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2420 Pathology > Module 9 Kidney/Urinary Tract > Flashcards

Module 9 Kidney/Urinary Tract Flashcards

1
Q

Kidney Function

A
  • Filter blood creating urine, excreting waste products
  • 1700L of blood per day
  • 1L of urine per day
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2
Q

Kidney Regulates

A
  • Water
  • Salt
  • Calcium
  • Phosphorus
  • Blood pH
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3
Q

Endocrine Function

A
  • Renin (BP)
  • Erythropoietin (RBC)
  • Vit D metabolism
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4
Q

Hilum Contents

A
  • Renal artery
  • Renal vein
  • Ureter
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5
Q

Renal Cortex Contents

A
  • Glomeruli
  • Tubules
  • Interstitium
  • Blood vessels
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6
Q

Medulla Contents

A
  • Collecting system (renal pyramids)
  • Pathway: renal calyces, renal pelvis, ureter
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7
Q

Ureter

A
  • Muscular tube entering bladder
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8
Q

Bladder

A
  • Urine reservoir (500mL)
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9
Q

Urethra

A
  • Fibromuscular tube from bladder to exterior
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10
Q

Renal Cell Carcinoma

A
  • Most common malignancy of kidney
  • Older patients (50-60s)
  • More common in males (2:1)
  • CCRCC most common subtype
  • Surgery (nephrectomy)
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10
Q

Risk Factors of Renal Cell Carcinoma

A
  • Tabaco smoking
  • Obesity
  • Hypertension
  • Unopposed estrogen
  • Exposure to heavy metals, petroleum products
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11
Q

Presentation of Renal Cell Carcinoma

A
  • Flank pain, palpable mass, hematuria (large tumours)
  • Fever
  • Weakness
  • Weight loss
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12
Q

Urothelial Carcinoma

A
  • Most common malignancy of bladder
  • Arise from urothelium
  • M:F 3:1
  • Common in older patients (50-80s)
  • Developed nations, urban dwellers
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12
Q

Urothelial Carcinoma Presentation

A
  • Painless hematuria
  • Sometimes urinary urgency, frequency, burning
  • Papillary appearance by cystoscopy
  • Sea anemone appearance
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13
Q

Urothelial Carcinoma Risk Factors

A
  • Cigarette smoking
  • Industrial exposure to chemical compounds
  • Parasitic infections
  • Drugs
  • Irradiation
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14
Q

Low Grade Urothelial Carcinoma

A
  • Slow growing
  • Papillary
  • Minimal atypia
  • Frequent reoccurrence
  • Not aggressive/invasive
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15
Q

High Grade Urothelial Carcinoma

A
  • More aggressive
  • Flat or nodular
  • High rate of reoccurrence
  • Atypical
  • Invasion
  • Metastasize
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16
Q

Urothelial Carcinoma Treatment

A
  • Local excision
  • Invasive chemotherapy/BCG (extensive)
  • Cystectomy (high grade)
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17
Q

Acute Pyelonephritis

A
  • Bacterial infection of kidney
  • Bladder infection symptoms
  • Due to UTI
  • Urine culture diagnosis
  • Recover full kidney function
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18
Q

Pyelonephritis Risk Factors

A
  • Urinary tract obstruction
  • Instrumentation
  • Vesicoureteral reflux
  • Pregnancy
  • Gender/age (young females)
  • Diabetes
  • Immunosuppression/immunodeficiency
18
Q

Chronic Pyelonephritis

A
  • Inflammation & scarring of kidney
  • Causes reflux, long term obstruction
  • Recurrent infection
19
Q

Acute Renal Failure

A
  • Decreased blood flow to kidney
  • Damage to kidneys
  • Obstruction of flow of urine
20
Q

Chronic Renal failure

A
  • Hypertension, diabetes, vasculitis
  • Primary glomerular/chronic tubulointerstitial disease
  • Chronic urinary tract obstruction
21
Q

Renal Failure Signs/Symptoms

A
  • Azotemia (increase BUN & creatinine)
  • Edema/swelling
  • Electrolyte disturbances
  • Metabolic acidosis (low pH)
  • Anemia (low hemoglobin)
  • Hypertension
  • Bone disease
22
Q

End Stage Renal Failure

A
  • Endpoint of kidney diseases
  • Sclerosis of glomeruli
  • Scarring/fibrosis of Interstitium
  • Loss of tubules
  • Chronic inflammation
  • Thickened arteries
23
Q

Renal Failure Treatment

A
  • Balanced diet (avoid Na, K)
  • Exercise
  • Medication for hypertension/diabetes
  • Diuretics
  • Dialysis
  • Transplant
24
Q

Glomerulus Disease

A
  • Important cause of renal disease
  • Affects rest of kidney
  • Impairs filtration (damage to basement membrane)
25
Q

Primary Glomerulopathies

A
  • Systemic disease affecting primarily the glomerulus
26
Q

Secondary Glomerulopathies

A
  • Systemic diseases affecting multiple organs including kidney
27
Q

Glomerulus Mechanism of Injury

A
  • Antibodies reacting in situ within glomerulus
  • Deposition of circulation preformed antigen-antibody complexes
28
Q

Nephritic Syndrome

A
  • Hematuria
  • Azotemia
  • Variable proteinuria
  • Oliguria
  • Edema
  • Hypertension
29
Q

Nephrotic Syndrome Signs

A
  • Proteinuria >3.5g/day
  • Hypoalbuminemia
  • Hyperlipidemia
  • Lipiduria
30
Q

Renal Tubules Diseases

A
  • Involve Interstitium
  • Acute tubular necrosis/injury most common cause of acute kidney injury
31
Q

Acute Tubular Injury/Necrosis Causes

A
  • Ischemia (decreased blood flow)
  • Toxic injury to tubules
32
Q

Clinical Course of Acute Tubular Injury

A
  • Decreased urine output
  • Rise in BUN & creatinine
  • Electrolyte abnormalities & metabolic acidosis
  • Urine volume increases with recovery
  • Outcome relates to duration & magnitude
  • Most patients recovery completely
32
Q

Atherosclerosis in the Kidney

A
  • Narrowing of arteries due to plaque build up
  • Decreased blood flow to kidney
  • Kidney atrophy
  • Chronic kidney failure
  • Risk of clot
32
Q

Hypertension Impacts

A
  • Major cause of end stage renal disease
  • Nephrosclerosis (sclerosis of renal arterioles)
  • Scarring of glomeruli
  • Chronic tubulointerstitial injury
  • Decrease in renal mass & function
32
Q

Reflux Complications

A
  • UTI
  • Pyelonephritis
  • Hydroureter/hydronephrosis
  • Chronic renal failure
33
Q

Reflux

A
  • Urine from bladder into ureters
  • Congenital anatomical defect
  • Conservative treatment resolve with growth/surgery
34
Q

Urinary Tract Obstruction Classification

A
  • Acute/chronic
  • Partial/complete
  • Unilateral/bilateral
35
Q

Intrinsic Obstruction

A
  • Lesions of urinary tract
36
Q

Extrinsic Obstruction

A
  • External compression
37
Q

Acute Obstruction

A
  • Flank pain
  • Renal colic
38
Q

Unilateral/Partial Obstruction

A
  • Asymptomatic
  • Unaffected kidney maintains renal function
39
Q

Chronic Obstruction

A
  • Chronic kidney disease
40
Q

Urinary Tract Stones

A
  • Form in kidney
  • Most commonly men 20-30 years
  • Familial predisposition
  • Underlying medical condition
  • Increase calcium in blood/urine
41
Q

Urinary Stone Treatment

A
  • Wait for stones to pass (fluids, pain management)
  • Lithotripsy (sound waves shatter stones)
  • Surgical removal
42
Q

Determinants of Urinary Stones

A
  • Increased urinary cone of stones (exceeds solubility)
  • Changes in urinary pH
  • Decreased urine volume
  • Bacteria present
42
Q

Urinary Stone Presentation

A
  • Asymptomatic
  • Cause severe renal colic
  • Abdominal pain
  • Kidney damage
  • Hematuria (blood in urine)
  • Predispose infection

2420 Pathology (13 decks)

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