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CSB520 EXAM LATEST UPDATE
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CSB520 EXAM LATEST UPDATERenal - Answer
1. Main malignancies that affect male and female urinary systems? - Answer 1. Prostate:
Adenocarcinoma
2. Nephroblastoma ( rare childhood sarcoma)
3. Renal cell carcinoma
4. Transitional carcinoma
What are the common cause of glomerulonephritis and possible consequences? -
Answer -Swelling of endothelium, decreased, blood flow, inflammation altering
permeability and focal loss of epithelial and endothelium
- decreased urinary output, proteinuria, haematuria
Consequences:
- chronic kidney failure by progression of disease from its origin in glomeruli to
tubulo-interstitial area and blood vessels
-Arterial vessels in glomerulus provide bloody supply to other areas kidney
-all areas kidney can become involved > reduction in function
- Both kidneys involved and as function of both kidneys reduces, clinical state of renal
failure follows.
Why is renal papilla susceptible to toxic injury and ascending infections? - Answer
Nipple like structure > end of renal pyramid that projects into calyx > area of kidney
where urine is at its most concentrated > can be affected by toxic injury > first bit of
kidney proper where an ascending infection will get to = causing necrosis
What are the major differences between ascending and descending infections and why
are the former more common in females vs males? - Answer 1.Descending coming down
through blood > can knock out both kidneys
2. Ascending> coming from lower urinary tract > more common in females
- shorter urethra > closer to anus > lack of prostate gland > UT more prone to trauma
- mucus changes over course of month that can cause bacterial adhesion
What are the possible causes and consequences of urinary stones? - Answer 1. Pain-
urinary/colic if stone is in muscular tube (ureter) + peristaltic wave compresses the wall
n stone > ischaemia and pain
,2. Bleeding from damage to lining epithelium of renal pelvis or UT
3. Obstruction of urine flow- depends on site, obstruction leads to infection, stones and
renal atrophy (hydronephrosis)
4. Predispose to infection - stone may damage lining epithelium reducing defence
against microorganism invasion; obstruction predisposes to infection
5. More stone formation (nidus)
6. Chronic irritation (metaplasia from transitional to stratified squamous epithelium) +
cancer
7. Severe cases cause dehydration and hyponatraemia
2 reasons why females at greater risk of UTI - Answer - shorter urethra
- urethral opening closer to anus
- lack of prostatic secretions
- increased risk micro trauma
- changes in mucous viscosity
Effects on renal failure on body - Answer a) Over activation of RAAS leading to retention
of sodium & water ^ blood volume as well as vasoconstriction of arteries & arterioles
causing ^ resistance = hypertension (can cause atherosclerosis, left ventricular
hypertrophy & failure) + ^ hydrostatic pressure causing oedema (worsened if there is
proteinuria causing reduced colloidal osmotic pressure)
b) decreased erythropoietin (EPO) leads to anaemia, lethargy and increased HR
c) Reduced activation of vitamin D & increased urinary loss of calcium & serum
retention of phosphate causes hyperparathyroidism = renal osteodystrophy and soft
tissue calcification
d) Acidosis leading to hyperkalaemia which can cause muscle stiffness and abdominal
pain or remain asymptomatic causing potentially life threatening cardiac arrhythmias
e) Increased nitrogenous waste within blood contributes to chronic poisoning leading to
lethargy and nausea, abnormal platelet functions & peripheral neuropathy
f) Loss of bone mass + lethargy = muscle atrophy
Glomerulonephritis and how does it led to chronic renal failure? - Answer - Affects both
kidneys as usually mediated by antibodies or antibody-antigen complexes in blood
- Progressive of disease from origin in glomeruli to tubulo-interstitial area + blood
vessels
, - Arterial vessels in glomeruli also supply blood to other areas of kidney
- All areas of kidney can become involved > reduction in function
- both kidneys commonly involved, as function of both kidneys reduces, clinical state
renal failure follows
What does the word blast denote? - Answer - Cancer has started in a cell that was never
normal to begin with
- sustained mutations during embryogenesis
How do kidneys respond to hypotension? - Answer - Activate
Renin-angiotensin-aldosterone system which results in:
- Angiotensin II > vasoconstriction
- Aldosterone > Increased sodium + water reabsorption > increasing blood volume EPO
release, which in long term increases haematocrit
- ADH release > increased thirst & H2O reabsorption
- Increased sympathetic tone (vasoconstriction + up regulation of B adrenergic
receptors in heart) > increased rate & force of contraction
In renal failure, over activation of RAAS > predisposes to systemic hypertension >
predisposes to atherosclerosis and left-sided heart failure
Risk factors for atherosclerosis? - Answer Male, smoking, increasing age, diabetes,
systemic hypertension, hyperlipidaemia
Cell of origin in prostate cancer? significance? - Answer - cell of origin is glandular
epithelial
-most common cancer of internal organs in males + 3rd most common cause of
cancer-related deaths in males
- incidence increases with advanced age
Main causes and potential consequences of PID - Answer Main causes:
- Gonorrhoea, Chlamydia + ascending infection ( staph, strep, coliform or clostridium
perfringens)
Complications:
- scarring and obstruction, abscess formation, peritonitis & sepsis infertility, ectopic
pregnancy, peritonitis, intestinal obstruction
Possible consequences of endometriosis? - Answer - common cause of female infertility
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