Flashcards in Pathology 1 Deck (40):
Is glomerulonepritis or pyelonephritis infective?
Pyelonephritis - bacterial infection
What is glomerulonephritis?
Group of renal conditions that are usually characterised by inflammation either of the glomeruli or small blood vessels in the kidneys
What is pyelonephritis?
Bacterial infection of the renal eliv, calyces. tubules and interstitium
Acute or chronic (more common)
What is the most common infecting organism of pyelonephritis?
What other organisms can cause pyelonephritis?
Give the risk factors for pyelonephritis?
Pregancy - ureteric dilation
Imstrumentation or surgery
urinary tract obstruction
Vesico-ureteric reflux (VUR)
What can cause urinary tract obstruction?
Congenital anomaly - duplex systems, posterior urethral valves
Prostatic disease (BPH)
What is Vesico-ureteric reflux (VUR)?
Incompetence of uretero-vsical valves - ureter enters bladder more perpendicularly
congenital or acquired
What can conribute to chronic pyelonephritis?
Do patients with chronic pyelonephritis produce large volumes of urine?
Yes - can't concentrate urine as nephrons don't work
What is the spread of TB to cause tuberculus pyelonephritis?
Haematogenous spread usually from the lung
What oraganisms can cause cystitis?
What is cystitis?
Lower urinary tract infection
acute inflammation but can become necrotizing if associated with outlet obtruction (prostatic disease in males)
What organism causes Schistosomiasis?
What does chronic Schistosomiasis predispose a pateint to?
Urothelial maligancy - esp. squamous carcinoma
What is hydronephrosis?
Water inside the kidney
urine back pressure into the calyces compresses the nephrons within the medullary pyramids leading to renal failure
What are the main causes of hydronephrosis?
Urinary tract obstruction and reflux
Which muscle is associated with bladder hypertrophy?
What is the Nephrotic syndrome?
Proteinuria >3g per day
What is the Nephritic sydrome?
Acute Kidney injury
Oedema/ fluid retention
Active urinary sediment
What is Stage 1 CKD?
GFR >90ml/min with evidence of kidney damage
What is Stage 2 CKD?
GFR > 60-90ml/min with evidence of kidney damage
Stage 3 CKD.
How is stage 3 CKD broken down?
3A - 45-60ml/min
3B - 30-44ml/min
Stage 4 CKD
Stage 5 CKD
What can cause CKD?
Paients with CKD often present late. What symptoms do they tend to present with?
If nocturia pt may resent earlier
What 2 drug classes are used to control BP and proteinuria in CKD?
If using ACEi for CKD what should be noted and what should be monitored?
Initial fall in GFR
Hyperkalaemia - monitor
Apart from managing BP and proteinuria, what other management options are available for CKD?
Good glycaemic control
reduce CV risk
Identify and treat complications of CKD
What are the complications of CKD?
Renal bone disease
What else could be anaemia in CKD apart from reduced EPO production?
What other deficiences should be checked for in a CKD patient with the complication of anaemia?
Waht is the target haemoglobin for a patient with CKD and anaemia?
What mechanism leads to rena bone disease in CKD?
Reduced Vit D hydroxylation in the kidney whihc leads ot reduced calcium absorption which causes secondary hyperparathyroidism
In advanced CKD, what other mechanism leads to secondary hyperparathyroidism?
Serum phosphate rises which increases PTH secretion (2y hyperparathyroidism)
What are the treatment options for renal bone disease?
Alfaccalcidol - hydroxylated Vit D
Phosphate intake - dietary advice
Phosphate binders - taken with meals to decrease gut absorption
At what stage is dialysis considered in CKD?
GFR ~20ml/min (deffos when <15ml/min)
Earlier if disease is progressing fast