nidus; urinary environment that supports continued crystallization of stone components
What are the requirements for Kidney stone formation?
nidus
-a location in which bacteria may multiply
stasis of urine; development of back-pressure
What are some damaging effects of Urinary obstruction?
stasis of urine
-predisposes to infection and stone formation.
development of backpressure
-interferes with renal blood flow and destroys kidney tissue
excessive amounts of insoluble salts in filtrate & low fluid intake
What are some causes of Calculi?
when flow of urine is obstructed
When do Calculi manifest?
urinary oxalate & long-term mega-dosing of vitamin c
What are some causes of Calcium stones?
calcium
Dietary _______ intake is inversely related to stones.
calcium
What are the most common kidney stones?
struvite
Which stones require surgery to be removed?
uti
What is the primary cause of Struvite stones?
impaired purine metabolism
What is the cause of uric acid stones?
begin asymptomatic; patients realize they have one when the ureter becomes obstructed; this results in pain and renal dysfunction
Explain the manifestation of Calculi.
the pain is caused by vigorous contracts of ureter
What causes pain in Kidney stones?
Extracorporeal shock wave lithotripsy; no surgery; some drugs can partially dissolve them
How are large stones dealt with?
diet, calcium salt, thiazide diuretics, cellulose phosphate
What are preventative treatments for Calculi?
Cystitis
-Lower UTIs
Pyelonephritis
-Upper UTIs
through the urethra
Where do bacteria usually enter in order to cause a UTI?
Prostatic hypertrophy
-condition in which an overgrowth of prostate tissue pushes against the urethra and the bladder, blocking the flow of urine.
Neurogenic bladder
-us due to neurologic dysfunction stemming from internal or external trauma, disease, or injury
Washout phenomenon, mucin layer, normal flora of periurethral area (in women), prostate secretions (in men)
What are some protective mechanisms against UTIs?
Washout phenomenon
-urine from the bladder normally washes bacteria out of the urethra
Mucin layer
-acts by binding water, which then serves as a protective barrier between the bacteria and the bladder epithelium
occur when GI bacteria spread from the anus to the urethra
How do infections of the urethra occur?
b
The pain in this condition originates from the renal capsule stretching.
a) cystitis
b) pyelonephritis
b
Which type of inflammation with the urinary tract results in urinary casts?
a) cystitis
b) pyelonephritis
a
The pain in this condition originates from urine flowing on inflamed bladder wall.
a) cystitis
b) pyelonephritis
b
Which condition results in a urinalysis that that has leukocytes & renal epithelial cells?
a) cystitis
b) pyelonephritis
the ability of tubules to concentrate urine; low is related to renal failure
What does specific gravity tell us in a Urinalysis? What does a low number tell us?
Bactrim, increased fluid intake
What treatment options are available for UTI?
tannin in cranberry juice makes it difficult for e.coli to stick to bladder mucosa
Why is cranberry juice recommended for UTI?