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)
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1
Q

Sudden complete obstruction

A

Mild dilation of pelvis and calyces and atrophy

2
Q

Intermittent obstruction

A

Progressive dilation because glomerular filtration not suppressed

3
Q

Obstruction labs

A
  • Increased urea and creatinine
  • Hyponatremia
  • Hyperchloremic metabolic acidosis
4
Q

Obstruction urinalysis

A

-Elevated pH due to nephron destruction

5
Q

Urolithiasis predisposing factors (3)

A
  • Gout
  • Cystinuria
  • Hyperoxaluria
6
Q

Calcium oxalate stone etiology (4)

A
  • Hyperparathyroidism
  • Diffuse bone disease
  • Sarcoidosis
  • Vit D toxicity
7
Q

Calcium oxalate stone mechanism

A

Nucleation by uric acid crystals

8
Q

Magnesium ammonium phosphate (struvite) stone etiology (2)

A
  • Proteus infection

- Staph infeciton

9
Q

Magnesium ammonium phosphate mechanism

A

Ammonium raises pH, struvite precipitates

-Staghorn calculi

10
Q

Only radiolucent stones

A

Uric acid stones

11
Q

Uric acid stone etiology (2)

A
  • Gout

- Leukemia

12
Q

Cystine stone etiology

A

Genetic defect in cystine reabsorption -> cystinuria

13
Q

Small v Large stones

A

large stones usually asymptomatic, small stones get lodged in ureters

14
Q

Stone clinical

A

Severe flank pain radiating to groin

  • Costovertebral tenderness
  • Nausea, vomiting, hematuria
15
Q

Acute pyelonephritis etiology

A

E. coli (90%)

16
Q

Acute pyelonephritis clinical

A

Fever, flank pain, dysuria, urgency

17
Q

Acute pyelonephritis findings

A

WBC casts in urine, WBC in blood, cystitis

18
Q

Increased risk of pyelonephritis

A
  • Vesico-ureteral reflux
  • Diabetes
  • Obstruction
  • Females
  • Immunosuppression
  • Trauma
19
Q

Acute pyelonephritis histology

A

Tubule inflammation

Glomeruli spared

20
Q

Papillary necrosis of renal papillae

A

Ischemia due to marginal blood supply

21
Q

Papillary necrosis of renal papillae etiology

A
  • Diabetes
  • Phenacetin (analgesic)
  • Sickle cell disease
22
Q

Papillary necrosis of renal papillae clinical

A

Same as acute pyelonephritis

-Can be insidious progressive renal failure

23
Q

Papillary necrosis of renal papillae histo

A

Coagulative necrosis rimmed by acute inflammation

24
Q

Xanthogranulomatous pyelonephritis

A

Chronic foamy histiocytic inflammation forming pseudotumerous lesion, must be excised

25
Q

Xanthogranulomatous pyelonephritis etiology

A
  • Gram negative bacteria

- Staghorn calculus

26
Q

Chronic pyelonephritis

A

Interstitial fibrosis and tubular atrophy

-Cortical scarring, distortion with blunted calyces

27
Q

Chronic pyelonephritis histology

A

Thyroidization of kidney (atrophic tubules)

28
Q

Chronic pyelonephritis etiology

A

Vesico-ureteral reflux

29
Q

Cystitis clinical

A

Dysuria, suprapubic pain, increased frequency, urgency

30
Q

Cystitis etiology

A

E. coli

31
Q

Cystitis urine test

A

Cloudy (WBCs)

  • Pyuria (positive leukocyte esterase test)
  • Nitrite test positive
  • Culture positive is diagnostic
32
Q

Urethritis etiology

A
  • E.coli
  • Chlamydia trachomatis (sterile pyuria)
  • Neisseria gonorrhoeae (sterile pyuria)
33
Q

Urethritis clinical

A

Dysuria, urgency of urination