000 autopsies.

A

Horseshoe kidneys

43
Q

How will the pH in the urinalysis be in patients with calcium phosphate stones?

A

Increased pH

44
Q

Stones in the kidney

A

Nephrolithiasis

45
Q

Intrinsic causes in upper urinary tract obstruction?

A

Stones

Renal Pathology (4 decks)

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