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Pathology 2210 > Urinary System > Flashcards

Urinary System Flashcards

(79 cards)

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1
Q

What are the functions of the kidney?

A

Filter blood
Remove waste products
Retain solutes of nutritional
Balance water volume, ion concentration and manage blood pressure

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2
Q

Podocytes have __________ that filter blood based on _____

A

Processes

Size

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3
Q

What is renal failure?

A

Is a condition where the kidney fails to filtered wastes out of the blood adequately

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4
Q

What is chronic renal failure ?

A

Progressive loss of kidney function over a period of months - years

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5
Q

What is acute renal failure?

A

Abrupt loss of kidney function over a period of days, usually caused by critical illness

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6
Q

What are the symptoms of renal failure?

A

Loss of blood components :
Haematuria - Blood cells in urine
Proteinuria - Proteins in urine

Failure to remove wastes (Azotemia) - things like high levels of urea and creatinine

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7
Q

Break down of the ___________________ will cause larger substances and cells to enter the filtrate

A

Glomerular Filtration Membrane

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8
Q

What is End-Stage Renal Disease (ESRD)?

A

It is a condition caused by wastes reaching toxic levels in the blood, it is fatal if left untreated

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9
Q

What are the symptoms of ESRD?

A

Weakness
High BP
Weight gain
Increased salt and fluid retention

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10
Q

Give a brief overview of Haemodialysis:

A

It is the filtration of blood with an artificial membrane
Chronic Treatment - 3 times a week 3-4 hours
Acute treatment - temporary renal replacement therapy

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11
Q

What is peritoneal dialysis?

A

Dialysis using the patients peritoneal membrane as a filter, fluid is pumped into the abdomen and allowed to equilibrate

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12
Q

How do we diagnose renal failure?

A
  • Clearance rates
  • Screening for proteinuria
  • Screening for haematuria
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13
Q

How do we do a blood and urine test?

A

[urine] / [plasma] x 24hr urine volume

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14
Q

What are clearance rates?

A

Clearance rates: measure the rate at which a marker (usually creatinine) is excreted

  • Creatinine has a clearance rate of 100ml/min
  • Requires a blood and urine test
  • Low clearance rate = decline in renal function
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15
Q

_________ is the most abundant protein in the proteinuric urine

A

Albumin

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16
Q

Glomerular diseases may be characterised by:

A 
Inflammation
Scarring
Membrane thickening
Podocytes disorganisation
Minimal change disease
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17
Q

Glomerular diseases are _________ in nature, glomerular tissue ________________

A

Progressive

Cannot regenerate

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18
Q

What is Glomerularnephritis?

A

A inflammatory disease of the glomerulus characterised by the presence of lots of cells including leukocytes in the glomerulus

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19
Q

What are the clinical features of glomerularnephritis?

A

Blocking of urine flow (Oliguria)

Podocyte damage can cause Proteinuria and/or Haematuria

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20
Q

What is Glomerulosclerosis?

A

A disease caused by damage to the glomerulus being repaired by laying down of collagen and other fibres. This affects the filtration membrane

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21
Q

Scarring of the glomerulus can be due to __________ or a secondary response to other diseases e.g. _______

A

Inflammation

Diabetes

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22
Q

What is Membranous Glomerulopathy?

A

A disease caused by the thickening of the capillary walls often with antibody deposits

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23
Q

The cause of membranous glomerulopathy is ________, it is linked to ________

A

Unknown

Diabetes

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24
Q

What is podocyte disruption?

A

It is the disruption of the regular structure, can be caused by flattening or detachment of podocytes

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25
Tubular necrosis is caused by ______, ______ and _________. It is often _______ in nature requires _______ dialysis treatment
Ischaemia, Toxins and Chemicals Acute Temporary dialysis
26
Tubules can _______ after several weeks
Regenerate
27
Tubule necrosis causes tubules to _____________. There is loss of the _____________ meaning that solutes can not be absorbed as readily
Collapse on themselves | Brush-border
28
The concentration of electrolytes are measured in ___________, 1 _____ = 1 __________
Equivalents | 1 charge = 1 equivalent
29
Most reabsorption occurs in the _____
PCT
30
What is reabsorbed in the PCT?
``` NaCl K Ca HCO3-, Glucose and AAs ```
31
What is secreted in the PCT?
H+ | NH3
32
What is reabsorbed in the LoH?
H20 NaCl Mg in the ascending limb
33
What is reabsorbed in the DCT?
NaCl
34
What is secreted in the DCT?
K+
35
What is reabsorbed in the collecting duct?
NaCl H2O Urea
36
What are diuretics?
Substances that promote water loss
37
What causes fluid disturbances?
Defective aquaporins (Diabetes Insipedus) Vomiting - loss of water and electrolytes Diarrhoea - loss of water and electrolytes
38
Electrolyte disturbances can be caused by:
Retention of electrolytes Redistribution of electrolytes - movement to balance charges causes issues with transport and other processes Defective transporters
39
Bicarbonate is reabsorbed in the ____
PCT
40
What causes Respiratory Acidosis?
Inefficient CO2 removal, pulmonary disease
41
What causes Respiratory Alkalosis?
Hyperventilation, too much CO2 removal | Anxiety and drugs
42
What causes Metabolic Acidosis?
Excess H+ | Renal failure
43
What causes Metabolic Alkalosis?
Excess HCO3- | Ingestion of antacids
44
How does the body respond to Respiratory Acidosis?
Kidneys reabsorb more HCO3 in the PCT
45
How does the body respond to Respiratory Alkalosis?
Kidneys don't reabsorb HCO3 in the PCT
46
How does the body respond to Metabolic Acidosis?
Lungs blow off more CO2 | Kidneys reabsorb more HCO3 in the PCT
47
How does the body respond to Metabolic Alkalosis?
Lungs blow off less CO2 | Kidneys don't reabsorb HCO3 in the PCT
48
What is the worst pH related disorder and why?
Metabolic Alkalosis because the body's response is usually inadequate, to reduce CO2 we have to reduce O2 gain
49
Give a brief description of kidney formation:
Kidneys start off as buds off of the bladder and ascend into position in the embryo
50
What is agenesis of the kidney?
1 kidney fails to form | The kidney that is left is often enlarged to cope with the extra load
51
One of the kidneys may fail to ________ this doesn't causes issues unless there is _______ of the ureter
Ascend | Kinking
52
______ of the kidneys can occur if they fail to ascend, this this doesn't causes issues unless there is _______ of the ureter. Most common type is ________
Fusion Kinking Horseshoe
53
There can be ____________________ of the ureter, these patients may be predisposed towards _______ if drainage doesn't occur properly
Full or partial duplication of the ureter | Infection
54
What is a simple cyst?
A thin epithelial layer enclosing a clear fluid
55
Simple cysts often _____________
Go undetected
56
How do cysts occur?
Mutation causes cell proliferation and fluid secretion into the space in between cells due to mutation in fluid transporters
57
What is polycystic kidney disease?
A progressive genetic disease Function declines as nephrons are destroyed and flow is impacted Can be asymptomatic or painful
58
What are the 2 different types of Polycystic kidney disease?
Childhood - Autosomal recessive - Cysts at birth - Death in early infancy Adult - Autosomal dominant - Can be asymptomatic until 40-50s - Relatively common
59
What are medullary cysts?
Cysts that occur in the medulla | Can seriously impact flow
60
What are acquired cysts?
Cysts that develop in long term dialysis patients
61
What causes urinary obstructuction?
``` Congenital anomalies Calculi (Stones) Prostatic Hypertrophy Tumours Inflammation Inflammation ```
62
What is Hydronephrosis and Hydroureter?
Blockage causes backwards pressure that causes dilation of the renal pelvis and medulla or ureter
63
What are renal calculi?
Stones formed from the precipitation of salts like uric acid and calcium in the urine
64
What encourages renal calculi?
- High salt concentrations - Urine stagnation - Infection
65
What is a staghorn calculus?
A renal calculi that is shaped like the renal pelvis
66
Stones may cause _______ or _______ the ureter lining and thus cause _______
Blockage or Tearing | Haematuria
67
What is Lithotripsy?
A surgery to remove stones by ultrasonic waves that shatter them into small particles that can be excreted
68
Micro-organisms in the urinary system are usually ________________
Flushed out with urine
69
When can infection can occur?
When urine is stagnant (Flow obstruction) Ureter lining is damaged Patient has a catheter
70
What is cystitis?
Infection of the bladder
71
What is pyelonephritis?
Infection in the kidney
72
Organisms that cause urinary infections are usually __________________
The patients enteric flora
73
Where can pyelonephritis originate from?
``` The blood (Haematogenous) Backwards flow from the bladder ```
74
How do we treat UTIs?
Treatment with antibiotics is usually successful if underlying cause is corrected as well
75
Recurrent Pyelonephritis can lead to _________ of renal tissue and therefore _____________
A decrease in function
76
Summarise benign kidney tumours:
Frequently found in the cortex Usually not harmful If in medulla can cause blockage and be a breeding ground for infection
77
Summarise features of the main malignant kidney tumour in adults:
Renal cell carcinoma - Can invade the calyces, pelvis, renal vein, and ureter - Can cause bleeding .'. we get Haematuria - Prognosis is bad because the by the time it's identified it's already metastasised
78
What are Wilms tumours?
A highly malignant tumour in children that occurs from spontaneous genetic abnormalities It causes a swollen abdomen and Haematuria
79
How do we treat Wilms tumours?
Nephrectomy Radiotherapy Prognosis is generally favourable

Pathology 2210 (20 decks)

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