UTI: Stone Formation Theories

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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?

  1. Proximal convoluted tubule
  2. Loop of Henle
  3. Distal convoluted tubule
  4. Collecting tubule

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

Glomerulus

What is the blood flow pathway in the glomerulus?

From afferent arteriole to glomerular capillaries to Bowman's Capsule to efferent arteriole

What is the starting point of urine formation?

Filtration of essentially protein-free plasma in the Bowman's capsule

What are the three theories used to explain stone formation?

Saturation theory, Matrix theory, Inhibition theory

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

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

Materials from the epithelial cells lining the tubules

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

What is the major manifestation of stone formation?

Pain

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

Renal colic

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

Transport maximum

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

Proximal tubule

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

Urea

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

K, Na, Cl

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

Glucose spills into the urine

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

What are the recommended prevention strategies for recurrent kidney stones?

Increase fluid intake, dietary changes, treat infections, use thiazide diuretics to lower urinary calcium

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

Upper UTIs are considered more serious than lower UTIs.

What is the most common cause of uncomplicated UTIs?

Escherichia coli

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

What are the common bacteria responsible for complicated UTIs?

Non-E.coli gram negative bacteria (Enterobacter, Pseudomonas) and gram positive cocci (Staphylococcus aureus)

What are the common predisposing factors for nosocomial UTIs?

Instrumentation and catheterization

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.

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.

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.

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.

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.

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.

Learn about the three theories used to explain stone formation in UTI: Saturation theory, Matrix theory, and Inhibition theory. Understand how factors like urine pH, solute concentration, and epithelial cells contribute to the formation of kidney stones.

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