pathologies Flashcards
1
Q
3 things to check urine for
A
cloudy/clear
sweet/pungent
colour - dark/light
2
Q
secondary indicators that urinary tract pathology is likely
A
oedema headaches - (dehydration) exhaustion nausea vomiting - confusion in elderly
3
Q
7 physical secondary signs of kidney problems
A
pale (rbcs) puffy face bags under eyes vertical wrinkles bulging veins on temples (renal pressure) swollen hands/fet swellings worse at night (protein loss)
4
Q
bladder camera op
A
cytoscopy
5
Q
typical clinical findings with kidney problems (4)
A
Anaemia
low K, Na, Ca
High urea
High creatinine
6
Q
painful, burning urination
A
dysuria
7
Q
large quantity of urine
A
polyuria
8
Q
little urine
A
oliguria
9
Q
no urine
A
anuria
10
Q
protein in urine
A
proteinuria
11
Q
bacteria in urine
A
bacteriuria
12
Q
waking in the night to urinate
A
nocturia
13
Q
blood in urine
A
haematuria
14
Q
Albumin in urine may indicate
A
kidney disease - gloerulonephritis
15
Q
glucose in urine may indicate
A
diabetes
16
Q
RBCs in urine may indicate
A
inflammatory urinary patholgy - eg - nephritis
17
Q
ketones in urine may indicate
A
using large amounts fat/protein for energy
18
Q
bilirubin in urine may indicate
A
liver pathology
19
Q
urobilinogen in urine may indicate
A
liver pathology
haemolytic disease
20
Q
casts - solid materials in urine may indicate
A
nephron disease/pyelonephritis
21
Q
microbes in urine may indicate
A
infection
22
Q
1 upper urinary tract pathology
A
pyelonephritis
23
Q
3 lower UT pathologies
A
prostitis
cystitis
urethritis
24
Q
why UTIs more common in women
A
shorter urethra, closer to anus
25
what is urinary tract infection
infection/inflammation of urinary tract - usually urethra
26
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Dysuria
frequent urge to urinate day/night
cloudy smelly urine
suprabubic pain
haematuria
```
Urinary tract infection
27
cause Urinary tract infection (3)
```
microbial infection (often from GIT bacteria)
urine flow obstruction
catheter use
```
28
diagnosis UTI
urine dip-stick - nitrates,
| blood - RBC, WBC
29
bladder infection
Cystitis
30
cystitis more common in older rather than younger men why
enlarged prostste
31
pain lower back/abdomen
dysuria
frequent urge to urinate but only tiny amount - Oliguria
dark, smelly, cloudy urine
systemic signs - fever, malaise, nausea, fever
acute Cystitis
32
causes acute cystitis
```
not emptying bladder fully
bacteria in urethra - honeymoon cystitis
(pee after sex)
wiping back to front
urine flow obstruction
catheter/diaphragm use
enlarged prostate
thinned lining (post menopausal)
diabetes
```
33
diagnosis cystitis
dipstick - bacteria, WBCs, maybe blood
34
mostly in older men when enlarged prostste obstructs urine flow causing residual urine
chronic Cystitis
35
collective term for inflammatory disorders of glomeruli
glomerulonephritis
36
most common disease of the kidneys
glomerulonephritis
37
```
back pain - kidneys swell
dark cloudy urine -
oliguria
facial/periorbital oedema -
increased blood pressure
systemic signs - tiredness, headaches, fever, nausea
```
acute glomerulonephritis
38
dark cloudy urine could indicate
proteins & RBCs
39
facial & perorbital oedema why
Na & water retenyion
40
diagnosis glomerulonephritis
urine - RBCs, protein
| blood - elevated serum urea, creatinine
41
allopathic treatment glomerulonephritis
strict bed rest few weeks
antibiotics & glucocorticoids
restricted sodium, water, protein consumption
42
10% of cases become chronic
2-5% fatal - renal failure
complications for -
Glomerulonephritis
43
chronic glomerulonephritis is
glomerulonephritis not healed after 2-3 weeks
may present with glomerular scarring
nephrotic syndrome
nephritic syndrome
44
what type of reaction is glomerulonephritis
autoimmune
45
what does the body form in response to prior infection that can lead to gflomerulonephritis
antigen-antibody immune complexes
46
where are antigen-antibody immune complexes deposited in lead up to glomerulonephritis
glomeruli - cause damaging immune reaction
| leads to leaky capillaries, excessive cell proliferation
47
glomerulonephritis - 1 kidney involved or symmetrical
symmetrical
48
in glomerulonephritis damaged kidneys allow what to leak into urine
protein & RBCs
49
in glomerulonephritis what causes congestion in glomeruli, interfering with filtration process
fibrin deposits, WBC & platelet aggregation
50
cause glomerulonephritis
auto-immune-mediated injury to glomeruli -
often 1/2 weeks after bacterial infection
often tonsils, sinuses, teeth, respiratory tract
51
glomerular sclerosis definition
scarring/fibrosis glomerular capillaries
52
nephrotic syndrome definaition
leaky glomeruli
53
2 causes glomerular sclerosis
glomerulonephritis
| end stage diabetes
54
causes nephrotic syndrome 5
```
glomerulonephritis
diabetic glomerulsclerosis
systemic lupus
infections (malaria, hepatitis)
drugs traetment
```
55
GFR
Glomerular Filration Rate
56
congestion of glomerular capillaries INHIBITS blood flow, leads to high blood pressure as kidneys produce more renin to increase blood flow and restore proper GFR
gloerular sclerosis
57
protein(albumin) seeps through leaky glomeruli - albuminaria
loss of plasma proteins = low plasma osmotic pressure & hypotonic capillaries, so fluid leaks into tissues = oedema
also, weight gain, pallor, normal BP, normal blood urea/creatinine
nephrotic sydrome
58
diabetic microangiopathy
progressive glomerulosclerosis - scarring
59
diabetic macroangiopathy
atheroma of renal arteries
60
cause of death in 10% of all diabetics
renal failure
61
diagnosis diabetuc kidney
albuminaria
62
initially none, fatigue, nausea, vomiting, itchy skin, metal taste in mouth, heartburn, oedema in limbs/eyelids
diabetic kidney
63
allopathic traetment diabetic kidney 4
normalise blood sugar levels
ACE inhibitors or angiotensin 2 to reduce blood pressure
low protein diet if kidney function reduced
severe cases dialysis/kidney transplant
64
Describe acute pyelonephritis 3
Acute microbial infection of renal pelvis & medulla which has usually spread up from bladder
Renal pelvis & calyces fill with purulent exudate
Medulla is inflamed and abscesses/necrosis may be present
65
Cause acute pyelonephritis
```
Infection spreading up from bladder
Obstructed flow of urine
Pregnancy
Diabetes
Medication abuse
Gout
```
66
Dysuria & other signs of cystitis
Pain in lower back
Sensitivity to touch in kidney area - often 1 sided
Fever fatigue nausea
Acute pyelonephritis
67
Diagnosis acute pyelonephritis
Urine - bacteriauria pus heamaturia
Urinary casts consisting if WBCs or renal epithelial cells, maybe protein
Blood - elevated WBCs & ESR
68
Allopathic treatment acute pyelonephritis
Antibiotics
Strict bed rest
Fluids
Warm packs
69
Severe cases pus compresses renal artery & vein or obstruct ureter
Recurrent/chronic infections = fibrosis, loss of tubule function
Reoccurrence is common
Infection often remains asymptomaticly in bladder - important to check
Acute pyelonephritis
70
Prophylactic
Preventative measure
71
Why can cranberry juice be a useful prophylactic for a UTI
Reduces ability of E Coli to adhere to bladder mucosa
72
Incompletely healed acute pyelonephritis or recurrent pyelonephritis
Chronic pyelonephritis
73
Can be undiagnosed for long time,
| Headache, tiredness, fever,, mild anaemia, high ESR
Chronic pyelonephritis
74
Chronic pyelonephritis diagnosis 3
Pus in urine
Bacteria in urine
High ESR
75
What are renal calculi
Kidney stones
76
How does arteriosclerosis, associated with hypertension, cause more hypertension
Arteriosclerosis causes decreased blood flow in glomeruli,
which reduces GFR,
Increases renin secretion
Causes further increase in BP
77
What is renal hypertension
Secondary hypertension, caused by chronic kidney disease
78
Renal calculi primarily affect
Men
79
Where can renal calculi occur
In whole urinary tract
80
What affect do renal calculi have on urine outflow
Can obstruct it
81
Renal calculi can consist of 4
Utica acid
Calcium
Struvite
Oxalates
82
Cause struvite renal calculi
Alkaline urine
83
Cause Uric acid stones in urine
Acid urine
84
Cause Uric acid crystals in urine
Gout
85
Cause calcium phosphate stones in urine
Hyperparathyroidism
86
Other causes kidney stones 3
Dehydration
Infection
Urine obstruction
87
Asymptomatic often early, maybe blood trace in urine
Later when stone moves, colic pain in kidney area radiating to groin
Nausea, vomiting, rapid pulse
Renal calculi
88
Lithotripsy
Shockwave or laser therapy for kidney stones
89
Preventative steps to take if family history of renal calculi
Adjust urine pH through diet
Reduce oxalates & Uric acid
Balance calcium levels
Increase fluid intake
90
What do diuretic drugs remove from body
Excess sodium & water
91
How do diuretics work
Lower rate of re absorption of filtrate from kidney tubules so more water and Na is excreted
92
Complications diuretics
Loss of electrolytes
| Muscle weakness/palpitations caused by excessive loss of K & Mg
93
What is dialysis
Artificial kidney used for acute renal failure
94
Two types dialysis
Haemodialysis
| Peritoneal dialysis
95
Why is prophylactic use of antibiotics v common with both forms of dialysis
Both carry risk of infection
