UUT obstruction

Question 1

What defines an upper urinary tract obstruction?

Answer 1

An obstacle to urine outflow between the upper renal calyx and the ureteral meatus.

Question 2

What is the consequence of an upper urinary tract obstruction?

Answer 2

Increased resistance and pressure upstream of the obstruction.

Question 3

What happens during the initial phase of obstruction?

Answer 3

Hyperperistalsis, followed by tonic-phasic adaptation and parietal fibrillation.

Question 4

Why is early obstruction damage reversible?

Answer 4

Because kidney functionality is only partially impaired at the start.

Question 5

What characterizes the belated phase of obstruction?

Answer 5

Anelastic distension of the pelvis and dilation of the intrarenal excretory cavities.

Question 6

What are chronic complications of untreated UUT obstruction?

Answer 6

Flattening of renal papillae, thinning of parenchyma, and irreversible kidney damage.

Question 7

What is the most common cause of acquired UUT obstruction?

Answer 7

Stones.

Question 8

How are UUT obstructions classified etiopathologically?

Answer 8

As congenital or acquired.

Question 9

Name a congenital cause of UUT obstruction.

Answer 9

Ureteropelvic junction obstruction (UPJO).

Question 10

What are endoluminal causes of obstruction?

Answer 10

Stones and clots.

Question 11

What are extrinsic causes of obstruction?

Answer 11

Retroperitoneal tumors, gynecological diseases, rectal neoplasms.

Question 12

What are parietal causes of obstruction?

Answer 12

Urothelial neoplasms and tuberculosis-related stenosis.

Question 13

What defines a unilateral UUT obstruction?

Answer 13

Involvement of a single excretory system.

Question 14

Why is bilateral obstruction more serious?

Answer 14

It can affect both kidneys and lead to renal failure.

Question 15

What is a common cause of acute UUT obstruction?

Answer 15

Stones.

Question 16

How does progressive obstruction present clinically?

Answer 16

Often asymptomatically with progressive hydronephrosis.

Question 17

What symptom characterizes acute obstruction?

Answer 17

Renal colic.

Question 18

What complication can result from obstruction with infection?

Answer 18

Sepsis or septic shock.

Question 19

What is Giordano’s maneuver used for?

Answer 19

Physical examination to assess renal pain.

Question 20

What blood tests are important in diagnosing UUT obstruction?

Answer 20

Serum creatinine, CRP, FBC, electrolytes.

Question 21

Why is ultrasound used in diagnosis?

Answer 21

It can detect pyelectasia and hydronephrosis quickly.

Question 22

What is the diagnostic gold standard imaging for UUT obstruction?

Answer 22

CT scan.

Question 23

What is the role of renogram?

Answer 23

Assess functional impairment and drainage.

Question 24

What is a typical emergency treatment for stone with sepsis?

Answer 24

Drainage followed by ureteroscopy.

Question 25

What is a Double J stent used for?

Answer 25

Maintaining urine flow from kidney to bladder past an obstruction.

Question 26

When is nephrostomy preferred?

Answer 26

When retrograde access is not possible due to severe obstruction.

Question 27

Where is nephrostomy catheter inserted from?

Answer 27

Through the lumbar region percutaneously.

Question 28

What is UPJO?

Answer 28

Obstruction at the ureteropelvic junction.

Question 29

Is UPJO more common in males or females?

Answer 29

Males.

Question 30

What is the most frequent cause of obstructive nephropathy in children?

Answer 30

UPJO.

Question 31

What anatomical feature characterizes UPJ?

Answer 31

A functional transition zone regulated by a pacemaker system.

Question 32

What are intrinsic causes of UPJO?

Answer 32

Atresia, parietal structural anomalies, high ureteral insertion, ampullary morphology.

Question 33

What is a common extrinsic cause of UPJO?

Answer 33

Crossing vessels compressing the UPJ.

Question 34

What are typical adult symptoms of UPJO?

Answer 34

Flank fullness, dull lumbar pain, infections, stones.

Question 35

What symptom might children with UPJO present?

Answer 35

Abdominal pain, hematuria, or UTI.

Question 36

What is the role of MRI in UPJO diagnosis?

Answer 36

Same info as CT, preferred in children or iodine allergy.

Question 37

What is the function of IV pyelography?

Answer 37

Visualizes enlarged pelvis and calices with normal ureter.

Question 38

When is watchful waiting used for UPJO?

Answer 38

In elderly with stable renal function.

Question 39

What is pyeloplasty?

Answer 39

Surgical removal of UPJ and reconnection of ureter to pelvis.

Question 40

What surgical technique is preferred for UPJO?

Answer 40

Anderson-Hynes pyeloplasty.

Question 41

What are the benefits of laparoscopic pyeloplasty?

Answer 41

Minimally invasive with fast recovery.

Question 42

What does robotic pyeloplasty allow?

Answer 42

Simultaneous removal of obstruction and repair.

Question 43

What does a flat renogram curve indicate?

Answer 43

Non-functioning kidney or severe obstruction.

Question 44

What does contrast-enhanced CT show in UUT obstruction?

Answer 44

Exact site, cause, and complications of obstruction.

Question 45

What is hydronephrosis?

Answer 45

Dilation of the renal pelvis and calices due to urine backup.

Question 46

Why can infection worsen obstruction?

Answer 46

It can lead to sepsis requiring emergency drainage.

Question 47

What is the main goal in acute obstruction therapy?

Answer 47

Drain urine and stabilize the patient before definitive treatment.

Question 48

What is the advantage of renogram over biohumoral tests?

Answer 48

It evaluates function of each kidney separately.

Question 49

Why is UUT obstruction a common cause of nephrectomy?

Answer 49

Because untreated chronic obstruction leads to irreversible damage.