Kidney Stone or UTI Quiz: Stone Formation Theories

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Questions and Answers

What is the functional unit of the kidney?

Nephron

What is the portion of blood that is filtered in the Bowman's Capsule called?

Filtrate

What are the segments of the nephron tubule?

Proximal convoluted tubule
Loop of Henle
Distal convoluted tubule
Collecting tubule

What is the structure that filters the blood in the nephron?

Glomerulus Signup and view all the answers

What is the blood flow pathway in the glomerulus?

From afferent arteriole to glomerular capillaries to Bowman's Capsule to efferent arteriole Signup and view all the answers

What is the starting point of urine formation?

Filtration of essentially protein-free plasma in the Bowman's capsule Signup and view all the answers

What are the three theories used to explain stone formation?

Saturation theory, Matrix theory, Inhibition theory Signup and view all the answers

According to saturation theory, what increases the risk of stone formation?

Supersaturation of urine with stone components like Ca oxalate, uric acid, magnesium ammonium phosphate Signup and view all the answers

What does matrix theory propose as the nidus for stone formation?

Materials from the epithelial cells lining the tubules Signup and view all the answers

What does inhibition theory suggest increases the risk of stone formation?

Deficiency of proteins that inhibit stone formation in the urine, such as Magnesium and citrate Signup and view all the answers

What is the major manifestation of stone formation?

Pain Signup and view all the answers

What are the two types of pain associated with stone formation?

Renal colic Signup and view all the answers

What is the maximum amount of substances that transport mechanisms can reabsorb per unit of time called?

Transport maximum Signup and view all the answers

In what part of the nephron does 65% of reabsorption and secretion processes occur?

Proximal tubule Signup and view all the answers

What end product of protein metabolism is eliminated through the kidneys?

Urea Signup and view all the answers

Which electrolytes are 65% to 80% reabsorbed in the proximal tubule?

K, Na, Cl Signup and view all the answers

What happens under certain circumstances like uncontrolled diabetes mellitus when substances exceed the transport maximum?

Glucose spills into the urine Signup and view all the answers

What is the function of the kidneys related to retaining substances vital to body function and completing reabsorption of glucose, amino acids, and fatty acids?

Retention of substances vital to the body function Signup and view all the answers

What are the recommended prevention strategies for recurrent kidney stones?

Increase fluid intake, dietary changes, treat infections, use thiazide diuretics to lower urinary calcium Signup and view all the answers

What distinguishes upper urinary tract infections (UTIs) from lower UTIs?

Upper UTIs are considered more serious than lower UTIs. Signup and view all the answers

What is the most common cause of uncomplicated UTIs?

Escherichia coli Signup and view all the answers

What are the risk factors associated with an increased risk of UTIs?

Obstruction and reflux, neurologic disorders affecting bladder emptying, postmenopausal women, men with prostate issues, and elderly individuals Signup and view all the answers

What are the common bacteria responsible for complicated UTIs?

Non-E.coli gram negative bacteria (Enterobacter, Pseudomonas) and gram positive cocci (Staphylococcus aureus) Signup and view all the answers

What are the common predisposing factors for nosocomial UTIs?

Instrumentation and catheterization Signup and view all the answers

Explain how obstruction in the urinary tract can lead to kidney infection.

Obstruction in the urinary tract can cause urine to remain in the bladder, acting as a medium for microbial growth. Pathogens in the contaminated urine can then ascend to infect the kidneys via the ureters. Signup and view all the answers

Describe the difference between Urethrovesical reflux and Vesicoureteral reflux.

Urethrovesical reflux involves the movement of urine from the urethra into the bladder, while Vesicoureteral reflux involves the movement of urine from the bladder into the ureters. Signup and view all the answers

How does the flap in the ureters prevent urine reflux during micturition?

The distal portion of the ureters forms a flap that is compressed against the bladder wall during micturition, preventing urine from being forced into the ureters. Signup and view all the answers

Explain the role of the protective mucin layer in the bladder.

The protective mucin layer in the bladder lines and protects it against bacterial invasion by forming a barrier that binds water. Signup and view all the answers

How do antibodies IgA contribute to the local immune response in the urinary tract?

Antibodies IgA play a role in the local immune response by assisting in defending against pathogens in the urinary tract. Signup and view all the answers

What is the function of pili in enhancing pathogen virulence in the urinary tract?

Pili are fine protein filaments that facilitate adherence of pathogens to structures in the urinary tract, enhancing their ability to cause infections. Signup and view all the answers

Study Notes

Kidney Function and Structure

The functional unit of the kidney is the nephron.
The nephron consists of the glomerulus, Bowman's capsule, and the nephron tubule.
The nephron tubule has three segments: proximal tubule, loop of Henle, and distal tubule.
The glomerulus is the structure that filters the blood in the nephron.
The blood flow pathway in the glomerulus is afferent arteriole → glomerulus → efferent arteriole.
The starting point of urine formation is the Bowman's capsule, where the filtrate is called the glomerular filtrate.

Stone Formation

The three theories used to explain stone formation are saturation theory, matrix theory, and inhibition theory.
According to saturation theory, supersaturation of the urine with stone-forming substances increases the risk of stone formation.
Matrix theory proposes that the matrix of the stone provides a nidus for stone formation.
Inhibition theory suggests that the absence of stone-inhibiting substances increases the risk of stone formation.
The major manifestation of stone formation is severe pain.
There are two types of pain associated with stone formation: colic and non-colic.

Reabsorption and Secretion

The maximum amount of substances that transport mechanisms can reabsorb per unit of time is called the transport maximum.
65% of reabsorption and secretion processes occur in the proximal tubule.
The end product of protein metabolism eliminated through the kidneys is urea.
Electrolytes such as sodium, potassium, and chloride are 65% to 80% reabsorbed in the proximal tubule.
If substances exceed the transport maximum, they will be excreted in the urine, such as in uncontrolled diabetes mellitus.
The kidneys retain substances vital to body function and complete reabsorption of glucose, amino acids, and fatty acids through a process called tubular reabsorption.

Prevention and Management of Kidney Stones

Recommended prevention strategies for recurrent kidney stones include increasing fluid intake, reducing sodium and oxalate intake, and avoiding foods high in animal protein.
Upper urinary tract infections (UTIs) are distinguished from lower UTIs by their location and severity.
The most common cause of uncomplicated UTIs is Escherichia coli (E. coli).
Risk factors associated with an increased risk of UTIs include female sex, sexual activity, and certain medical conditions.
Common bacteria responsible for complicated UTIs include Pseudomonas aeruginosa, Klebsiella pneumoniae, and Enterococcus spp.
Common predisposing factors for nosocomial UTIs include urinary catheterization, long-term care, and surgical instrumentation.

Urinary Tract Infections

Obstruction in the urinary tract can lead to kidney infection by allowing bacteria to ascend and multiply in the urinary tract.
Urethrovesical reflux refers to the backward flow of urine from the bladder into the urethra, while vesicoureteral reflux refers to the backward flow of urine from the bladder into the ureters.
The flap in the ureters prevents urine reflux during micturition by closing the ureteral orifice.
The protective mucin layer in the bladder helps to prevent bacterial adhesion and colonization.
Antibodies IgA contribute to the local immune response in the urinary tract by providing immune defense against pathogens.
Pili in bacteria enhance pathogen virulence in the urinary tract by facilitating adhesion and colonization.

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UTI: Stone Formation Theories