Urinary Patho

• Hydronephrosis


  Swelling of the kidneys due to obstruction of urine flow
• Hydronephrosis in both kidneys
• Immediate cessation of urine production
• An attack of renal colic
• Ischemia and necrosis


  Lack of blood supply and death of tissue in the compressed area
• Hydronephrosis leads to ischemia and necrosis in the compressed area
• Exposure to chemicals and cigarette smoke is a predisposing factor to bladder cancer
• The common initial sign of adenocarcinoma of the kidney is microscopic hematuria
• Nephrosclerosis does not usually result in acute renal failure
• Polycystic kidney disease


  Results in gradual degeneration and chronic renal failure
• Wilms' tumor is related to a genetic defect
• Severe kidney disease can cause cardiac arrhythmias due to hypokalemia or hyperkalemia
• Very low GFR and increased serum urea indicates the early stage of acute renal failure
• Causes of acute tubule necrosis and acute renal failure


  • Prolonged circulatory shock
  • Sudden significant exposure to nephrotoxins
  • Crush injuries or burns
• Diabetes is a cause of chronic renal failure
• Polyuria during renal insufficiency


  Caused by loss of tubule function
• Hypocalcemia in end-stage renal failure

  Caused by a deficit of activated vitamin D and hyperphosphatemia
• Cystitis is more common in females due to the short, wide urethra adjacent to areas with resident flora
• Increased serum urea and decreased serum bicarbonate indicate a decreased GFR
• Nephrosclerosis is not likely to lead to hydronephrosis
• Vesicoureteral reflux is a common congenital defect that leads to cystitis in young children
• Limited protein intake contributes to severe anemia in chronic renal failure
• When acidosis becomes decompensated in renal failure, a key indicator is serum pH dropping below 7.35
• Furosemide


  Diuretic that decreases reabsorption of sodium and water
• Bilateral acute glomerulonephritis causes acute renal failure
• Increased serum urea and creatinine is a significant indicator of renal insufficiency
• Uremic signs of renal failure include encephalopathy, osteodystrophy, azotemia and acidosis, but not high blood pressure
• Osteodystrophy in chronic renal failure

  Caused by failure of the kidney to activate vitamin D
• Agenesis (absence) of a kidney is often not diagnosed because the two functioning kidneys provide adequate function
• Wilms' tumor is an encapsulated mass in one kidney
• Oliguria


  Reduced urine output resulting from inflammation and necrosis of the tubules
• Micturition reflex


  Initiated by increased pressure distending the bladder
• Decreased blood flow into the kidneys

  Increases angiotensin and causes systemic vasoconstriction
• Acute post-streptococcal glomerulonephritis


  Inflammation results from a type III hypersensitivity reaction
• In acute post-streptococcal glomerulonephritis, the inflammation causes increased permeability of the glomerular capillaries and decreased GFR
• Circulatory shock causes decreased GFR and increased renin secretion
• Autoregulation in the kidneys


  Local minor reflex adjustments in the arterioles to maintain normal blood flow
• Factors directly controlling reabsorption of water and electrolytes by the kidneys

  • Atrial natriuretic hormone
  • Antidiuretic hormone
• Uncontrolled essential hypertension may cause chronic renal failure due to damage to afferent arterioles and renal ischemia
• Urine with low specific gravity is usually related to renal failure due to tubule damage