[PPT] Urinary and Renal Disorders
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Questions and Answers

What type of hypersensitivity is primarily involved in Systemic Lupus Erythematosus (SLE)?

  • Type III hypersensitivity (correct)
  • Type IV hypersensitivity
  • Type II hypersensitivity
  • Type I hypersensitivity

In IgA Nephropathy, where are the immune complexes primarily deposited?

  • In the renal tubules
  • In the glomerular basement membrane
  • In the perivascular space
  • In the glomerular mesangium (correct)

Which mechanism is primarily responsible for glomerular injury in Goodpasture Syndrome?

  • Vasculitis-mediated inflammation
  • Direct binding of antibodies (correct)
  • Immune complex deposition
  • Infection-induced damage

What is a common outcome of damage to the glomerular filtration barrier?

<p>Increased permeability allowing proteinuria (B)</p> Signup and view all the answers

Which condition can lead to rapidly progressive glomerulonephritis (RPGN)?

<p>ANCA-associated vasculitis (D)</p> Signup and view all the answers

What can result from immune complex deposition in glomeruli in conditions like SLE?

<p>Hypercellularity and inflammation (D)</p> Signup and view all the answers

What GFR level indicates a clinical diagnosis of chronic kidney disease (CKD)?

<p>Below 60 mL/min/1.73 m² (B)</p> Signup and view all the answers

In the pathophysiology of nephritic syndrome, which inflammatory cells are primarily recruited following immune complex activation?

<p>Neutrophils (C)</p> Signup and view all the answers

What is the role of reactive oxygen species (ROS) in glomerular injury?

<p>Damages glomerular structures (C)</p> Signup and view all the answers

Which of the following is a modifiable risk factor for chronic kidney disease (CKD)?

<p>Obesity (D)</p> Signup and view all the answers

What is the GFR level at which end-stage renal disease (ESRD) occurs?

<p>Below 15 mL/min/1.73 m² (C)</p> Signup and view all the answers

Which statement about the transmission of chronic kidney disease (CKD) is true?

<p>Transmission is possible only in cases of genetic predisposition. (D)</p> Signup and view all the answers

Which chronic condition is the leading cause of diabetic nephropathy?

<p>Diabetes Mellitus (D)</p> Signup and view all the answers

Which of the following is not a consequence of chronic kidney disease (CKD)?

<p>Increased hydration levels (B)</p> Signup and view all the answers

What is the role of proteinuria in chronic kidney disease (CKD)?

<p>Both a marker and a contributor to disease progression (D)</p> Signup and view all the answers

Which demographic group is more likely to have higher rates of chronic kidney disease (CKD)?

<p>Native Americans (D)</p> Signup and view all the answers

What characterizes urge incontinence?

<p>Overactivity of the detrusor muscle resulting in a sudden urge to urinate (A)</p> Signup and view all the answers

What is the primary cause of overflow incontinence?

<p>Excessive bladder pressure due to obstruction (B)</p> Signup and view all the answers

Which of the following best defines functional incontinence?

<p>Involuntary leakage due to cognitive decline (A)</p> Signup and view all the answers

What triggers urine leakage in mixed incontinence?

<p>A combination of stress and urge factors (D)</p> Signup and view all the answers

What type of risk factor is obesity concerning urinary incontinence?

<p>A modifiable risk factor increasing abdominal pressure (C)</p> Signup and view all the answers

Why are urinary incontinence conditions typically considered non-transmissible?

<p>Urinary incontinence is linked to lifestyle factors rather than infections (D)</p> Signup and view all the answers

What effect does smoking have on urinary incontinence?

<p>It causes chronic coughing that can increase abdominal pressure (A)</p> Signup and view all the answers

Which of the following is true about urinary incontinence caused by neurological dysfunction?

<p>It can lead to urge incontinence due to loss of bladder control (B)</p> Signup and view all the answers

What happens to the unaffected kidney when there is a unilateral obstruction?

<p>It undergoes compensatory hypertrophy. (A)</p> Signup and view all the answers

What bacterial infection can occur as a secondary complication of urinary tract obstruction?

<p>Pyelonephritis caused by E. coli (B)</p> Signup and view all the answers

Which factor increases the risk of nephrolithiasis (kidney stones)?

<p>Inadequate hydration (A)</p> Signup and view all the answers

Which demographic is most affected by prostate enlargement?

<p>Men aged &gt;50 years (C)</p> Signup and view all the answers

What is a common risk associated with pelvic organ prolapse?

<p>Higher risk in women with multiple pregnancies (C)</p> Signup and view all the answers

What condition can lead to urethral stricture?

<p>Scar tissue from trauma (B)</p> Signup and view all the answers

Which of the following is a risk factor for neurogenic bladder?

<p>Spinal cord injury (A)</p> Signup and view all the answers

Which of the following is NOT a cause of upper urinary tract obstruction?

<p>Prostate enlargement (C)</p> Signup and view all the answers

What are the primary causes of nephrotic syndrome?

<p>Minimal Change Disease, Focal Segmental Glomerulosclerosis, Membranous Nephropathy (A)</p> Signup and view all the answers

What characterizes nephrotic syndrome?

<p>Massive protein loss and hypoalbuminemia (A)</p> Signup and view all the answers

Which of the following is NOT considered a secondary cause of nephrotic syndrome?

<p>Minimal Change Disease (B)</p> Signup and view all the answers

What is the main pathogenic mechanism in nephrotic syndrome?

<p>Injury to the glomerular filtration membrane (D)</p> Signup and view all the answers

Which option describes a feature of the glomerular filtration barrier?

<p>Fenestrated endothelium, glomerular basement membrane, and podocytes (A)</p> Signup and view all the answers

What is a common consequence of injury to the glomerular filtration barrier?

<p>Increased protein permeability leading to proteinuria (B)</p> Signup and view all the answers

Which autoimmune disease is specifically associated with membranous nephropathy?

<p>Systemic Lupus Erythematosus (SLE) (D)</p> Signup and view all the answers

Which of the following conditions can lead to post-streptococcal glomerulonephritis?

<p>Streptococcus infections (A)</p> Signup and view all the answers

Which non-modifiable risk factor increases the likelihood of urinary tract infections in women?

<p>Shorter urethra (C)</p> Signup and view all the answers

What modifiable risk factor is associated with urinary stasis and upper urinary tract infections?

<p>Indwelling catheters (C)</p> Signup and view all the answers

Which of the following is a pathological change that can occur in pyelonephritis?

<p>Increased inflammation in the renal pelvis (B)</p> Signup and view all the answers

Which condition can lead to a higher risk of urinary tract infections due to impaired immune responses?

<p>Diabetes Mellitus (D)</p> Signup and view all the answers

What anatomical characteristic is linked to a higher risk of pyelonephritis in females compared to males?

<p>Shorter urethra (B)</p> Signup and view all the answers

What is an effect of postmenopausal changes that increases the risk of urinary tract infections?

<p>Atrophy of the urogenital mucosa (C)</p> Signup and view all the answers

Which bacterial type is most commonly associated with urinary tract infections?

<p>Escherichia coli (A)</p> Signup and view all the answers

Which of the following is NOT a modifiable risk factor associated with urinary tract infections?

<p>Congenital abnormalities (C)</p> Signup and view all the answers

Which factor is NOT associated with the progression of chronic kidney disease?

<p>Urinary tract infection (C)</p> Signup and view all the answers

What is a characteristic feature of uremic syndrome in chronic kidney disease?

<p>Accumulation of urea and toxins (D)</p> Signup and view all the answers

Which type of urinary incontinence is specifically triggered by physical activities such as coughing or sneezing?

<p>Stress urinary incontinence (B)</p> Signup and view all the answers

What mechanism leads to overflow urinary incontinence?

<p>Bladder overdistention (D)</p> Signup and view all the answers

Which statement accurately describes mixed urinary incontinence?

<p>It involves symptoms of both stress and urge incontinence. (C)</p> Signup and view all the answers

What is the primary function of the kidneys in maintaining the internal environment?

<p>To filter metabolic waste and regulate electrolyte balance (C)</p> Signup and view all the answers

Which part of the nephron is responsible for the initial filtration of blood?

<p>Glomerulus (A)</p> Signup and view all the answers

What role do podocytes play in the nephron?

<p>They regulate filtration by covering the glomerular capillaries (C)</p> Signup and view all the answers

What is the primary function of the detrusor muscle in the bladder?

<p>To expel urine during micturition (D)</p> Signup and view all the answers

Which anatomical structures drain urine from the kidneys before it enters the ureter?

<p>Minor calyces and major calyces (C)</p> Signup and view all the answers

Which characteristic is associated with nephritic syndrome?

<p>Hematuria (B)</p> Signup and view all the answers

What is evaluated in a urinalysis?

<p>Color, turbidity, and specific gravity (A)</p> Signup and view all the answers

How does the kidney regulate water and solute transport?

<p>By altering the permeability of tubular cells according to need (B)</p> Signup and view all the answers

Which of the following statements about kidney stones is true?

<p>Nephrolithiasis may occur due to supersaturation of salts. (A)</p> Signup and view all the answers

What is the significant indicator of renal failure?

<p>Decreased GFR (C)</p> Signup and view all the answers

Which component of urine is NOT typically found in normal urine?

<p>Protein (B)</p> Signup and view all the answers

Which classification of kidney dysfunction is characterized by less than 10% renal function remaining?

<p>End-stage renal failure (D)</p> Signup and view all the answers

What is the typical pH range for normal urine?

<p>4.5 - 8.0 (D)</p> Signup and view all the answers

What is the role of the renal cortex?

<p>To house glomeruli and parts of nephrons (D)</p> Signup and view all the answers

Which factor does NOT contribute to urinary tract obstruction?

<p>Lesions above the sacral spinal cord. (C)</p> Signup and view all the answers

What is the most common type of acute kidney injury?

<p>Prerenal (C)</p> Signup and view all the answers

What are common clinical manifestations of upper urinary tract obstruction?

<p>Renal colic and vomiting (D)</p> Signup and view all the answers

What is the significance of the negatively charged basement membrane in the nephron?

<p>It prevents leakage of large proteins into filtrate (B)</p> Signup and view all the answers

Which factor can contribute to the progression of chronic kidney disease?

<p>Proteinuria (A)</p> Signup and view all the answers

What indicates a decline in renal function in chronic kidney disease?

<p>GFR less than 60 mL/min/1.73 m2 for 3 months (D)</p> Signup and view all the answers

What is the primary cause of hematuria in urine sediment analysis?

<p>Large quantities of red blood cells (D)</p> Signup and view all the answers

Which condition can lead to poor bladder contraction ability?

<p>Sacral spinal cord lesions (C)</p> Signup and view all the answers

Which of the following is NOT a clinical manifestation of nephrotic syndrome?

<p>Hypertension (D)</p> Signup and view all the answers

Which condition is likely related to postrenal acute kidney injury?

<p>Urinary tract obstruction (C)</p> Signup and view all the answers

What occurs as a result of urinary stasis in the urinary tract?

<p>Increased risk of infection (B)</p> Signup and view all the answers

What is a common complication of urinary tract obstruction?

<p>Dilation and damage of urinary structures (D)</p> Signup and view all the answers

In the context of aging, what happens to the number of nephrons?

<p>They decrease over time. (A)</p> Signup and view all the answers

Which of the following best defines urinary tract infections (UTIs)?

<p>Infections occurring anywhere within the urinary tract. (D)</p> Signup and view all the answers

What is the primary site of infection in acute cystitis?

<p>Urinary bladder (A)</p> Signup and view all the answers

Which symptom is commonly associated with acute pyelonephritis?

<p>Back pain (D)</p> Signup and view all the answers

What is the consequence of chronic pyelonephritis?

<p>Chronic kidney failure (A)</p> Signup and view all the answers

What mechanism is commonly responsible for the injury observed in acute glomerulonephritis?

<p>Immune-mediated tissue damage (A)</p> Signup and view all the answers

What manifestation is indicative of glomerular damage?

<p>Hematuria and proteinuria (D)</p> Signup and view all the answers

Which factor increases the risk for developing chronic pyelonephritis?

<p>Recurrent renal infections (D)</p> Signup and view all the answers

What best describes the pathophysiological change in acute glomerulonephritis?

<p>Increased permeability leading to hematuria (C)</p> Signup and view all the answers

What type of hypersensitivity is involved in acute post-streptococcal glomerulonephritis?

<p>Type III hypersensitivity (C)</p> Signup and view all the answers

Which clinical manifestation is least likely associated with chronic glomerulonephritis?

<p>Severe back pain (A)</p> Signup and view all the answers

How does acute pyelonephritis typically spread?

<p>Ascending infection from the bladder (D)</p> Signup and view all the answers

What is the correct order of components within the filtration system in the nephron?

<p>Glomerulus, Proximal convoluted tubule, Loop of Henle, Distal convoluted tubule (A)</p> Signup and view all the answers

Where are the nephrons primarily located in the kidney?

<p>Renal cortex and renal medulla (C)</p> Signup and view all the answers

What is the primary role of the renal calyces?

<p>Receive urine from the collecting ducts (D)</p> Signup and view all the answers

Which structure does NOT pass through the renal hilum?

<p>Reproductive veins (A)</p> Signup and view all the answers

Which type of nephron is primarily responsible for concentrating urine?

<p>Juxtamedullary nephron (C)</p> Signup and view all the answers

What is the primary function of the glomerulus in the nephron?

<p>Filter blood to form urine (D)</p> Signup and view all the answers

Which part of the nephron is responsible for the majority of reabsorption?

<p>Proximal convoluted tubule (C)</p> Signup and view all the answers

Which structure is involved in the drainage of urine from the kidney?

<p>Renal calyx (C)</p> Signup and view all the answers

What is acute kidney injury (AKI) primarily characterized by?

<p>Sudden decline in kidney function (A)</p> Signup and view all the answers

Which classification does not pertain to the types of acute kidney injury?

<p>Chronic (C)</p> Signup and view all the answers

What is a common clinical manifestation of acute kidney injury?

<p>Elevated serum creatinine level (B)</p> Signup and view all the answers

What underlying mechanism characterizes prerenal acute kidney injury?

<p>Renal hypoperfusion (D)</p> Signup and view all the answers

Which of the following best describes chronic kidney disease?

<p>Progressive and irreversible decline (D)</p> Signup and view all the answers

Which of these is NOT a feature of end-stage renal disease?

<p>Possible return to normal kidney function (A)</p> Signup and view all the answers

What is a primary cause leading to chronic kidney disease?

<p>Uncontrolled hypertension (C)</p> Signup and view all the answers

Which clinical manifestation is commonly associated with kidney obstruction?

<p>Frequent urination with little output (B)</p> Signup and view all the answers

What is a primary focus of clinical consult during the overview on November 20, 2024?

<p>Management of chronic kidney disease with mineral and bone disorder (D)</p> Signup and view all the answers

Which topic is discussed immediately after the break on November 21, 2024, at 11:45 AM?

<p>Glomerular disorders and renal failure (C)</p> Signup and view all the answers

During which time slot is the midterm preparation scheduled on November 21, 2024?

<p>12:30-12:50 PM (C)</p> Signup and view all the answers

What is a key component of the review activities scheduled on November 20, 2024?

<p>Practice Quiz for GU (A)</p> Signup and view all the answers

Which topic is scheduled for a clinical consult involving Jamie Bucknell on November 21, 2024?

<p>Microscopic hematuria (A)</p> Signup and view all the answers

What duration is allocated for the discussion on Normal Kidney Anatomy and Function on November 21, 2024?

<p>20 minutes (C)</p> Signup and view all the answers

How long is the break scheduled on November 20, 2024?

<p>15 minutes (D)</p> Signup and view all the answers

Which of the following topics is included in the overview on November 20, 2024?

<p>Chronic renal failure (D)</p> Signup and view all the answers

What is a direct effect of sympathetic stimulation on the kidneys?

<p>Vasoconstriction of renal arterioles (C)</p> Signup and view all the answers

Which substances are normally not filtered by the glomerulus in a healthy kidney?

<p>Red blood cells, Large proteins, Platelets (A)</p> Signup and view all the answers

Where does the majority of reabsorption of nutrients occur in the nephron?

<p>Proximal convoluted tubule (A)</p> Signup and view all the answers

Which segment of the nephron is primarily affected by antidiuretic hormone (ADH) for water reabsorption?

<p>Collecting duct (B)</p> Signup and view all the answers

What is the primary physiological response of the kidneys during sympathetic stimulation?

<p>Retention of sodium and water (D)</p> Signup and view all the answers

Which substance is primarily secreted by the juxtaglomerular cells in response to sympathetic stimulation?

<p>Renin (D)</p> Signup and view all the answers

Which option correctly identifies substances that the kidneys filter out?

<p>Sodium, Potassium, Chloride (D)</p> Signup and view all the answers

What impact does sympathetic stimulation have on glomerular filtration rate (GFR)?

<p>GFR decreases to conserve renal function (D)</p> Signup and view all the answers

What type of incontinence is characterized by a blockage of the bladder outlet, commonly seen in men with an enlarged prostate?

<p>Overflow incontinence (C)</p> Signup and view all the answers

Which of the following describes the involuntary loss of urine due to a sudden, intense urge to urinate?

<p>Urge incontinence (A)</p> Signup and view all the answers

What is a common reason for overflow incontinence, particularly in men?

<p>Enlarged prostate (D)</p> Signup and view all the answers

Which type of incontinence involves the combination of both stress and urge incontinence symptoms?

<p>Mixed incontinence (A)</p> Signup and view all the answers

Continuous dribbling of urine due to an overfilled bladder is indicative of which type of incontinence?

<p>Overflow incontinence (A)</p> Signup and view all the answers

Which factor can lead to overflow urinary incontinence aside from an enlarged prostate?

<p>Neurological disorders (D)</p> Signup and view all the answers

In what situation might a patient experience urge incontinence?

<p>Feeling sudden pressure without prior warning (A)</p> Signup and view all the answers

Which statement correctly describes a potential cause of urinary incontinence in men?

<p>Prostate enlargement leading to obstruction (C)</p> Signup and view all the answers

What condition can lead to increased calcium filtration and the formation of calcium oxalate stones?

<p>Hypercalcemia (D)</p> Signup and view all the answers

How does a low calcium diet increase the risk of calcium oxalate stone formation?

<p>Prevents calcium from binding to oxalate in the gut (B)</p> Signup and view all the answers

Which factor contributes to decreased citrate levels, leading to heightened risk of calcium oxalate stone formation?

<p>Excess bicarbonate in urine (C)</p> Signup and view all the answers

What role does citrate play in preventing calcium oxalate stone formation?

<p>Citrate binds with calcium and oxalate (D)</p> Signup and view all the answers

Which of the following conditions is characterized by malabsorption that can contribute to the formation of calcium oxalate stones?

<p>Diarrheal diseases (C)</p> Signup and view all the answers

Which mechanism can lead to the decreased availability of calcium to bind oxalate in the urine?

<p>Decreased citrate reabsorption (B)</p> Signup and view all the answers

What is a key dietary factor that can lead to hyperoxaluria and increase the likelihood of calcium oxalate stone formation?

<p>High protein diet (B)</p> Signup and view all the answers

What physiological condition can lead to decreased urinary citrate and increased risk of calcium oxalate stones?

<p>Type I renal tubular acidosis (C)</p> Signup and view all the answers

Flashcards

Chronic Kidney Disease (CKD)

A condition where the kidneys are damaged and cannot filter waste products from the blood effectively.

Glomerular Filtration Rate (GFR)

The rate at which the kidneys filter blood, measured in milliliters per minute per 1.73 square meters of body surface area.

GFR Decline

A decline in GFR below 60 mL/min/1.73 m² indicates a potential long-term kidney damage.

End-Stage Renal Disease (ESRD)

ESRD occurs when GFR falls below 15 mL/min/1.73 m², making dialysis or a kidney transplant necessary.

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Diabetic Nephropathy

A common cause of CKD, resulting from high blood sugar levels damaging the kidneys.

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Hypertension and CKD

High blood pressure can harm the kidneys by increasing pressure within the filtering units, causing damage.

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CKD Transmission

Conditions with a genetic predisposition, like polycystic kidney disease, are not communicable between individuals.

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Risk Factors for CKD

Risk factors for CKD can be modified, like diabetes, hypertension, and smoking, or non-modifiable, like family history and ethnicity.

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What is Nephrotic Syndrome?

A kidney disorder characterized by excessive protein loss in urine (proteinuria), low blood albumin levels (hypoalbuminemia), swelling (edema), and high blood lipids (hyperlipidemia/hyperlipiduria). It results from damage to the glomerular filtration barrier, increasing permeability to proteins while maintaining the ability to restrict red blood cell movement.

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Minimal Change Disease (MCD)

A type of nephrotic syndrome where damage to podocytes leads to the loss of negative charge on the glomerular basement membrane (GBM). This allows albumin to pass into the urine, leading to proteinuria.

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Focal Segmental Glomerulosclerosis (FSGS)

A type of nephrotic syndrome where scarring (sclerosis) occurs in segments of some glomeruli. It can be caused by various factors, including HIV infection, obesity, and heroin use.

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Membranous Nephropathy

A type of nephrotic syndrome characterized by immune complex deposition on the glomerular basement membrane (GBM). It is associated with autoimmune diseases (like lupus), cancer, and certain infections.

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Systemic Lupus Erythematosus (SLE)

An autoimmune attack on the kidneys that can lead to nephrotic syndrome. It occurs in systemic lupus erythematosus (SLE), a disease where the immune system attacks various parts of the body.

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What are the key components of the glomerular filtration membrane?

Damage to the glomerular filtration membrane, composed of fenestrated endothelium, glomerular basement membrane (GBM), and podocytes with foot processes, is the key factor in the development of nephrotic syndrome.

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What is the pathophysiology of nephrotic syndrome?

The process of how nephrotic syndrome develops. It involves injury to the glomerular filtration membrane, leading to proteinuria, hypoalbuminemia, edema, and hyperlipidemia.

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Systemic Lupus Erythematosus (SLE) and Nephritis

An autoimmune disorder where antibodies attack the glomerulus, causing inflammation and damaging the filtering function of the kidneys.

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IgA Nephropathy (Berger's Disease)

A condition where IgA antibodies deposit in the glomerulus, causing inflammation and damage to the filtering units.

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Goodpasture Syndrome

An autoimmune disorder where antibodies attack type IV collagen in the glomerulus, leading to inflammation, complement activation, and kidney damage.

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Immune Complex Deposition

Antigen-antibody complexes deposit in the glomerular capillary walls causing inflammation, complement activation, and tissue damage.

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Direct Antibody Binding

Autoantibodies directly bind to type IV collagen in the glomerular basement membrane causing inflammation and cell damage.

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Glomerular Filtration Barrier Damage

Damage to endothelial cells, basement membrane, and podocytes increases the permeability of the glomerular capillary, allowing proteins and red blood cells to leak into the urine.

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Pathophysiology of Nephritic Syndrome

A condition where the glomerular capillary walls are injured due to immune-mediated mechanisms, leading to increased permeability, inflammation, and reduced GFR.

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Glomerulonephritis

A group of conditions characterized by inflammation of the glomerulus, leading to kidney damage and reduced function.

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Female Anatomy and UTI Risk

The urethra in females is shorter than in males, which increases the risk of bacteria reaching the bladder.

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Postmenopausal Changes and UTIs

Decreased estrogen levels after menopause cause the vaginal lining to thin, weakening the body's natural defenses against infection.

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Congenital Abnormalities and UTIs

Structural defects in the urinary tract, such as vesicoureteral reflux (VUR), can cause urine to flow backward, making UTIs more likely.

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Urinary Stasis and UTIs

Incomplete bladder emptying can lead to bacterial growth and an increased risk of infection ascending to the kidneys.

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Catheters and UTI Risk

Indwelling catheters provide a direct pathway for bacteria to enter the urinary tract, increasing the risk of infection.

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Sex and Pyelonephritis Risk

A shorter urethra makes females more susceptible to pyelonephritis, an infection of the kidneys.

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Vesicoureteral Reflux (VUR) and Pyelonephritis

Abnormal backward flow of urine from the bladder to the kidneys, common in children, increases the risk of pyelonephritis.

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Pregnancy and Pyelonephritis Risk

Hormonal changes and pressure from the growing uterus during pregnancy can slow urine flow, leading to stasis and an increased risk of pyelonephritis.

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Urge Incontinence

Characterized by involuntary bladder contractions caused by overactivity of the detrusor muscle, leading to a sudden urge to urinate. This can be triggered by sensory stimuli (like irritation or infection) or neurological dysfunction (like Parkinson's disease or stroke).

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Overflow Incontinence

Occurs when bladder pressure surpasses urethral pressure due to a chronically overfilled bladder. This is often caused by bladder outlet obstruction, like an enlarged prostate. The obstruction prevents complete bladder emptying, causing continuous, small-volume leakage.

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Functional Incontinence

Not related to urinary system dysfunction. It happens when individuals are unable to physically or cognitively access a toilet, often due to cognitive impairment (e.g., dementia) or physical limitations (e.g., immobility).

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Mixed Incontinence

A combination of stress and urge incontinence. This means the person might have a weakened pelvic floor (typical of stress incontinence) as well as overactive detrusor muscle (typical of urge incontinence).

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Urinary Incontinence Transmission

Urinary incontinence is not contagious. It's a non-infectious condition. While some infections, like urinary tract infections (UTIs) can cause temporary incontinence, they are not the primary cause of incontinence.

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Obesity as a Risk Factor for Incontinence

Increased abdominal pressure due to excess weight can contribute to stress incontinence. This pressure can make it harder to control urine leakage when coughing, laughing, or sneezing.

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Smoking as Risk Factor for Incontinence

Chronic coughing, often caused by smoking, puts pressure on the bladder, which can lead to stress incontinence. Smoking can also weaken the pelvic floor muscles that help control bladder function.

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Modifiable and Non-Modifiable Risk Factors for Incontinence

Risk factors for urinary incontinence fall into two categories: modifiable (things you can change) and non-modifiable (things you can't change). Modifiable factors include things like obesity and smoking, while non-modifiable factors include things like age, genetics, and certain medical conditions.

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Compensatory Hypertrophy

When one kidney is affected by obstruction, the unaffected kidney grows larger (hypertrophy) to compensate and maintain normal function.

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Long-Term Obstructions and Kidney Damage

Long-term blockage or obstruction in the urinary tract can cause scarring (fibrosis) and irreversible damage to the kidneys.

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Urinary Tract Obstructions - Transmissibility

Urinary tract obstructions are not caused by infections, but are physical or anatomical problems within the urinary tract.

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Secondary Infections from Obstructions

Infections can occur as a result of urinary tract obstructions, often involving bacteria like E. coli. These infections can be transmitted through contaminated water or direct contact.

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Nephrolithiasis (Kidney Stones)

Kidney stones are a common cause of upper urinary tract obstruction, especially in men and middle-aged adults.

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Prostate Enlargement

Prostate enlargement (BPH) is common in men over 50 years old and can lead to lower urinary tract obstruction.

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Pelvic Organ Prolapse

Pelvic organ prolapse occurs when organs in the pelvis drop down and can obstruct the urethra.

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Urethral Stricture

Urethral stricture is a narrowing of the urethra, often caused by scar tissue after injury or surgery.

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What is a nephron?

The functional unit of the kidney, responsible for filtering waste products from the blood and producing urine.

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What are the roles of afferent and efferent arterioles in the nephron?

Afferent arterioles bring blood to the glomerulus, while efferent arterioles carry filtered blood away.

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What are podocytes and why are they important?

Podocytes are specialized cells in the glomerulus that regulate filtration by wrapping around capillaries, preventing large molecules like proteins from passing through.

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What is filtrate?

Filtrate is the fluid that enters Bowman's capsule after being filtered through the glomerulus. It contains water, electrolytes, and small molecules.

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What is reabsorption in the nephron?

The process of reabsorbing water, nutrients, and electrolytes back into the bloodstream from the filtrate.

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What is secretion in the nephron?

The process of moving waste products and other substances from the blood into the filtrate.

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What is the renal cortex?

The outer layer of the kidney, containing glomeruli, renal tubules, and blood vessels.

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What is the renal medulla?

The inner layer of the kidney, containing collecting ducts, loops of Henle, and renal papillae.

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What is the detrusor muscle and what is its function?

The detrusor muscle is a smooth muscle that contracts to force urine out of the bladder during micturition (urination).

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What is urinalysis?

Urinalysis is a test that examines the physical and chemical properties of urine, providing information about kidney function, the presence of infection, and other conditions.

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Normal Urine pH

The pH of normal urine ranging from 4.5 to 8.0.

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Urine Specific Gravity

A measure of solute concentration in urine, typically between 1.0005 and 1.035.

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Hematuria

Red blood cells in urine, indicating bleeding in the urinary tract.

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Urine Casts

Accumulations of cellular precipitates found in urine sediment, indicating different types of kidney problems.

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Urinary Tract Obstruction

A blockage in the urinary tract, interfering with urine flow at any point. It can be caused by anatomical or functional reasons.

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Pressure in Bowman's Capsule

Increased pressure within Bowman's capsule, leading to decreased renal filtration.

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Renal Colic

Sharp, intense pain in the back or side, caused by a kidney stone passing through the urinary tract.

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Prostate Enlargement (BPH)

Enlargement of the prostate gland, commonly affecting men over 50, which can obstruct the urethra.

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Urinary Tract Infection (UTI)

A bacterial infection that travels up the urethra to the bladder, often causing pain, burning, and frequent urination.

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Cystitis

Inflammation of the bladder, the most common site for UTIs. It's characterized by frequent urination, painful urination, urgency, and lower abdominal pain.

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Pyelonephritis

Infection and inflammation of one or both kidneys. It's often preceded by cystitis and can cause fever, chills, nausea, vomiting, and back pain.

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Acute Glomerulonephritis

A type of glomerulonephritis that develops rapidly and is often caused by an immune response to a recent infection, such as strep throat.

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Nephrotic Syndrome

A collection of symptoms caused by damage to the glomerular filtration barrier. It is characterized by protein in the urine, low levels of protein in the blood (hypoalbuminemia), swelling (edema), and high blood lipids.

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Chronic Glomerulonephritis

A type of glomerulonephritis that develops slowly over time and can lead to chronic kidney disease. It can be caused by many factors, including diabetes, systemic lupus erythematosus, and high blood pressure.

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Proteinuria

A condition where the glomerular filtration barrier is damaged, allowing proteins to leak into the urine. This is a key feature of nephrotic syndrome.

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Autoimmune Response

An immune response where antibodies are produced against a person's own tissues. This can lead to damage to the glomerulus, as in glomerulonephritis.

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Urinalysis

A test that examines the physical and chemical properties of urine. It can provide information about kidney function, the presence of infection, and other health conditions.

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Uremia

The accumulation of waste products in the blood, leading to various health problems.

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Urinary Incontinence

Involuntary leakage of urine, often caused by weakened pelvic floor muscles or overactive bladder.

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What is Acute Kidney Injury (AKI)?

A sudden decline in kidney function with a decrease in glomerular filtration and accumulation of nitrogenous waste products in the blood. It's indicated by an increase in serum creatinine and blood urea nitrogen.

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What is Chronic Kidney Disease (CKD)?

A progressive loss of renal function associated with systemic diseases. It's characterized by a Glomerular Filtration Rate (GFR) less than 60 mL/min/1.73 m2 for 3 months or more, irrespective of cause.

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What is Glomerulonephritis?

A condition where the glomeruli are inflamed, leading to kidney damage and reduced function. It can be caused by various factors including infections, autoimmune diseases, and medications.

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What is Prerenal AKI?

The most common type of AKI, caused by reduced blood flow to the kidneys due to conditions like low blood pressure or heart failure.

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What is Intrarenal AKI?

A condition that arises from damage to the kidney itself, often caused by glomerulonephritis, acute tubular necrosis, or acute interstitial nephritis.

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What is Postrenal AKI?

A rare type of AKI caused by a blockage in the urinary tract, preventing urine from draining properly.

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How does sympathetic stimulation affect kidney function?

Sympathetic stimulation of the kidneys leads to constriction of renal blood vessels (afferent arterioles), promoting blood pressure regulation and decreasing blood flow to the kidneys, which in turn reduces glomerular filtration rate (GFR) and the workload on kidneys.

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What is renin and where is it released?

Renin is an enzyme secreted by the juxtaglomerular cells in the kidney. It's a crucial part of the renin-angiotensin-aldosterone system (RAAS), which regulates blood pressure and fluid balance.

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What does the glomerulus filter?

The glomerulus filters blood, but it doesn't allow large proteins, red blood cells, or platelets to pass through, as they are too big to be filtered.

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Where does most nutrient reabsorption occur in the nephron?

The proximal convoluted tubule is the primary site for reabsorbing essential nutrients from the urine filtrate back into the bloodstream. This includes glucose, amino acids, water, electrolytes, and other important molecules.

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What is the role of ADH in the nephron?

Antidiuretic hormone (ADH), also known as vasopressin, acts on the collecting duct of the nephron. It increases water reabsorption back into the bloodstream, preventing excessive water loss in the urine.

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How do loop diuretics work?

Loop diuretics like furosemide and bumetanide work by blocking sodium and chloride reabsorption in the ascending loop of Henle. This increases water excretion in the urine, leading to increased urinary output.

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Glomerular Filtration

The process of filtering blood through the glomerulus in the nephron, producing a fluid called filtrate that contains water, electrolytes, and small molecules.

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Reabsorption

The process of reabsorbing essential substances like water, electrolytes, and nutrients back into the bloodstream from the filtrate within the nephron.

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Secretion

The process of removing waste products and other substances from the bloodstream and transporting them into the filtrate within the nephron.

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Renal cortex

The outer layer of the kidney, containing glomeruli, renal tubules, and blood vessels. This is where filtration occurs.

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Renal medulla

The inner layer of the kidney, containing collecting ducts, loops of Henle, and renal papillae. Reabsorption and concentration of urine take place here.

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Nephron

The functional unit of the kidney, responsible for filtering waste products from the blood and producing urine. Each kidney contains millions of nephrons.

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Renal corpuscle

A specialized structure in the nephron, responsible for initial filtration of blood. It consists of a capillary network (glomerulus) surrounded by Bowman's capsule.

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Renal hilum

The entry/exit point on the medial (inner) side of each kidney for structures like blood vessels, nerves, and the renal pelvis.

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What is Cystitis?

A condition where the bladder is inflamed, often caused by a bacterial infection. Common symptoms include frequent urination, painful urination, urgency, and lower abdominal pain.

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What is Pyelonephritis?

An infection and inflammation of one or both kidneys, often preceded by cystitis. Symptoms include fever, chills, nausea, vomiting, and back pain.

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Stress Incontinence

Inability to control urine leakage, especially during physical activities like coughing, sneezing, or exercise.

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Benign Prostatic Hyperplasia (BPH)

An enlarged prostate gland can cause urinary incontinence.

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Overflow Urinary Incontinence

A condition where the bladder is constantly overfilled and releases small amounts of urine unintentionally, often due to a blockage or nerve damage.

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Uric Acid Stone

A type of kidney stone formed from uric acid, a waste product produced by the body.

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Calcium Oxalate Stone

The most common type of kidney stone, formed from calcium bound to oxalate.

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Calcium Phosphate Stone

A type of kidney stone composed of calcium and phosphate.

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Struvite Stone

A type of kidney stone formed from magnesium, ammonium, and phosphate.

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Cystine Stone

A type of kidney stone formed from the amino acid cystine.

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How can a low calcium diet lead to increased risk of calcium oxalate stone formation?

This dietary practice can paradoxically increase the risk of calcium oxalate stone formation by allowing more oxalate to be absorbed into the bloodstream.

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What are the factors contributing to calcium oxalate stone formation?

The presence of high levels of calcium in the urine filtrate can lead to an increased risk of calcium oxalate stone formation.

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How does citrate prevent kidney stones?

Citrate, a natural substance found in urine, helps prevent kidney stones by binding to calcium and making it less available to bind with oxalate.

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Study Notes

Urinary and Renal Disorders

  • Urinary Tract Obstructions: Blockages or restrictions impairing urine flow. Classified as upper or lower.

  • Upper Urinary Tract Obstruction Causes:

    • Nephrolithiasis (kidney stones): Crystal formation, including calcium oxalate, calcium phosphate, struvite, and uric acid.
    • Congenital anomalies: Structural abnormalities.
    • Compression: Tumors, pregnancy, fibrosis.
  • Lower Urinary Tract Obstruction Causes:

    • Prostate enlargement (BPH): Common in older males.
    • Urethral stricture: Narrowing due to infections, trauma, or scar tissue.
    • Pelvic organ prolapse (females): Organs like bladder, rectum, or uterus prolapse.
    • Bladder dysfunction (neurogenic bladder): Neurological conditions impairing bladder contraction.
    • Low bladder wall compliance
  • Pathophysiology of Obstruction:

    • Blockage and Pressure Increase: Urine accumulates, increasing intraluminal pressure, reducing GFR and decreasing kidney function.
    • Hydronephrosis: Kidney swelling from urine backup, leading to renal damage over time.
    • Infection and Urinary Stasis: Risk of infection (e.g., UTI) due to accumulation of urine.

Urinary Incontinence

  • Urinary Incontinence (UI): Involuntary urine leakage due to anatomical, neurological, or functional disorders.

  • Types:

    • Stress incontinence: Leakage with increased abdominal pressure.
    • Urge incontinence: Sudden urge to urinate.
    • Overflow incontinence: Chronic bladder overfilling causing dribbling.
    • Mixed incontinence: Combination of stress and urge incontinence.
    • Functional incontinence: Inability to reach a toilet due to physical impairments.

Urinary Tract Infections (UTIs)

  • UTIs: Infections affecting the urethra, bladder, ureters, and kidneys. Classified as lower or upper.

  • Most Common Cause: Escherichia coli (E. coli). Other microorganisms include Proteus, Enterobacter, and Klebsiella pneumoniae.

  • Lower UTI (Cystitis) Pathophysiology: Bacteria enter the urinary tract, attach to bladder epithelial cells and proliferate, causing inflammation in the bladder wall. Urine stasis allows bacteria to multiply.

  • Upper UTI (pyelonephritis) Pathophysiology: Infection spreads from the bladder to the kidneys via the ureters, leading to inflammation.

Glomerular Disorders

  • Glomerulonephritis: Inflammation of the glomeruli, a vital part of the kidney responsible for filtering blood. Causes can be primary or secondary.
    • Primary Cause: Immunological responses (types II, III, and IV hypersensitivity), infections (e.g., post-streptococcal glomerulonephritis (PSGN)).
      • Immune complex deposition: In Type III hypersensitivity, antigen-antibody complexes can get lodged in the glomeruli, activating the complement system, leading to inflammation and tissue damage.
      • Antibody-mediated injury: In Type II hypersensitivity, antibodies may directly attack glomerular components, or bind to antigens that are already within the kidney, damaging glomerular tissues. (e.g. Goodpasture syndrome, post-streptococcal glomerulonephritis).
      • Cell-mediated injury: Type IV hypersenstivity involve T cells targeting glomerular cells, and leading to inflammation and tissue damage
    • Secondary Cause: Diabetes, hypertension, lupus, infections such as hepatitis B and C.
    • Pathophysiology: Immune complexes deposition, antibody-mediated attacks, complement activation, endothelial damage, inflammation. Resulting in fibrosis and kidney impairment.

Acute Kidney Injury (AKI)

  • Acute Kidney Injury (AKI): Sudden decline in kidney function, leading to reduced glomerular filtration, fluid electrolyte imbalances and accumulation of nitrogenous waste). Causes are categorized as prerenal, intrarenal, or postrenal.
    • Prerenal: Reduced blood flow to kidneys (e.g., hypotension, dehydration, heart failure).
    • Intrarenal: Damage within the kidney itself (e.g., acute tubular necrosis (ATN), glomerulonephritis, acute interstitial nephritis).
      • Tubular necrosis: Damaged renal tubules can't reabsorb properly and can leak, causing a build-up of waste products in the blood.
    • Postrenal: Obstruction in urine flow (e.g., kidney stones, tumors, prostate enlargement).
    • Key to recovery is restoring appropriate blood flow.

Chronic Kidney Disease (CKD)

  • Chronic Kidney Disease (CKD): Progressive and irreversible loss of kidney function, characterized by a glomerular filtration rate (GFR) less than 60 mL/min/1.73 m² for 3 or more months.
    Causes: Diabetes (including diabetic nephropathy), Hypertension, Glomerulonephritis, Polycystic Kidney Disease.

  • Important Pathophysiology Points:

    • Loss of Functional Nephrons: Injury damages nephrons, leading to reduced filtering ability.
    • Hyperfiltration: Remaining nephrons try to compensate for lost function by increasing filtration rate, potentially damaging remaining nephrons.
    • Tubulointerstitial inflammation: Inflammatory cells and cytokines lead to fibrosis and scarring, which further impairs function.
    • Systemic Hypertension: Conditions like hypertension contribute to disease progression.
  • Risk Factors: Diabetes, hypertension, smoking, age, certain infections, and family history.

Nephrotic Syndrome

  • Nephrotic Syndrome: Characterized by massive protein loss (proteinuria), hypoalbuminemia, edema, and hyperlipidemia. Primarily affects the glomerular filtration barrier.

  • Causes:

    • Minimal Change Disease (MCD): Most common in children—damage to the podocytes, typically resolving spontaneously.
    • Focal Segmental Glomerulosclerosis (FSGS).
    • Membranous Nephropathy: Immune complex deposits.
  • Pathophysiology:

    • Damage to the GBM (glomerular basement membrane) increases protein permeability.
    • Proteinuria, hypoalbuminemia, edema, and hyperlipidemia.

Nephritic Syndrome

  • Nephritic Syndrome: Characterized by blood in the urine (hematuria), decreased urine output (oliguria), hypertension, and increased proteinuria. Affects the glomerular capillaries primarily.
  • Causes:
    • Post-streptococcal glomerulonephritis (PSGN): Common cause following a streptococcal infection.
    • Systemic lupus erythematosus (SLE)
    • IgA nephropathy
    • Goodpasture syndrome

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Explore the various urinary and renal disorders, focusing on urinary tract obstructions and their causes. The quiz covers upper and lower urinary tract obstruction causes, pathophysiology, and potential complications such as hydronephrosis. Test your knowledge on these critical health topics.

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