Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Urinary > Week 7 > Flashcards

Week 7 Flashcards

1
Q

What is urolithiasis

A

Formation of stones in the urinary tract

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Most common location of urolithiasis

A

Renal pelvis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Where can uroliths be found

A

Renal pelvis and calyces
Ureter (usually from kidney)
Bladder

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Causes of bladder stones

A

Bladder outflow obstruction - urethral structure, prostate obstruction, neurogenic bladder
Foreign body e.g catheter or non absorbable sutures
Passed down form upper tract

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Symptoms of bladder stones

A

Anuria

Painful bladder distension (urinary retention)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are nephroliths

A

Solid materials formed in kidneys from minerals and urine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Types of nephroliths

A

99% calcium stones - calcium oxolate, calcium phosphate, uric acid, struvite
1% other - drug, cysteine, ammonium acid urate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Causes of nephrolithiasis

A

Urine supersaturation
Urine stasis
Drugs
Congenital e.g polycystic kidney

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are Randall’s plaques

A

Calcium oxolate stones growing on interstitial deposits of calcium phosphate e.g renal papillae, ducts of Bellini, free in solution

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is urine supersaturation

A

Solvent contains more solute than it can hold so crystals form by nucleation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Broad cause of urine supersaturation

A

Low water content - dehydration
High mineral content
Low solubility of solute

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What alters solubility of solute in urine

A

Urine pH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Consequences of acidic or alkaline urine

A

Acid - favours calcium oxolate and uric acid stone formation

Alkaline - favours calcium phosphate stone formation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is renal tubular acidosis

A

Persistently alkaline urine and increased citrate excretion

Leads to calcium phosphate stone formation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What senses serum Ca

A

Parathyroid glands
Kidneys
Brain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Actions of PTH

A

Stimulates osteoclasts
Increases renal reabsorption of Ca
Increases phosphate excretion
Increases calcitriol synthesis

17
Q

Actions of calcitriol

A

Stimulates osteoclasts
Increases renal reabsorption of Ca
Increases intestinal absorption of Ca

18
Q

Actions of calcitonin

A

Inhibits osteoclasts

Increase excretion of Ca

19
Q

Causes of hypercalciuria

A

Hypercalcaemia
Excessive dietary Ca
Excessive breakdown of bone e.g prolonged immobilisation
Increased gut absorption (idiopathic)

20
Q

Causes of hypercalcaemia

A 
Hyper secretion of PTH
Increased bone destruction
Excessive dietary Vitamin D and Ca
Thiazides diuretics
Sarcoidosis - macrophages activate vitamin D precursor
21
Q

Causes of hyper secretion of PTH

A

Parathyroid hyperplasia/tumour
Secondary to renal failure - retention of phosphate reduces Ca in serum
Ectopic secretion of PTHrP by a malignant tumour

22
Q

Reasons for increased bone destruction

A

Immobilisation
Bone marrow tumour
Diffuse skeletal metastases
Paget’s disease

23
Q

Clinical signs of hypercalcaemia

A 
Severe muscle weakness
Fractures or bone pain
Renal stones
Gallstones
Constipation
Depression
Seizures
24
Q

Causes of hyperoxaluria

A

Type 1/2 primary hyperoxaluria - autosomal recessive disorder of oxolate synthesis
Increased intestinal absorption - secondary to GI disease e.g Chron’s
High dietary oxolate intake - tea, rhubarb, spinach, nuts
Low Ca intake - stimulates oxolate absorption in gut

25
Q

What are struvite stones

A

Magnesium ammonium phosphate stones with variable amounts of Ca

26
Q

What causes struvite stones

A

Secondary to infection by microorganisms that produce:
Urease enzyme - produce ammonium hydroxide
Mucoprotein - provides organic matrix for stone formation

27
Q

What is the usual type of struvite stone

A

Staghorn calculi - cast of renal collecting system

28
Q

Risk factors for struvite stones

A 
Risk factors for UTIs:
Spinal cord injury
Neurogenic bladder
Vesicoureteric reflux
Urinary tract obstruction
29
Q

Risk factors for uric acid stones

A

Hyperuricaemia

Urine pH <5.5

30
Q

What is uric acid

A

Endpoint of purine metabolism

31
Q

Causes of hyperuricaemia

A

Idiopathic gout

Increased cell turnover - lympho/myelo-proliferative disorders, following chemotherapy

32
Q

Which renal stone is hardest to detect

A

Uric acid

It is radiolucent (need CT)

33
Q

Symptoms of renal stones

A 
Asymptomatic 
Renal colic
Recurrent UTI
Loin pain
Haematuria
Renal failure
Urinary tract obstruction
34
Q

Where is renal colic pain referred to

A

Flank to iliac fossa
Inner thigh
Labia/scrotum

35
Q

How do you investigate renal stones

A

Mid stream urine sample - culture, detect RBCs and crystals
Serum sample - urea, electrolytes, creatinine, minerals
AXR
CT (ideally during pain)
Examine calculi

36
Q

Complications of renal stones

A

Acute pyelonephritis
Pressure necrosis of renal parenchyma
Urinary obstruction
Ulceration through wall of collecting system

37
Q

Treatment for renal stones

A

Analgesia
Ureteroscopy
Percutaneous nephrolithotomy - remove renal stones by cutting into back
Shock wave lithotripsy - focused ultrasonic energy to fragment stones so they can be passed spontaneously (<5mm)

38
Q

Prevention of renal stones

A

Keep hydrated to reduce urine supersaturation
Increase Ca excretion (diuretics)
Potassium citrate to alkalinise urine - reduces risk of calcium oxolate, uric acid and cysteine stones

Urinary (6 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions