Nephrolithiasis

Question 1

Nephro-

Answer 1

Kidney

Question 2

Renal

Answer 2

Belonging to the kidneys

Question 3

nephrology

Answer 3

Study of kidneys

Question 4

urology

Answer 4

Study of urinary tract

Question 5

-lithos

Answer 5

Stones

Question 6

Calculi

Answer 6

Accidental, doesn’t belong to body

Question 7

obstructive urologic disorders severity depends on

Answer 7

Degree
location
Duration
Timing

Question 8

where can obstructive urologic disorders occur?

Answer 8

Urethra
Ureters
Bladder
Kidneys

Question 9

renal pelvis obstruction etiology

Answer 9

Renal calculi

Question 10

ureter obstruction etiology

Answer 10

Renal calculi
Pregnancy
Tumors

Question 11

bladder and urethra obstruction etiology

Answer 11

Bladder cancer
Neurogenic bladder
Prostatic hyperplasia
Prosthetic cancer
Urethral strictures – narrowing

Question 12

Complications of obstructed urology

Answer 12

stasis of urine
Back up pressure – hydroureter, Hydro nephrosis, postrenal acute kidney injury

Question 13

s/sx acute obstruction

Answer 13

Depends on site, cause, speed of onset

Question 14

Nephrolithiasis

Answer 14

renal calculi, kidney stones
Clumps of crystals in urinary tract
Forms in renal pelvis

Question 15

Where can nephrolithiasis occur?

Answer 15

Anywhere between the pelvis and bladder

Question 16

Nephrolithiasis risk factors

Answer 16

Men
20-30 years old
Caucasian
Family history
Congenital defect
Obesity
Warm weather

Question 17

etiology of nephrolithiasis

Answer 17

Crystallize solutes in urine, forms stones

Depends on: individual risk factors, characteristics of urine, type of stones formed

Question 18

calcium oxalate

Answer 18

Most common form of stones
Due to family history, idiopathic*, increase in calcium and oxaluria

Question 19

struvite “ staghorn”

Answer 19

7 to 10%
Due to UTI, urine splitting bacteria

Question 20

Uric acid

Answer 20

7 to 10%
Due to gout, elevated levels of purine

Question 21

pathogenesis of nephrolithiasis

Answer 21

Urine is solution of solvent (water) and solutes (particles)

Problem – supersaturation with solute

Crystals begin forming in nephron

Question 22

how is crystal formation enhanced?

Answer 22

Dehydration
Immobility/sedentary lifestyle

Question 23

s/sx acute renal colic

Answer 23

Wavelike pain in ureter
Flank and radiates down groin
Spasms, severe
Intermittent/sharp
N/V
Diaphoresis, cool clammy skin
Increase in heart rate, and respiratory rate

Question 24

pharm therapy for acute pain

Answer 24

morphine or NSAIDS
IV. Fluids.

Question 25

pharm therapy for preventative

Answer 25

Calcium – thiazide diuretics Struvite– antibiotics urate–allopurinol

Question 26

UTI protective factors

Answer 26

PH – acidic Presence of urea Man – prostatic secretions Women – urethral gland, secretions urine flow– unidirectional Immune system

Question 27

what structure difference in women makes them more prone to UTIs?

Answer 27

Shorter urethra

Question 28

Risk factors of UTI

Answer 28

CAUTI Women Peri irritation Increased age Pregnancy Sex Obstruction or reflux Immobility Incontinence Decrease cognition Bad hygiene

Question 29

pathogenesis of pyelonephritis

Answer 29

ascending pattern Starts at: contaminated perineum Urethra Bladder – cystitis Ureter Kidney

Question 30

Pyelonephritis

Answer 30

Inflammation of the kidneys

Question 31

Etiology of pyelonephritis

Answer 31

Ascending infection with E. coli Bloodstream infection

Question 32

risk factor for pyelonephritis

Answer 32

Pregnancy

Question 33

s/sx of pyelonephritis

Answer 33

Opaque and foul smelling urine Sudden onset – fever, chills, CVA tenderness lower UTI – dysuria N/V Anorexia

Question 34

pathogenesis of pyelonephritis

Answer 34

Inflammatory response Kidney tissue damage

Question 35

Urosepsis

Answer 35

Severe systemic response to UTI

Question 36

Who is at high risk of urosepsis?

Answer 36

Elderly Diabetics Immuno suppressed

Question 37

Prognosis of urosepsis

Answer 37

High mortality

Question 38

Kidney cancer

Answer 38

Renal cell carcinoma

Question 39

Risk factors for kidney cancer

Answer 39

1) smoking obesity Increased age, males Genetics

Question 40

Prognosis of kidney cancer

Answer 40

If metastasized – high mortality

Question 41

s/sx late kidney cancer

Answer 41

CVA tenderness Hematuria Palpable, abdominal mass

Question 42

Are there any signs of kidney cancer early on?

Answer 42

No

Question 43

metastases of kidney cancer

Answer 43

Travels to lung or bone Can cause dyspnea, cough, bone pain

Question 44

chemo for kidney cancer

Answer 44

Bio treatments surgery required to remove effective kidney

Question 45

Bladder cancer

Answer 45

4th most common cancer in men Urothelial carcinoma

Question 46

Risk factors for bladder cancer

Answer 46

1) smoking Males Occupations, with exposure to toxins – paint, rubber Low fluid intake

Question 47

Early signs of bladder cancer

Answer 47

Hematuria – pink/reddish

Question 48

later signs of bladder cancer

Answer 48

Frequency, urgency, dysuria

Question 49

chemo for bladder cancer

Answer 49

Depends on stage Stage one – intravesical chemo Advanced stages – systemic chemo

Question 50

Intravesical therapy

Answer 50

Live BCG vaccine