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Pathology 3000 > Urinary Tract > Flashcards

Urinary Tract Flashcards

(48 cards)

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1
Q

Glomeruli

A

Bundle of capillaries for filtering blood

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2
Q

Primary function of urinary tract

A

Formation and excretion of urine

  1. Ultrafiltration of blood in the nephrons of the kidneys
  2. Urine then enters renal collecting system
  3. Through ureters to urinary bladder
  4. Discharged through urethra
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3
Q

Nephron

A

Basic functional unit of the kindey
Contains glomeruli, tubules and collecting ducts
~90% of fluid is reabsorbed
Conserves water, balances pH and ionic composition of blood

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4
Q

Hormones that kidneys synthesize (2)

A
  1. Renin

2. Erythropoietin

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5
Q

Renin

A

Raises blood pressure

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6
Q

Erythropoietin

A

Stimulates RBC production in the bone marrow

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7
Q

Hormones that regulate kidney function (3)

A
  1. Antidiuretic hormone
  2. Arterial natriuretic factor
  3. Aldosterone
    Imperative for normal kidney function
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8
Q

Antidiuretic hormone

A

Stimulates water uptake in the distal convoluted tubules

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9
Q

Arterial natriuretic hormone

A

Stimulates water loss

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10
Q

Aldosterone

A

Increases sodium reabsorption which increases body fluid volume

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11
Q

Juxtaglomerular apparatus

A

Senses pressure in distal tubule, and promotes production of renin

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12
Q

Developmental disorders (4)

A

Very common, mostly asymptomatic

  1. Renal agenesis
  2. Horseshoe kidney
  3. Polycystic kidney disease
  4. Multicystic renal dysplasia
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13
Q

Renal agenesis

A

Bilateral or unilaterial

No kidneys

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14
Q

Horseshoe kidney

A

Kidneys fuse at posterior section
Function usually not impaired
Accidental discovery

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15
Q

Polycystic kidney disease

A

Autosomal polycystic kidney disease - 85% due to mutation in polycystin-1
Kidneys lose function completely and need dialysis/donor (40-50yo)
Bilateral involvement, massive enlargement, almost complete parenchymal replacement by cysts, derived from blocked tubules
Cysts arise in nephron, epithelial lining, interstitial inflammation and fibrosis

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16
Q

Symptoms of autosomal dominant polycystic kidney disease

A

Hematuria, oliguria, flank pain

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17
Q

Cystic renal dysplasia

A

Sporadic, non-familial
Abnormal metanephric differentiation
Unilateral or bilateral kidney enlargement, multicystic
Immature ducts surrounded by undifferentiated mesenchyme
Often focal cartilage, abnormal lobar organization
Mostly associated with ureteropelvic obstruction, ureteral agenesis or atresia and other abnormalities of lower urinary tract

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18
Q

Local symptoms of kidney disease

A

Changes is urine volume - polyuria or oliguria

and composition - hematuria, glucosuria, pyuria

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19
Q

Pyuria

A

Pus formation in urine

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20
Q

Systemic symptoms of kidney disease

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A

Fever
Malaise (infections)
Uremia

21
Q

Uremia

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A

Accumulation of various metabolites in the blood

Creatinine, uric acid, ammonia

22
Q

Glomerular disease (4)

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A
  1. Immunogenic diseases
  2. Metabolic
  3. Circulatory disturbances
  4. Multiple mechanisms
23
Q

Glomerulonephritis

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A

Immunogenic disease of glomerulus

24
Q

Metabolic glomerular diseases (2)

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A
  1. Diabetes

2. Amyloidosis

25
Circulatory disturbances causing glomerular diseases (3)
1. Hypertension 2. Atherosclerosis 3. Disseminated intravascular coagulation
26
Symptoms of glomerular disease *** (4)
1. Rapidly progressive glomerulonephritis 2. Nephritic syndrome 3. Nephrotic syndrome 4. Isolated hematuria or proteinuria
27
Nephrotic syndrome (7)
1. Increased glomerular permeability 2. Nephrotic range proteinuria 3. Hypoalbuminemia 4. Edema 5. Hyperlipidemia (lipiduria) 6. Thrombo-embolism 7. Infection
28
Nephritic syndrome (7)
1. Hematuria 2. RBC casts, dysmorphic/fragmented RBC in urine 3. Oliguria 4. Proteinuria 5. Hypoalbuminemia 6. Edema 7. Hypertension
29
Crescentic glomerulonephritis
Immune related Severe glomerular injury Formation of fibrinous exudate inside Bowman's capsule Usually in patients with anti-glomerular basement membrane disease (Goodpasture's syndrome) Anuria and acute renal failure
30
Acute glomerulonephritis
Immune-mediated inflammation of the glomerulus, 1-2 weeks after acute infection Nephritic syndrome Glomeruli filled with inflammatory cells
31
Poststreptococcal Acute Glomerulonephritis by EM (5)
1. Deposition of immune complexes in glomerular basement membrane 2. Glomeruli appear hypercellular, with increased mesangial cells and inflammatory cells 3. Compression of capillaries causing renin release 4. BM damage leads to hypoalbumemia 5. Peripheral edemia
32
Membranous nephropathy
Common cause of nephrotic syndrome in adults Immune-mediated glomerulopathy Thickening of BM secondary to massive deposition of immune complexes Staining for Ig, C3 shows granular staining around capillary walls
33
Lipoid nephrosis
Minimal change disease Most common nephrotic syndrome in children Nephrotic syndrome with hyperlipidemia and lipiduria Fusion of foot processes by electron microscopy
34
Chronic proliferative glomerulonephritic (4)
1. IgA nephropathy 2. Membranoproliferative GN 3. Focal mesangial proliferative GN 4. SLE (no effective treatments except SLE)
35
Diabetic glomeruloscerlosis
Most prevalent metabolic disease affecting kidneys Hyperglycemia causing changes in renal glomeruli, arterioles, interstitium Thickening of BM and mesangial matrix (diffuse or nodular) Proteinuria (10-20 years after onset) Prone to bacterial infections, pyelonephritis
36
End-stage glomerulopathy (4)
1. Chronic renal failure 2. Symmetrically shrunken, fine surface granularity caused by loss of renal tubules 3. Patients develop progressive uremia 4. Replacement of glomeruli by collagen
37
Acute tubular necrosis
Sudden decrease in arterial pressure leads to acute hypoperfusion in the kidneys
38
Nephroangiosclerosis
Decreased blood flow due to renal artery artherosclerosis | Leading to ischemic glomerulosclerosis
39
Urinary stones (4)
1. Calcium (75) 2. Struvite (15) 3. Uric acid (5) 4. Cystine (1)
40
Ascending UTI
Bacteria reach urinary tract through the urethra More common Women more susceptible Predisposing conditions: nodular prostatic hyperplasia, urolithiasis, bladder catheterization, pregnancy
41
Descending UTI
Bacteria reach urinary tract from the blood Hematogenous infection Usually preceded by sepsis or septic emboli
42
Acute pyelonephritis
Suppurative infection of the kidneys Appears swollen, pale Microabsesses
43
Chronic pyelonephritis
Develops from repeated bouts of acute pyelonephritis | Persistant infection leads to destruction of the renal parenchyma, affected kidneys become small and irregularly scarred
44
Acute cystitis
Congestion and mucosal hemorrhage Mucosa may be ulcerated or covered with pus Fever, pain, hematuria, pyuria
45
Chronic cystitis
Mucosa has considerable thickening, ulceration and hemorrhage
46
Cystitis
Inflammation of the bladder wall
47
Cystitis in elderly men
Complication of nodular prostatic hyperplasia
48
Cystitis in women
Bacteria cystitis may be associated with sexual intercourse and pregnancy

Pathology 3000 (14 decks)

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