Disorders Of The Urinary System

Front 1

aetiology of carbuncle of kidney

Back 1

mostly haematogenous spread due to Staphylococcus aureus (from a cutaneous boil)

Front 2

Bladder and urethra infections are named?

Back 2

Cystitis and Urethritis

Front 3

clinical fetures of adenocarcinoma of the kidney

Back 3

- May be symptomless until late in the disease

- features of malignancy such as weight loss, anaemia, pyrexia of unknown origin (fever)

- Haematuria

- Mass in abdomen or aching loin pain- Secondary bondy deposits which may cause pathological fracture (hypercalcaemia).

Front 4

compare and contrast clinical features of cystitis and pyelonephritis

Back 4

Cystitis:

Dysuria

Suprapubic pain

Urinary frequency and urgency

cloudy, smelly or bloody urine

Pyelonephritis:

Dysuria

pain in loins (one or both)

urinary frequency

Cloudy urine, may be blood stained

Front 5

Cystitis can be caused by drugs, toxins and radiation. However, it is mostly due to bacteria. Mention 3 bacteria causing cystitis

Back 5

-E coli (most commonly)

-Proteus

-Klebsiella

-Pseudomonas

-Enterococcus

-Staphylococcus

Front 6

Define colovesical fistula?

Back 6

A fistulous passage connecting the colon and urinary bladder.

Front 7

Glomerulonephritis contains two different mechanisms in pathogenesis?

Back 7

immune-complex and nephrotoxic

Immune-complex:

antobodies to either exogenous or endogenous nonglomerular antigens results in the formation of immune-complex which gets passively trapped in the glomerular basement membrane. glomerular injury is due to compement fixation and release of immunologic mediators.

Nephrotoxic:

Antibodies reacts with the patients own glomerular basement membrane as the antigen (true autoimmune disease).

Front 8

Name 5 predisposing factors for Pyelonephritis (infection of kidney pelvis and parenchyma)?

Back 8

1 Diabetes Mellitus

2 Gout

3 vesico-ureteric reflux

4 40 years+

5 obstruction of urinary flow(due to stone, bladder diverticulum, prostate)

Front 9

Pathology of acute pyelonephritis includes?

Back 9

- Inflammatory changes of the renal pelvis and calyces.

- enlarged Kidney, hyperaemic, with scattered small abscesses.

- inflamed kidney and infiltrated by

polymorphs --> necrosis and abscess formation.

Front 10

Pathology of chronic Pyelonephritis?

Back 10

- involving 1 or both kidneys

- May be gross scarring of kidneys

- patchy fibrosis and appearance of calcification

Front 11

Pyelonephritis is divided into acute and chronic. Explain the two different aetiologies.

Back 11

Acute pyelonephritis:

- Mostly due to ascending urinary tract infection caused by E.coli

Chronic Pyelonephritis:

- Infection above an unrelieved obstruction.

- conditions causing urinary stasis in the bladder, ureter or kidney pelvis.

Front 12

Pyonephrosis is what by definition?

Back 12

A collection of pus in the renal pelvis

Front 13

Routes of infection involves three different scenarios, what are they?

Back 13

1 Ascending route:- Faeces -> perineum -> Urethra ->bladder ->Ureter -> renal pelvis -> Kidney

2 Haematogenous route:renal or perirenal abscess due to fungi, mycobacterium, streptococcus or staphylococcus.

3 Direct extension:Colon - Colovesical fistula - bladder

Front 14

vesico-ureteric reflux is happening why?

Back 14

an opening in the junction between bladder and ureter when the bladder contracts during micturition.

Front 15

Vesico-ureteric reflux may cause what type of clinical features?

Back 15

if mild: no associated kidney damage or symptoms.

If severe: may cause pyelonephritis and later -> renal failure