Sketchy Path: Hydronephrosis and Urinary Tract Obstruction Flashcards
What is hydronephrosis?
Dilation of the renal calyces
Urinary obstruction shrinks the kidney by _______________.
pressure atrophy
Sudden onset hydronephrosis can cause ______________.
renal papillary necrosis (like the bolt popping off of the pyramidal section of the wheel)
The most common cause of congenital hydronephrosis –detectable by ultrasound, btw –is ___________.
a congenital kink in the ureteropelvic junction (like the kid in the cab of the firetruck kinking the hose near the pelvis holding up the #1 sign)
The ureteropelvic junction is the last part of the ureter to canalize and sometimes it fails to do so completely.
The second most common cause of congenital hydronephrosis is ______________.
vesicoureteral reflux (like the girl spraying the hose back from the puddle toward the kid in the cab); this will present with dilated ureter, too
What anomaly causes VUR?
Perpendicular entry of the ureter into the bladder (like the 90º angle of the hose handle that the girl has)
In addition to hydronephrosis, VUR leads to ______________.
UTIs (like the girl spraying the VUR hoses at the woman enjoying her UTI box juice) and pyelonephritis (like the bumpy pineapple)
Chronic VUR and pyelonephritis can lead to ____________.
CKD in a kid (HTN, metabolic acidosis, hyperkalemia, hyperphosphatemia, etc.)
The most common cause of bilateral hydronephrosis in boys is ______________.
posterior urethral valve, which is a remnant of the Wolffian duct that blocks the urethra right where it exits the bladder (think of the boy being pulled from the posterior side with the Wolf shirt)
Posterior urethral valve can lead to ____________.
Potter syndrome (like the boy with the Potter bear)
The most common cause of urinary obstruction in an adult is ______________.
kidney stone (like the bricks falling onto the hose)
Other than kidney stones, _____________ can also cause acute ureteral obstruction.
surgery (like the firefighter breaking down the door with the scalpel)
The following are symptoms of nephrolithiasis:
- Flank pain
- Gross hematuria
- _____________.
Nausea and vomiting (like the guy about to barf because he’s afraid of heights)
What are some causes of chronic urinary tract obstruction?
- Cancer (woman’s crab belt buckle)
- Retroperitoneal fibrosis such as Gardner syndrome or retroperitoneal fibrosis (like the ureter hose going behind the fibrotic trees)
Retroperitoneal fibrosis is associated with _______________.
IgG4 disorders like Reidel’s or autoimmune pancreatitis (like the four flashing IgG molecules on the firetruck)
