Urinary Tract Disorders & Diseases – Flashcards
Unlock all answers in this set
Unlock answersquestion
Urinary Tract Infections (UTI)
answer
The common cause of UTI is E.coli where adhere to the walls of bladder & are not flushed out during urination. UTIs infect both the upper & lower urinary tracts. They are much more common in women than men. Due to the length of the Urethra & its proximity to the anus as well as irritation caused by tampons, & sexual activity.
question
What are some predisposing factors for UTI infection?
answer
Incontinence, retention, incomplete emptying of the bladder, obstruction of flow, microbes, pregnancy, scar tissue, renal calculi, & an enlarged prostate.
question
Cystitis
answer
Inflammation of the bladder & the urethra sometimes ulceration appear. The chronic form can spread to the kidney causing more damage.
question
What are the sins & symptoms of Cystitis?
answer
Lower abdomen pain, dysuria, urgency, frequency, nocturia. Urines appearance is cloudy with a foul odor. Urinalysis will show pyuria & microscopic hematuria.
question
Pylenephritis
answer
Inflammation of the renal pelvis .Purulent exudes fill the pelvis & calyces while the medulla becomes inflamed. Abscesses & necrosis is seen extending through the medulla, cortex, & the surface of the capsule. Compressing the renal artery, vein, & obstruct ting urine flow.
question
If both kidneys are infected with Pylenephritis & bilateral obstruction occurs what is the usual outcome?
answer
Acute Renal Failure
question
What is the effect of chronic Pylenephritis?
answer
Scar tissue, recurrent infections, & chronic renal failure.
question
What are the signs & Symptoms of Pylenephritis?
answer
Dull aching pain in the flank area, dysuria, systemic signs, renal casts (leukocytes & renal epithelial cells) are present in a urinalysis
question
What are the treatment for UTIs?
answer
Antibiotics & cranberry juice which is a prophylactic measure.
question
What is the effect of cranberry juice in UTI infection?
answer
The tannin in the juice reduces the ability of E.coli to adhere to the bladders wall.
question
Acute Poststreptoccocal Glomerulonephritis (APSGN)
answer
There are many forms of Glomerulonephritis this is just 1 example. This is an infection of a beta-hemolytic Streptococcus. It begins as an URT infection E.g. Sterp throat & begins infecting the kidneys about 2 weeks after the URT infection. Common in children between the ages of 3-7 boys seem to be more vulnerable.
question
The Pathophysiology of APSGN
answer
When the URT begins there is a type 3 hypersensitivity reaction. An antibodies-antigen complex is formed. This complex lodges itself in the kidneys & activates the complement system. This causes an inflammatory response. Sense capillary permeability is increased; cells begin leaking into the filtrate. Reducing the GFR & retention of fluids & waste. Acute renal failure is possible if blood flow is greatly reduced.
question
What are the signs & symptoms of APSGN?
answer
A dark & cloudy appearance of urine (Smokey or Coffee colors), Facial then general edema, BP rises, flank or back pain, systemic signs, oliguria.
question
Why does the BP rise in APSGN?
answer
A decrease blood flow in the kidney will trigger rennin secretion which will cause a rise in BP & edema.
question
Why is there oliguria in APSGN?
answer
Due to a decrease in GFR
question
What will a Urinalysis revile in APSGN?
answer
Protein urea, Gross hematuria, & erythrocyte casts.
question
What will a blood test revile in APSGN?
answer
Elevated serum levels of Creatininie, urea & a decreased in GFR.
question
What are the treatments for APSGN?
answer
Dietary reductions of fluids, sodium, protein, Glucocorticoids, BP drugs, antibiotics.
question
What is the outcome of APSGN?
answer
1. A full recovery 2. Acute renal failure 3. Chronic Glomerulonephritis which eventually leads to chronic renal failure.
question
Nephrotic Syndrome
answer
A secondary condition to other renal or systemic diseases or exposure to toxins & drugs. An abnormality of the glomerular capillaries causing increased capillary permeability that allows proteins especially albumin to leak into the filtrate. This condition also causes edema. This disorder is often recurrent.
question
What are the signs & symptoms of Nephrotic Syndrome?
answer
Hypoalbuminemia, Anasarca (massive edema with weight gain), impairs appetite (ascites), pleural effusion (difficulty breathing), breakdown of skin & infection.
question
A Urinalysis of Nephrotic Syndrome will revel what?
answer
Proteinuria, lipiduria, & casts made of fatty, epithelial, & hyaline. The urine will also be froth.
question
What are the treatments of Nephrotic Syndrome?
answer
Glucocorticoids, other drugs, restriction of sodium & an increase in protein.
question
Urolithiiasis (Calculi/Kifney stones)
answer
Stones range in size from small to very large. They tend to form where there is an excessive amount of insoluble salts in filtrate. A mass is formed as deposits of insoluble salts, cells, & debris build up. They only become known once they begin to block urine flow.
question
What is one condition that causes the formation of renal calculi?
answer
Immobility because it causes a stasis of urine to form resulting in chemical changes of the urine.
question
What is one way to remove small stones from the urinary tract?
answer
Increase fluid intake to 8 glasses of water a day.
question
What are the different types of renal calculi?
answer
Calcium, Magnesium, Ammonia, Phosphate, Uric acid, & Cystine stones.
question
Calcium stones
answer
They consist of Calcium oxalate or Calcium Phosphate or both. 75% of stones are theses kinds. Causes include; Immobility, bone diseases, Hypereparathyroid hormone, renal -tubular acidosis., & an HIV drug called INDINAVIR.
question
Stuvite Stones
answer
Stones made of Magnesium, Ammonia,& Phosphate. AKA Staghorn Stones. These stones are extremely large 8 found in alkaline urine that conatains bacterium with Urease . They can fill the entire renal pelvis & often need to be surgically removed.
question
Uric Acid Stones
answer
These stones are not seen on X-rays and are seen in conditions where there is an excessive amount of Uric acid production E.g. gout. They are also found in chemotherapy patients, high purine diets.
question
Cystine Stones
answer
These stones are very rare they are caused by a genetic disorder in renal transport of Cystine.
question
What are the signs & symptoms of Renal Stones?
answer
Flank pain, infections, Renal colic (spasms of pain from flank to the groin), nausea, vomiting, cool-clammy skin.
question
What causes the Renal Colic pain?
answer
The ureter is contracting in a strong force to remove the stone & to clear the obstruction. This pain is very severe & intense.
question
Treating renal stones
answer
Extracorpal shockwave lithotripsy (ESWL), surgey, drugs, pain relif, antibiotic,
question
Hydronephrosis
answer
A secondary issue caused by tumors, calculi, scar tissue, stenosis or kinking or the ureter to name a few. There is a disruption of outgoing urine flow. This causes a back pressure & a dilated area that is filled with urine. It is Asymptomatic with mild flank pain unless an infection begins. If the condition is bilateral it can lead to chronic renal failure.
question
Renal Cell Carcinoma
answer
An adenocarcinoma of the kidneys. Often beginning in the renal cortex. Asymptomatic in the beginning then normal signs of cancer begin along with dull flank pain. A silent killer that metastasis to lungs, liver, or bone. It is unresponsive to treatments a nephroectomy is the usual course with a 5 year survival rate.
question
Bladder Cancer
answer
This cancer often develops as mutable tumors that are highly malignant. Common in workers exposed to chemical in the lab or an industry like dyes, rubber, & aluminum. Other factors include cigarette smoking, & high analgesics intake. Treatment includes resection of tumors chemotherapy & or radiation.
question
Nephrosclerosis
answer
Vascular changes similar to arteriosclerosis. Often asymptomatic until late in the game. The change can begin in the kidneys or it is sometimes a secondary condition to hypertension, Diabetes Mellitus . Whatever the case the cycle of hypertension must be controlled or renal failure & CHF can occur.
question
Agenesis
answer
The development of only kidney.
question
Ectopic kidney
answer
The kidney & it's ureter are displaced
question
Hypoplasia of the Kidney
answer
Often unilateral failure of the kidney to develop to full size
question
Fusion
answer
The 2 kidneys are fused together during development resulting in a horse shoe shapped kidney. Which usually function normal.
question
Adult Polycystic kidney Disease
answer
The most common form is an autosomal dominant gene found on chromosome 16 . The development over many years of mutable cysts that cover both kidneys. The kidneys hypertrophy, then tissue destruction begins & chronic renal failure occurs. Sometime cysts are also found in liver or cerebral aneurysms are found.
question
Polycystic Dissease in children
answer
A recessive gene & signs are manifested at birth. Stillbirth is common or death occurs within the first few months.
question
Wilms Tumor (Nephroblastoma)
answer
The most common tumor of children found on chromosome 11. A unilateral tumor is present which is large and encapsulated. High blood pressure & pulmonary metastases can occur. Diagnosis is around the age of 2-5 year when a bulge in the abdomen becomes obvious. Treatment includes surgery, chemotherapy, & radiation with a great the prognosis of 90%.
question
Acute Renal Failure
answer
Both kidney need to be involved leading to reduced GFR, oliguria or anuria. The failure can be reversible if the underlining cause is addressed. Dialysis can be used to sustain permanent damage. This is a very rapid procedure
question
The etiology of Acute Kidney Failure
answer
Glomerulonephritis (bilateral), Circulatory Shock, Heart failure, Shock caused by burns or crushing trauma,Acute bilateral infections, Sepsis, Nephrotoxins, & mechanical obstructions E.g. calculi, & tumors .
question
What effect does burns have on the kidneys?
answer
Damaged Erythrocytes break down in the circulation of burn victims. This causes the release of free Hemoglobin that can begin to accumulate in the tubules. Hemoglobin is toxic to the tubule epithelial resulting in inflammation & necrosis.
question
What is the effect of crushing trauma on the kidneys.
answer
When skeletal muscle is crushed, Myglobin is broken down & has the same toxic effect on the kidneys as Hemoglobin.
question
What are the signs & symptoms of Acute Renal Failure
answer
Elevated BUN & Ceratinine serum levels, Metabolic Acidosis, Hyperkalemia. All of these are signs that the kidney are unable to get rid of waste products.
question
What are the treatments of Acute Renal Failur?e
answer
Underlining causes, Dialysis to maintain homeostasis, fluid & electrolyte monitoring
question
Chronic Renal Failure
answer
A gradual irreversible destruction of kidney over a prolonged time, that has several stages
question
What are the stages of Chronic Renal Failure?
answer
1. Decreased Reserve: 60% of Nephrons are lost, increased Cereatinine serum levels, GFR is reduced , & serum Urea levels are normal 2. Renal Insufficiency: 75% of Nephrons are lost, blood chemistry changes occur, GFR is as low as 20%, Nitrogen wastes (Urea & Cereatinine) are in the blood, Tubule function declines resulting in; the inability to concentrate urine, the ability to control secretion & excretion of acids & electrolytes. Osmotic Diuresis occurs when the functional nephrons begin filtering an increased solute load resulting in large volumes of dilute urine, Erythropoiesis decreases & BP rises,The heart needs to begin compensating. 3. End stage failure or Uremia: 90 % of Nephrons are lost, Wastes, acids ,fluid & electrolytes are all retained effecting all body systems Marked Oliguria Or Anuria develops
question
What is the etiology of Chronic Renal Failure?
answer
Nephrosclerosis, Diabetes Mellitus, Nephrotoxins, bilateral kidney inflammation & infection, & Polycystic Kidney Disease & hypertension.
question
What are the early signs & symptoms of Chronic Renal Failure?
answer
Polyuria, Nocturia, systemic signs, Alter blood chemistry causing bone marrow depression & impaired cellular functions, & High blood pressure
question
What are the signs & symptoms of end stage Chronic Renal Failure?
answer
Oliguria, dry, pruritic hyperpigmented & easily bruised skin, peripheral neuropathy, impotence, abnormal menarche, decreased libido, encephalophy, CHF, arrhythmias, Hypocalcemia Hyperphosphatemia, Osteodystrophy, tetany,, Uremic frost of the skin, breath that smells like urine, systemic infections
question
Why is Hypocalcemia & Hyperphosphatemia present in chronic renal failure?
answer
Due to the inability of the kidneys to activate Vitamin D in order to absorb calcium & metabolism & increased phosphate retention
question
What are the 3 main factors in diagnosing Chronic Renal Failure?
answer
Anemia, Acidosis, Azotemia
