Dobson Renal Path 2 Flashcards
what structures in female are embryologic equivalent of prostate?
Skene’s glands located on either side of your urethra and link your urethra with the vagina.
What forms the filtration barrier in the glomeruli?
- capillary endothelium
- Basement membrane (type IV collagen)
- foot processes of podocytes
Warning signs of Kidney disease?
- Creatinine and BUN outside normal range
- GFR <60
- blood or protein in urine
- htn
- more frequent urination at night or painful
- puffiness around eyes, swelling of hands or feet
Prune belly syndrome? What are the associations with it?
- M>F
- Anterior abdominal wall muscle abnormalities
- Hydroureteronephrosis is almost always b/l and present
- Vesicureteral reflux b/l in most cases
- renal dysplasia in half patients
- Cryptorchidism
- UTI
Compare bilateral and unilateral agenesis?
- b/l is incompatible with life and usually seen in stillborn infants and has other congenital disorders
- unilateral is uncommon but compatible with life if no othe congenital anomaliles exist
- normal kidney is enlarged
what is Renal Hypoplasia?
- failure of kidney to develop to normal size
- can be b/l resulting in renal failure in early childhood but more common as a unilateral defect
When is true renal hypoplasia seen?
Low birth weight infants and may contribute to their increased lifeetime risk for chronic kidney disease
What is an ectopic kidney?
cephalic migration of the kidney occurs during normal embryological development to move them into their normal retroperiotneal location, but if this process is arrested it results in abnormal location of the kidney
What is the most common and serious congenital anomaly?
- Vesicoureteral reflux, this predisposes the person to ascending pyelonephritis and loss of renal function
- there can be abnormal connections between the bladder and vagina,, rectum or uterus creating congenital vesicouterine fistulae
what is the most common cause of hydronephrosis in infants and kids? How does it present?
- Ureteropelvic junction obstruction, it presents early in life affecting males and is b/l 20% of the time and has other anomalies with it. Agenesis of contralateral kidney,
- Presents with hydronephrosis UTI hematuria FTT epsis and azotemia
Describe UPJ obstruction when it occurs in adults. (presentation and what causes it?)
- more common in women and unilateral
- Preseents with ⅓ of cases having UTI, ⅓ hematuria, ⅓ abdominal pain/vomiting
- abnormal organization of smooth mm bundles or excess stromal deposition of collagen btw smooth mm bundles at the UPJ or rare cases extrensic compression by extra vessel
What are the sites where it is commmon for ureters to be compressed?
- UPJ
- Crossing external iliac artery or pelvic brim
- Entering the bladder
Where do diverticula in the urinary tract system usually occur? How do you get them, how do they present, and association?
- Bladder
- can be congenital or acquired
- small and asx but are sites of urinary stasis and predispose to infectionn and formation of bladder calculi
- Carcinoma may arise (rarely) in diverticula
What is Exstrophy of the bladder? What is associated with it?
developmental failure in anterior wall of abdomen and bladder
exposed bladder mucosa may undergo colonic glandular metaplasia and has frequent infection that spreads to upper urinary tract
What type of carcinoma is associated with extrophy of the bladder?
Adenocarcinoma
