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Flashcards in diseases of the urinary tract 1 Deck (45):
1

what are the main functions of the kidney

eliminate metabolic waste, regulate fluid and electrolyte balance, acid base balance, production of some hormones (renin and EPO)

2

how to patients with renal disease present

acute renal failure- rapid rise in urea and creatinine
chronic renal failure- gradual declining function.

3

3 components of nephritic syndrome

oedema, proteinuria and haematuria.

4

3 conditions of nephrotic syndrome

oedema, proteinuria and hypoalbuimanemia.

5

what defines proteinuria

>3g per 24 h

6

what 2 structures form the renal cortex

medulla is dark, cortex is light.

7

in what structure in the glomerulus found

Bowman's capsule.

8

what structures are involved in filtration of the kidney

podocytes, foot processes, endothelial cells and basement membrane which allows filtration.

9

function of renal tubules

collects what you need and filters what you don't need

10

how can the immune system damage the glomeruli

circulating immune complexes deposit in glomeruli
circulating antigen deposit in the glomeruli which complement antibodies of the basement membrane.
this causes damage via Complement activation, Neutrophil activation, Reactive oxygen species, Clotting factors.

11

what are non-immunological factors which cause damage to the glomeruli.

injury to endothelial vessels.
altered basement membrane due to hyperglycaemia in diabetes.
abnormal basememnt membrane or podocytes- inherited condition
deposition of abnormal proteins in the kidney e.g. amyloid.

12

how does schema cause tubular damage

hypotension- shock/ septic patients.
glomerular damage
damage to vessels within the kidney.

13

what toxic material can cause tubular damage

Direct toxins- X ray, heavy metal.
Hypersensitivity reactions e.g. to drugs
Deposition of crystals in tubules- gout uric acid crystals
Deposition of abnormal proteins in the tubules

14

define thrombotic microangioapthy (vascular damage) and what causes it to happen

thrombi in capillaries and small arterioles due to endothelial damage

15

causes of endothelial damage

bacteria, toxins, drugs, abnormal complement and clotting pathways.

16

define vasculitis

acute or chronic inflammation of the blood vessels.

17

what 3 factors cause renal damage

damage to tubules
damage to the glomerulus
damage to the blood vessels.

18

nephrotic syndrome damages which structure within the kidney

glomerulus.

19

what are the main complications of nephrotic syndrome

infections, thrombosis, pitting oedema.

20

diagnosis of nephrotic syndromes

renal biposy

21

what is the most common cause of nephrotic syndrome in adults

membranous nephropathy

22

what is the most common cause of nephrotic syndrome in children

minimal change disease.

23

other symptoms of nephrotic syndrome except the triad

hypertension and hyperlipidaemia.

24

other symptoms of nephritic syndrome except the triad

Hypertension
Acute renal failure

25

what is the most common cause of nephritic syndrome in adults and children

post infective glomerulonephritis.

26

after what infection does post infective glomerulonephritis occur

Streptococcal throat infection.

27

how is acute renal failure diagnosed

anuria/oliguria + raised creatinine and urea

28

treatment for acute renal failure

short term dialysis.

29

what are the pre-renal causes of acute renal failure

dehydration, hypotension

30

what are the post renal causes of acute renal failure

tumours of the urinary tract, tumours of the pelvis, bladder stones, prostatic enlargement.

31

what are the renal causes of acute renal failure in adults

vasculitis, acute interstitial nephritis (tubular damage with inflammation)

32

what are the renal causes of acute renal failure in children

Henoch- Schmlein purpura
haemolytic uraemic syndrome
acute interstitial nephritis.

33

what is Henoch-Schonlein purport and what age group is it common in

children
Specific type of IgA nephropathy

34

define haemolyctic uraemic syndrome and what age group does is commonly affect

children
acute nephritis, haemolysis and thrombocytopenia,

35

what are the complication of acute renal failure

cardiac failure, arrthymias (electrolyte imbalance), GI bleeding, Jaundice, Infections

36

what are the 5 stages of chronic renal failure

stage 1- kidney damage with normal of increased GFR
stage 2- mild reduction in GFR
stage 3-moderate reduction in GFR
stage 4-severe reduction in GFR
stage 5-kidney failure.

37

what are the common causes of chronic renal failure in adults

diabetes, glomerulernephriris, reflux nephropathy

38

what are the common causes of chronic renal failure in children

Developmental abnormalities/malformations
Reflux nephropathy
Glomerulonephritis

39

why might bops not be helpful in diagnosis of chronic renal failure

Kidney shows severe scarring with loss of glomeruli and tubules
Similar changes are seen in end-stage renal disease due to any cause

40

what the the effects of chronic renal failure

reduced excretion of water and electrolytes- oedema and hypertension.
reduced excretion of toxic metabolites
reduced production of EPO- anaemina
renal bone disease

41

most common diagnosis of elderly patient with acute renal failure

Acute interstitial nephritis due to drug reactions.
myeloma- tumour of plasma cells which for immunoglobulins and circulate in the kidney

42

most likely diagnose of male with haematuria and rash

Henoch-Schonlein purpura

43

most likely diagnosis of Teenager/young adult with haematuria

Post-infective glomerulonephritis
IgA nephropathy.

44

most likely diagnosis of Adult with acute renal failure, fever and myalgia

vasculitis.

45

most likely diagnosis of Young woman with haematuria and facial rash

Lupus