Acute unilateral renal obstruction and hypertension are caused by - ANSWER-Renal
stones
most common type of kidney stone - ANSWER-Calcium oxalate
Amount of cardiac output that kidneys expect to receive - ANSWER-20-25%
Passage of kidney stones can be extremely painful and cause referred pain to where? -
ANSWER-Umbilicus area
The kidney stones are often jagged, so what ends up happening is that they get stuck in
what? - ANSWER-The ureters
When that kidney stone gets stuck in the ureter, what does it obstruct? - ANSWER-Urine
flow
The kidneys will react due to obstruction, because they expect their 20-25% of cardiac
output. The kidneys do not know why they are not getting their normal share of cardiac
output but they sense the decreased perfusion due to the obstruction, so those kidneys
activate what - ANSWER-The RAAS system
With activation of that RAAS system from the kidneys, there is angiotensin, which is a
powerful peripheral constrictor. So, what happens within those kidneys themselves is
decreased tissue perfusion so they activate the RAAS system which contains the
angiotensin with powerful constrictor properties, so it constricts what? - ANSWER-
Arterioles
When angiotensin constricts the arterioles, what happens as a result? - ANSWER-
Hypertension, so basically HTN happens due to urinary obstruction
Which population do we think mainly about when we think about UTIs? - ANSWER-The
older populaiton
, With older adults it may be harder to determine if they have a UTI because clinically, the
main manifestation that is often seen with the elderly and a UTI is what? - ANSWER-
Confusion, abdominal pain or discomfort, blood in urine.
What can a UTI lead to very quickly, especially with the older population? - ANSWER-
sepsis
Infection of one or both upper urinary tracts (ureter, renal pelvis, kidney interstitium) is
what? - ANSWER-Pyelonephritis
most common risk factors for pyelonephritis - ANSWER-Urinary obstruction, and reflux of
urine from the bladder.
most common culprit of pyelonephritis - ANSWER-E. coli, proteus, pseudomonas
Why do we think of E. coli, especially for women with pyelonephritis? - ANSWER-
Because of proximity of the anus to the urinary tract
On urinalysis what would you see with pyelonephritis - ANSWER-WBC casts, because
they are only formed in the renal tubules
Urine should always go (----) and when there is an obstruction urine goes (----) -
ANSWER-Forward, backward
When the urine flows backward from an obstruction, where does it flow back into -
ANSWER-The renal pelvis
What is the renal pelvis? - ANSWER-is the funnel-like dilated part of the ureter in the
kidney, The renal pelvis functions as a funnel for urine flowing to the ureter.
When the urine flows backward from an obstruction into the renal pelvis, what happens?
- ANSWER-it causes inflammation, which is caused by bacteria
A condition that includes non bacterial infectious cystitis and noninfectious cystitis is
called what? - ANSWER-Painful bladder syndrome or interstitial cystitis
Painful Bladder Syndrome/Interstitial Cystitis (PBS/IC) mimics - ANSWER-UTI, but is non
bacterial. Patients present with UTI and are treated with multiple rounds of abx and do
not improve is the clue it is PBS/IC
Cause of PBS/IC - ANSWER-Non bacterial infectious cystisis:
- Viral
- Mycobacterial
- Chlamydia
- Fungal
Noninfectious Cystitis:
- Radiation
- Chemical
- Autoimmune
- Hypersensitivity
Which patients do we generally think about when we think about PBS/IC? - ANSWER-
Diabetics because they are prone to infection, but when they have gotten what we think
is a UTI and we keep giving antibiotics again and again, and here it is the third time, we
need to think that they probably have PBS (painful bladder syndrome or also known as
interstitial cystitis).
Because it is difficult to differentiate between pyelonephritis and cystitis by clinical
manifestations alone, what diagnostic testing should be performed? - ANSWER-Urine
culture, urinalysis, and clinical manifestations
stones
most common type of kidney stone - ANSWER-Calcium oxalate
Amount of cardiac output that kidneys expect to receive - ANSWER-20-25%
Passage of kidney stones can be extremely painful and cause referred pain to where? -
ANSWER-Umbilicus area
The kidney stones are often jagged, so what ends up happening is that they get stuck in
what? - ANSWER-The ureters
When that kidney stone gets stuck in the ureter, what does it obstruct? - ANSWER-Urine
flow
The kidneys will react due to obstruction, because they expect their 20-25% of cardiac
output. The kidneys do not know why they are not getting their normal share of cardiac
output but they sense the decreased perfusion due to the obstruction, so those kidneys
activate what - ANSWER-The RAAS system
With activation of that RAAS system from the kidneys, there is angiotensin, which is a
powerful peripheral constrictor. So, what happens within those kidneys themselves is
decreased tissue perfusion so they activate the RAAS system which contains the
angiotensin with powerful constrictor properties, so it constricts what? - ANSWER-
Arterioles
When angiotensin constricts the arterioles, what happens as a result? - ANSWER-
Hypertension, so basically HTN happens due to urinary obstruction
Which population do we think mainly about when we think about UTIs? - ANSWER-The
older populaiton
, With older adults it may be harder to determine if they have a UTI because clinically, the
main manifestation that is often seen with the elderly and a UTI is what? - ANSWER-
Confusion, abdominal pain or discomfort, blood in urine.
What can a UTI lead to very quickly, especially with the older population? - ANSWER-
sepsis
Infection of one or both upper urinary tracts (ureter, renal pelvis, kidney interstitium) is
what? - ANSWER-Pyelonephritis
most common risk factors for pyelonephritis - ANSWER-Urinary obstruction, and reflux of
urine from the bladder.
most common culprit of pyelonephritis - ANSWER-E. coli, proteus, pseudomonas
Why do we think of E. coli, especially for women with pyelonephritis? - ANSWER-
Because of proximity of the anus to the urinary tract
On urinalysis what would you see with pyelonephritis - ANSWER-WBC casts, because
they are only formed in the renal tubules
Urine should always go (----) and when there is an obstruction urine goes (----) -
ANSWER-Forward, backward
When the urine flows backward from an obstruction, where does it flow back into -
ANSWER-The renal pelvis
What is the renal pelvis? - ANSWER-is the funnel-like dilated part of the ureter in the
kidney, The renal pelvis functions as a funnel for urine flowing to the ureter.
When the urine flows backward from an obstruction into the renal pelvis, what happens?
- ANSWER-it causes inflammation, which is caused by bacteria
A condition that includes non bacterial infectious cystitis and noninfectious cystitis is
called what? - ANSWER-Painful bladder syndrome or interstitial cystitis
Painful Bladder Syndrome/Interstitial Cystitis (PBS/IC) mimics - ANSWER-UTI, but is non
bacterial. Patients present with UTI and are treated with multiple rounds of abx and do
not improve is the clue it is PBS/IC
Cause of PBS/IC - ANSWER-Non bacterial infectious cystisis:
- Viral
- Mycobacterial
- Chlamydia
- Fungal
Noninfectious Cystitis:
- Radiation
- Chemical
- Autoimmune
- Hypersensitivity
Which patients do we generally think about when we think about PBS/IC? - ANSWER-
Diabetics because they are prone to infection, but when they have gotten what we think
is a UTI and we keep giving antibiotics again and again, and here it is the third time, we
need to think that they probably have PBS (painful bladder syndrome or also known as
interstitial cystitis).
Because it is difficult to differentiate between pyelonephritis and cystitis by clinical
manifestations alone, what diagnostic testing should be performed? - ANSWER-Urine
culture, urinalysis, and clinical manifestations
