Renal/Urinary Disease Flashcards

Question

Tubule Diseases

Answer 1

- Ischemia (post-surgical, truma) - Nephrotoxic (mercury, lead, antifreeze) - Drug-induced (antibiotics, diuretics) - Other primary renal disease (eg, nephritis, hypertension)

Answer 2

Clot in lument - No passage of urine

Answer 3

Antifreeze disrroys tubules - Oxylate crystals -- Need to transplant kidney

Answer 4

- Interstitial nephritis-nonbacterial - Pyelonephritis (acute/chronic)-bacteria - Drug-induced nephritis -- Analgesic nephropathy-generally multiple drugs: phenacetin, aspirin, acetaminophen --- Immune case likely Type I hypersensitivity, more rarely Type IV -- Antibiotic nephropathy: sulfonamides, synthetic penicillins, rifampin, NSAIDs, AmphoB

Answer 5

Caused by infection, ascending infections; most commonly E.coli or other gram negative bacteria or hematogenous infection (less common) (Fever, flank pain, pyuria) - Can be acute or chronic (chronic can lead to chronic renal failure) - Antibiotics successful but reinfection is common - More common in females (10:1); incidence in males increase with onset of prostate disease Associated with: - UTIs - Sexual activity - Obstruction (stones, BPH, tumors) - Diabetes - Vesicoureteral reflux (VUR)-ascending infections - UT mainpulation (catheterization). Candida common organism - Pregnancy - Immunosuppression/immunodeficiency

Answer 6

Ischemia(most commonly thrombo) emboli, often from recent MI with mural thrombi, or hypovolemia Hypertension, particularly when coupled with diabetes - Essential hypertension is very common, will cause wide-spread renal injury and symmetrical atrophy - Malignant hypertension-much less common -- Extremely serious. BP>200/120 mm -- Requires prompt, aggressive medical intervention -- Will cause renal vascular injury; may cause stroke -- Even with treatment, 5-year survival 50% Arteriolonephrosclerosis: caused by hypertension Hyaline degeneration of artery/arteriole walls *Virtually all kidney disease will secondarily affect renal vessels*

Answer 7

Benign Hypertension - Major target: Small arterioles - Cause vessel narrowing and medial thickening - Resulting ischemia (from narrowing) leads to interstitial fibrosis, tubular atrophy, glomerulosclerosis - Cortical surface is finely granular, capsule is adherent - Cause some degree of functional effect, such as decreased GFR Rarely a direct cause of death except in African Americans via uremia and renal failure

Answer 8

Retina of patient - Hemmorage of retina vesse | Not much was there

Answer 9

Infection Stones Carcinoma Prostatic hperplasia (males)

Answer 10

Common: 5-10% of individuals during lifetime; M>F - 80% are calcium stones - Magnesium ammonium phosphate stones (10%) -- Associated with urea splitting organism such as Proteus ssp. -- Both associated with persistently alkaline urine - Uric acid and cysteine stones (6-9%) seen with acidic urine Generally unilateral (80%), but may be multiple in that kidney - Tendency to form stones are familial - Occur in setting of urine stasis, infection, metabolic disease, change in urinary pH, urothelial trauma; whenever conditions of super-saturation exist - Often present with flant pain radiating to groin and gross hematuria (termed renal colic) May pass spontaneously if small; surgery or lithotrips may be required if large and cause obstruction - Long term obstruction may lead to hydronephrosis and predisposes to recurrent bacterial infection

Answer 11

Uric acid and cysteine stones (6-9%)

Answer 12

Most arise from tubular epithelium - Most common in males (2X) in 6th-7th decade; 2-3% of all cancers; Overall mortality is 40% - Tobacco strongest risk factor. Genetic factors associated (loss or inactivation of von Hippel-Lindau gene VHL) on chromosome 3p - Incidence greatly increased (>30x) with chronic dialysis and associated polystic disease - Present with painless hematuria, flank pain and palpable mass - Cancer present in multiple histological forms with distinctly different prognoses - May give many forms of paraneoplastic signs-polycythemia, hypercalcemia, change in secondary sexual characteristics, hypertension, fever of unknow orign - Frequenly have metastasized to lung and/or bones when found - Metastases may resolve (rarely-not cured) with removel or primary tumor (doesn't response to chemo or radio therapy)

Answer 13

Treatable by chemo and radiation - young children under 4 Blastoma in name mean embronic

Answer 14

Cystitis and UTIs are primarily a disease of adults - Most common cause of cystitis is bacterial infection: E. coli, Proteus, Klebsiella, Enterobacter. Also fungi, and Schistosoma in the middle east - Associated with diabetes, obstruction, theraputic radiation, catheterization - Bladder infection is more common in women - May give rise to ascending pyelonephritis - Symptoms: frequency (every 15-20 min), lower abdominal pain, and dysuria

Answer 15

Present as painless hematuria with M:F ratio of 3:1 (50-80 age) - B-naphthylamine increase risk 50x - Smoking is the most common risk factor - Tumor penetrates bladder wall and has a high recurence rate (5-year survival 60%) Cause of death is urinary obstruction rather than metastasis

Answer 16

Rarer than bladder but have poorer prognosis with <10% and 50% 5-year survival In areter => prognosis terrible <10% survival

Answer 17

Exocrine gland which surrounds the proximal urethra - Hyperplasia occurs in the periurethral transition zone - Cancer arises in the periphery of the gland - Hormone responsive - Supplies 20-30% of seminal vol; semen is slightly alkaline to neutralize pH in vagina; this prolongs it's life - Prostate secretes PSA - Normal: 11 grams Skene glands of female are classified as female prostate glands; skene glands produce PSA

Answer 18

Frequency increase with age; by 80 years, 90% of males will have BPH - Result from action of both androgens and estrogen - DHT (produced by action of 5a-reductase) is a major mediator of prostate - Weak urinary stream, hesitancy, urgency frequency, incomplete bladder emptying, nocturia, incontinence, UTI - May cause urinary obstruction - Does not progress to cancer

Renal/Urinary Disease Flashcards

(42 cards)