Urinary System Path (exam 5)

Question 1

What is the most common renal pathology?

Answer 1

Obstruction

Question 2

What is an urinary tract obstruction?

What causes them?

Answer 2

Interference with the flow of urine at anywhere in urinary tract
Any anatomic or functional defect

Question 3

What is hydroureter?
What typically causes it?
What can hydroureter cause?

Answer 3

To much water or fluid in the ureters
Usually due to a blockage at the entrance to the bladder
Can lead to hydronephrosis

Question 4

What is hydronephrosis?

What does it lead to?

Answer 4

To much water or fluid in the kidneys

Can lead to increased pressure in kidneys or tubules, increasing CHP

Question 5

Is hydroureter or hydronephrosis more pathologic?

Why?

Answer 5

Hydronephrosis due to the negative effects on kidneys

Question 6

What is compensatory hypertrophy?

What leads to it?

Answer 6

Overcompensation by one kidney due to poor functioning of the other kidney
The healthy kidney hypertrophoes
From obstruction of 1 kidney, from a kidney removal, from pyelonephritis

Question 7

What is post-obstructive diuresis?

Answer 7

High increase in urination frequency (increased kidney output) once a kidney obstruction is removed/ alleviated

Question 8

What are renal calculi?

What are the classifications of renal calculi?

Answer 8

They are kidney stones, or urinary stones (once they enter the urinary system)
Calcium oxalate or calcium phosphate (most common)
Struvite stones (ammonia, magnesium stones)
Uric acid and cystine stones

Question 9

What causes renal calculi?

What are the most common risk factors?

Answer 9

Most often percipitated and crystallized minerals, Supersaturation of one or more salts, precipitation of a salt from liquid to solid state
Risk factors most likely from changes in pH, also temperature and dehydration (changes in mineral concentration levels)

Question 10

What are symptoms of renal calculi?

Answer 10

Renal Colic (intense but intermittent flank pain), hematuria, vomiting

Question 11

What substance has the largest contribution to formation of renal calculi?

Answer 11

Calcium derived stones

Question 12

How do you treat renal calculi?

Answer 12

High fluid intake, decreasing dietary intake of stone-forming substances, stone removal
Lithotripsy (ultrasound waves used to break up kidney stones into smaller pieces)

Question 13

What is prostatitis?

Answer 13

Inflammation of prostate in males

Can block flow of urine and lead to weak urine flow and pain urinations (dysuria)

Question 14

What is neurogenic bladder (detrusor dyssynergia)?

What are the types?

Answer 14

Loss of nervous control of the bladder
Detrusor hyperreflexia: urinary frequency increases
Detrusor areflexia: decreased urinary frequency

Question 15

What are the types of renal tumors?

How do they differ?

Answer 15

Renal adenomas: typically benign growths

Renal cell carcinomas (RCC): highly malignant tumor growths

Question 16

Who are bladder tumors more common in?

What is an important, distinguishing symptom?

Answer 16

Older malls (60 or older) who smoke and drink
Massive amounts of gross, painless hematuria

Question 17

What is an urinary tract infection?

Answer 17

Inflammation of the urinary epithelium usually caused by bacteria

Question 18

What bacteria usually causes UTIs?
What yeast (fungus)?

Answer 18

E coli (bacteria)
Candida albicans (yeast)

Question 19

Why are women more likely to get UTIs?

Answer 19

Length of urethra (women shorter)
Proximity to anus/ rectum (women closer)
Prostate (secretes antibiotics, antimicrobial secretions)

Question 20

What is cystitis?
What are the types?
What do they present with?

Answer 20

Bladder inflammation/ infection
Noninfectious cystitis: not bacteria, its caused by yeast, virus, autoimmune or hypersensitivity
Present with cloudy urine, abdominal pain, dysuria, increased frequency, sometimes hematuria

Question 21

What is pyelonephritis?
What do we usually see with it? Why?
What can it lead to?

Answer 21

Kidney inflammation/ infection that has crossed into the renal pelvis
Usually see compensatory hypertrophy because typically only 1 kidney affected
Leads to obstruction (lack of urine formation) because of lack of filtration

Question 22

Differentiate the types of pyelonephritis?

Answer 22

Acute pyelonephritis: short term/ localized infection, no tissue change
Chronic pyelonephritis: recurring acute infections or stone formation that leads to permanent scarring

Question 23

What do glomerular disorders affect?

Answer 23

Affect filtering at the glomerulus and disrupt the membrane functioning
Decreased glomerular filtration rate: reduced creatinine clearance
Elevated BUN
Loss of negative charge of glomerular filtration membrane, prtein in the urine: proteinuria

Question 24

What do glomerular disorders result in?

Answer 24

Hypoalbuminemia which causes hypocalcemia

Edema

Question 25

What is glomerulonephritis?

What causes it?

Answer 25

Inflammation of the glomerulus
Commonly due to hypersensitivity reactions: type 2- antibodies against the glomerular, type 3- depositions of antigen antibody complexes
From post-streptococcal infection, viral infection, diabetes

Question 26

What does glomerulonephritis lead to?

Answer 26

Systemic disorder that affects BOTH kidneys
Most common cause of end-stage renal failure
Can lead to nephrotic syndrome

Question 27

What is nephrotic syndrome?

Answer 27

Loss of 3.5 or more grams of protein per day in the urine
From increased glomerular permeability
Leads to hypoalbuminemia and then hypocalcemia, edema
Rapid onset but it is not kidney failure

Question 28

What is acute kidney injury?

What causes it

Answer 28

Acute renal failure
Sudden (rapid onset) lack of renal function
Lack of blood flow (renal hypoperfusion) decreases filtration and lowers GFR
From impaired renal blood flow, generally from trauma or hemorrhage
Most common cause is glomerulonephritis

Question 29

What is chronic renal failure?

What are some things it causes?

Answer 29

Irreversible loss of renal function (end stage failure)
Loss of kidney function affects homeostatic control mechanisms and negatively impacts multiple systems
Proteinuria and uremia: protein in urine, high urea in blood
Creatinine and urea clearance: goes down
Fluid and electrolyte balance disrupted
Acid-base balance disrupted
Anemia: because we don’t release EPO
Loss of bone density
Hypocalcemia: because of hypoalbuminemia

Question 30

How does the renal system cause metabolic acidosis?

Answer 30

Increased filtration of bicarb (retain more hydrogen)
Increased reabsorption of hydrogen
Decreased reabsorption of bicarb (HCO3-)
Decreased secretion of hydrogen
Increased secretion of bicarb

Question 31

How does the renal system cause metabolic alkylosis?

Answer 31

Increased filtration of hydrogen
Increased reabsorption of bicarb
Decreased reabsorption of hydrogen
Increased secretion of hydrogen
Decreased secretion of bicarb