Patho W6 LO

Podcast

Play an AI-generated podcast conversation about this lesson

Questions and Answers

What is the definition of acute cystitis?

Infection of renal parenchyma (UUT)

Inflammation of the bladder (LUT) (correct)

Inflammation of the urethra (LUT)

Inflammation of the kidney (UUT)

Which of the following is NOT a common clinical manifestation of acute pyelonephritis?

Flank pain

Fever

Frequency (correct)

Dysuria

What risk factor is unique to urethritis compared to acute cystitis?

Sexual activity (correct)

Decreased immune function

Recent catheterization

Urinary stasis

Which pathogen is most commonly associated with acute cystitis?

E. coli (C) Signup and view all the answers

Which statement about polycystic kidney disease (PKD) is correct?

Hypertension is a common clinical manifestation of PKD (B) Signup and view all the answers

Which symptom is NOT typically associated with acute cystitis?

CVA tenderness (B) Signup and view all the answers

What is an important difference in the clinical manifestation of acute pyelonephritis compared to lower urinary tract infections?

Presence of fever and chills (D) Signup and view all the answers

What is the main route of infection for acute pyelonephritis?

Ascending from the urinary tract (C) Signup and view all the answers

What condition is characterized by an increase in extracellular fluid volume?

Edema (C) Signup and view all the answers

Which of the following symptoms is most likely associated with metabolic acidosis?

DKA & Kussmaul respirations (A) Signup and view all the answers

What factor could lead to hypokalemia?

Diuretic use (A) Signup and view all the answers

How does the body primarily regulate acid-base homeostasis in the short term?

Buffer systems (A) Signup and view all the answers

Which of the following symptoms typically correspond with hypocalcemia?

Chvostecks & Trousseaus Signs (D) Signup and view all the answers

What is the primary cause of respiratory acidosis?

Hypoventilation (D) Signup and view all the answers

Which of the following fluid-related symptoms would indicate extracellular fluid volume excess?

High blood pressure (A) Signup and view all the answers

What is primarily responsible for the regulation of bicarbonate levels in the body?

Renal regulation (A) Signup and view all the answers

What is a hallmark feature of nephrotic syndrome?

Significant proteinuria (D) Signup and view all the answers

Which condition is typically associated with azotemia?

Nephritic syndrome (A) Signup and view all the answers

Which clinical manifestation is most likely seen in acute kidney injury (AKI)?

Rhabdomyolysis (B) Signup and view all the answers

Which of the following is a common cause of chronic kidney disease (CKD)?

Diabetes (A) Signup and view all the answers

What characterizes end stage renal disease (ESRD)?

Permanent loss of kidney function (A) Signup and view all the answers

In nephritic syndrome, which of the following is more commonly observed?

Significant hematuria (A) Signup and view all the answers

Which of the following lab findings is indicative of chronic kidney disease (CKD)?

Low glomerular filtration rate (A) Signup and view all the answers

What condition may develop due to the loss of anticoagulants in nephrotic syndrome?

Hypercoagulable state (A) Signup and view all the answers

Which of the following mechanisms primarily causes prerenal acute kidney injury?

Ischemia due to low blood flow (D) Signup and view all the answers

In which phase of acute kidney injury (AKI) does the tubular function begin to recover?

Recovery phase (B) Signup and view all the answers

Which symptom is considered part of the uremic syndrome in end stage renal disease (ESRD)?

Nausea and fatigue (B) Signup and view all the answers

What can be a consequence of edema in nephrotic syndrome?

Pulmonary congestion (B) Signup and view all the answers

Which factor is NOT a traditional risk factor for end stage renal disease (ESRD)?

Excessive exercise (C) Signup and view all the answers

Which of the following is a classic triad of symptoms in renal cell carcinoma?

Flank pain (B) Signup and view all the answers

What is the most common type of kidney stone?

Calcium oxalate stones (D) Signup and view all the answers

Which of the following is NOT a risk factor for nephrolithiasis?

High fiber diet (C) Signup and view all the answers

What condition is indicated by massive proteinuria greater than 3.5 g/day?

Nephrotic syndrome (C) Signup and view all the answers

Which of the following is a key indicator of glomerular disease?

Decreased urine production (A) Signup and view all the answers

What is the male-to-female ratio for bladder carcinoma?

3:1 (A) Signup and view all the answers

Which complication is associated with ongoing renal damage in recurrent UTIs?

Progressive renal failure (C) Signup and view all the answers

What is a primary goal of managing end-stage renal disease?

Controlling blood pressure (A) Signup and view all the answers

What symptom is a hallmark of bladder carcinoma?

Hematuria (B) Signup and view all the answers

What indicates a poor prognosis in renal cell carcinoma?

Anemia (B) Signup and view all the answers

Acute glomerulonephritis is frequently linked to which of the following?

Post-streptococcal infections (B) Signup and view all the answers

What is a common site for metastasis from renal cell carcinoma?

Lung (D) Signup and view all the answers

Which of the following is a treatment option for severe glomerulonephritis?

Dialysis (D) Signup and view all the answers

What is a risk factor for both nephrolithiasis and glomerular disease?

Diabetes mellitus (C) Signup and view all the answers

Study Notes

Urinary Tract Infections (UTIs)

UTIs are classified as upper urinary tract (UUT) infections (kidney) or lower urinary tract (LUT) infections (bladder and urethra).
Acute pyelonephritis is a UUT infection, characterized by kidney inflammation.
Acute cystitis is a LUT infection involving bladder inflammation.
Urethritis is a LUT infection affecting the urethra.

Acute Cystitis

Risk factors include female gender, sexual activity, urinary stasis, catheterization, and immune deficiencies.
Symptoms present with urgency, frequency, dysuria, hesitancy, post-void dribbling, hematuria, and suprapubic pain. Fever and CVA tenderness are absent unless pyelonephritis is also present.
Primarily caused by ascending bacterial infection (E. coli, Klebsiella, Proteus, Staphylococcus saprophyticus).

Urethritis

Risk factors include sexual activity, STIs (gonorrhea, chlamydia), urethral trauma, and recent catheterization.
Symptoms include dysuria, urethral discharge, itching, irritation, and sometimes hematuria. Frequency and urgency may also occur.
Predominantly caused by STIs (Neisseria gonorrhoeae, Chlamydia trachomatis), though E. coli and Mycoplasma genitalium can also cause it.

Acute Pyelonephritis

Risk factors include kidney stones, strictures, obstructions, diabetes, sickle-cell disease, and polycystic kidney disease.
Symptoms include lower UTI symptoms (urgency, frequency, dysuria), fever, chills, nausea, vomiting, CVA tenderness, flank pain, malaise, myalgia, and leukocytosis.
Results from ascending or hematogenous infection (E. coli, S. aureus, Enterobacter).

Polycystic Kidney Disease (PKD)

A genetic disorder causing fluid-filled cysts in the kidneys, leading to enlargement and functional loss.
Autosomal dominant PKD is common, with onset in the 30-50 age range.
Autosomal recessive PKD is rare, presenting in infancy or childhood.
Clinical manifestations include enlarged kidneys (abdominal pain, fullness), hypertension, hematuria, flank pain, kidney stones, recurrent UTIs, and progressive renal failure.
Extrarenal manifestations can include cysts in other organs (liver, pancreas, spleen), cardiovascular issues (brain aneurysms, mitral valve prolapse), and diverticulosis.
Management involves blood pressure control, pain management, and dialysis or transplant for end-stage renal disease.

Renal Cell Carcinoma (RCC)

Accounts for 85% of primary malignant kidney tumors.
Male-to-female ratio is 1.5:1, peaking in ages 50-60.
Risk factors include smoking, hypertension, and obesity.
Often asymptomatic, with poor prognosis indicators like weight loss, weakness, anemia, and bone pain.
The classic triad of symptoms includes gross hematuria, flank pain, and a palpable mass.
Metastasis occurs in approximately one-third of new cases, commonly affecting bone, brain, lung, and liver.

Bladder Carcinoma

The second most common urological malignancy.
Male-to-female ratio is 3:1, with a mean age of diagnosis at 65.
Smoking is a significant risk factor.
Hematuria is the hallmark symptom, although 20% are asymptomatic.
Pain varies based on tumor size and location.

Nephrolithiasis and Urolithiasis

Nephrolithiasis refers to kidney stones.
Urolithiasis encompasses stones in any part of the urinary tract.
Prevalence is 8% and increasing, more common in males (2:1 ratio), peaking in ages 30-50.
Recurrence rates are 10% within 1 year and 50% within 5 years.
Calcium oxalate is the most common stone type.
Risk factors include low fluid intake, excessive vitamin C, loop diuretics, inflammatory bowel disease, diabetes, and hyperparathyroidism.
Clinical manifestations include renal colic (severe flank pain radiating to the groin), writhing, persistent discomfort, nausea and vomiting, hematuria, diaphoresis, tachycardia and tachypnea. Urgent intervention is needed in cases of solitary kidney, bilateral stones, intractable pain/vomiting, or acute kidney injury (AKI).

Glomerular Diseases/Glomerulonephritis

Glomerular diseases affect the kidney's filtering units (glomeruli).
Clinical manifestations include hematuria, proteinuria, hypertension, edema, and decreased GFR.
Four major syndromes: asymptomatic urinary abnormalities, nephritic syndrome, acute glomerulonephritis, and nephrotic syndrome.
End-stage renal disease (ESRD) can result from untreated progression.
Early detection via urine tests is crucial.

Nephritic Syndrome

Acute glomerulonephritis is an inflammatory condition of the glomeruli, causing hematuria, decreased GFR, proteinuria (not massive), azotemia, RBC casts in urine, hypertension, and peripheral edema.

Nephrotic Syndrome

Characterized by abnormal glomerular permeability resulting in significant proteinuria (hallmark), hypoalbuminemia, edema, hyperlipidemia, lipiduria (frothy urine), and a hypercoagulable state.

Acute Kidney Injury (AKI)

An abrupt decline in renal function due to ischemic or nephrotoxic insults, reducing GFR.
Classified as prerenal, intrarenal, and postrenal.
Etiologies include hypotension, sepsis, nephrotoxic drugs, and rhabdomyolysis.
Clinical manifestations include decreased GFR, weight gain, edema, azotemia, and abnormal urine volume (anuria or oliguria).
Three phases: oliguric, diuretic, and recovery.

Chronic Kidney Disease (CKD)

Progressive decline in kidney function lasting over three months.
Diagnosed via GFR below 60 mL/min or evidence of kidney damage.
Clinical manifestations involve lab abnormalities (elevated creatinine, BUN), fluid overload, anemia, electrolyte imbalances, uremia, and endocrine disorders.
Etiologies include diabetes (43%), hypertension (26%), glomerulonephritis (10%), pyelonephritis (4%), and cystic/hereditary/congenital factors (2%).

End-Stage Renal Disease (ESRD)

Irreversible decline in kidney function, requiring dialysis or transplant.
Risk factors include proteinuria, hypertension, age, diabetes, smoking, obesity, and family history.
Clinical manifestations include volume overload, electrolyte imbalances (hyperkalemia, hyponatremia, hypocalcemia), and uremic syndrome (nausea, fatigue, itching).

Body Fluid Distribution

Total body water is about 60% of body weight in adults.
Intracellular fluid (ICF) is 40%, extracellular fluid (ECF) is 20% (interstitial fluid 15%, plasma 5%).

Extracellular Fluid Volume (ECF) Deficits and Excesses

ECF deficit (dehydration) presents with thirst, dry mouth, low blood pressure, and increased heart rate.
ECF excess (fluid retention) manifests as swelling, high blood pressure, and shortness of breath.

Clinical Dehydration and Edema

Clinical dehydration results from fluid loss exceeding intake.
Edema is abnormal interstitial fluid accumulation causing swelling.

Electrolyte Imbalances

Hyponatremia (low sodium): thirst, confusion, muscle twitching, seizures.
Hypokalemia (low potassium): muscle weakness, arrhythmias, numbness.
Hypocalcemia (low calcium): nausea, vomiting, constipation, confusion.

Acid-Base Homeostasis

Regulation achieved by buffer systems, respiratory regulation, and renal regulation.
Metabolic acidosis: Low bicarbonate or high acids (pH < 7.35), caused by diabetic ketoacidosis, renal failure, severe diarrhea.
Metabolic alkalosis: High bicarbonate or low acids (pH > 7.45), caused by vomiting, diuretics, excessive antacid use.
Respiratory acidosis: CO2 accumulation due to hypoventilation (pH < 7.35), caused by COPD, respiratory depression.
Respiratory alkalosis: CO2 decrease due to hyperventilation (pH > 7.45), caused by anxiety, fever, high altitude.

Studying That Suits You

Use AI to generate personalized quizzes and flashcards to suit your learning preferences.