Path 4 Obstructive Renal Disease & Nephrolithiasis Flashcards Preview

Test 9 > Path 4 Obstructive Renal Disease & Nephrolithiasis > Flashcards

Flashcards in Path 4 Obstructive Renal Disease & Nephrolithiasis Deck (33):
1

Sudden complete obstruction

Mild dilation of pelvis and calyces and atrophy

2

Intermittent obstruction

Progressive dilation because glomerular filtration not suppressed

3

Obstruction labs

-Increased urea and creatinine
-Hyponatremia
-Hyperchloremic metabolic acidosis

4

Obstruction urinalysis

-Elevated pH due to nephron destruction

5

Urolithiasis predisposing factors (3)

-Gout
-Cystinuria
-Hyperoxaluria

6

Calcium oxalate stone etiology (4)

-Hyperparathyroidism
-Diffuse bone disease
-Sarcoidosis
-Vit D toxicity

7

Calcium oxalate stone mechanism

Nucleation by uric acid crystals

8

Magnesium ammonium phosphate (struvite) stone etiology (2)

-Proteus infection
-Staph infeciton

9

Magnesium ammonium phosphate mechanism

Ammonium raises pH, struvite precipitates
-Staghorn calculi

10

Only radiolucent stones

Uric acid stones

11

Uric acid stone etiology (2)

-Gout
-Leukemia

12

Cystine stone etiology

Genetic defect in cystine reabsorption -> cystinuria

13

Small v Large stones

large stones usually asymptomatic, small stones get lodged in ureters

14

Stone clinical

Severe flank pain radiating to groin
-Costovertebral tenderness
-Nausea, vomiting, hematuria

15

Acute pyelonephritis etiology

E. coli (90%)

16

Acute pyelonephritis clinical

Fever, flank pain, dysuria, urgency

17

Acute pyelonephritis findings

WBC casts in urine, WBC in blood, cystitis

18

Increased risk of pyelonephritis

-Vesico-ureteral reflux
-Diabetes
-Obstruction
-Females
-Immunosuppression
-Trauma

19

Acute pyelonephritis histology

Tubule inflammation
Glomeruli spared

20

Papillary necrosis of renal papillae

Ischemia due to marginal blood supply

21

Papillary necrosis of renal papillae etiology

-Diabetes
-Phenacetin (analgesic)
-Sickle cell disease

22

Papillary necrosis of renal papillae clinical

Same as acute pyelonephritis
-Can be insidious progressive renal failure

23

Papillary necrosis of renal papillae histo

Coagulative necrosis rimmed by acute inflammation

24

Xanthogranulomatous pyelonephritis

Chronic foamy histiocytic inflammation forming pseudotumerous lesion, must be excised

25

Xanthogranulomatous pyelonephritis etiology

-Gram negative bacteria
-Staghorn calculus

26

Chronic pyelonephritis

Interstitial fibrosis and tubular atrophy
-Cortical scarring, distortion with blunted calyces

27

Chronic pyelonephritis histology

Thyroidization of kidney (atrophic tubules)

28

Chronic pyelonephritis etiology

Vesico-ureteral reflux

29

Cystitis clinical

Dysuria, suprapubic pain, increased frequency, urgency

30

Cystitis etiology

E. coli

31

Cystitis urine test

Cloudy (WBCs)
-Pyuria (positive leukocyte esterase test)
-Nitrite test positive
-Culture positive is diagnostic

32

Urethritis etiology

-E.coli
-Chlamydia trachomatis (sterile pyuria)
-Neisseria gonorrhoeae (sterile pyuria)

33

Urethritis clinical

Dysuria, urgency of urination