Week 18 Pathology - Renal II

Question 1

What are the two major categories of obstructive uropathy?

Answer 1

Congenital (i.e. urethral atresia, valve malformations urethra/ureter)
Acquired

Question 2

List common causes of obstructive uropathy:

Answer 2

Calculi/slough from papillae
Proliferative lesion (i.e. BPH, carcinoma, contiguous malignant disease)
Inflammation: prostatitis, ureteris, urethritis
Neurogenic: spinal cord damage with bladder paralysis
Pregnancy

Question 3

What is the initial functional disturbance causes by obstructive uropathy/hydronephrosis?

Answer 3

Tubular function disturbance, largely loss of ability to concentrate the urine

i.e. why post obstructive diuresis occurs

Question 4

How long does partial and complete obstruction take to cause permanent kidney damage?

Answer 4

3 weeks complete
3 months partial

Question 5

Where are the most common sites of renal calculi formation?

Answer 5

Renal pelvis
Calyces
Bladder

Question 6

What are the 3 major types /composition of stone”?

Answer 6

1. Calcium oxalate + phosphate (80%) –> calciuria, sometimes in the setting of increased absorption
2. Magnesium ammonium phosphate (10%) –> “Struvite stones” occurring in alkaline urine, usually in setting of bacterial infection
3. Uric acid (10%) –> acidic urine

Question 7

What are the commonest causes of epididymo-orchitis?

Answer 7

Chlamydia trachomatis
Neisseria gonnorhoea
E. coli
Pseudomonas
Mumps
Autoimmune

Question 8

What are the causes of pyelonephritis?

Answer 8

Most common = E. coli

Others:
- Klebsiella
- Proteus
- Enterobacter