Renal & Gastrointestinal Pathophysiology Review

Question-and-Answer flashcards covering definitions, pathophysiology, risk factors, and clinical manifestations of acute cystitis, pyelonephritis, chronic kidney disease, urolithiasis, urinary incontinence, polycystic kidney disease, and diverticular disease.

What is the usual anatomic route of infection in acute cystitis (UTI)?

Microorganisms ascend from the distal urethra toward the bladder.

Which bacterium is most commonly responsible for acute cystitis and pyelonephritis?

Escherichia coli (E. coli).

Name two anatomic or mechanical factors that increase a woman’s risk for a urinary tract infection.

Short urethra and close proximity of urethra to the anus.

List three mechanical obstructions that predispose to UTIs in either sex.

Renal calculi, enlarged prostate, indwelling catheters.

Which cellular change occurs in the bladder wall during an acute cystitis?

Necrosis of urinary tract epithelium cells.

Give four hallmark clinical manifestations of acute cystitis.

Dysuria, urgency, increased frequency, hematuria with cloudy or purulent urine.

How does pyelonephritis differ from cystitis in terms of tissue affected?

Pyelonephritis involves infection and inflammation of the renal parenchyma, potentially causing scarring.

State two common risk factors for developing pyelonephritis.

Urinary obstruction from renal calculi and incomplete bladder emptying; frequent sexual intercourse is also a risk.

What are the two most common underlying diseases that lead to chronic kidney disease (CKD)?

Hypertension and diabetes mellitus.

Why do patients with CKD experience systemic ‘waste build-up’?

Failing kidneys cannot adequately filter metabolic wastes from the blood.

Name four typical manifestations of chronic kidney disease.

Reduced energy/weakness, shortness of breath, generalized swelling, and foamy or bubbly urine.

Which electrolyte is especially prone to dysregulation in CKD and can produce cardiac complications?

Potassium (K⁺).

What are the two definitive treatments for end-stage chronic kidney disease?

Dialysis and kidney transplant.

Define urolithiasis.

Development of renal calculi (kidney stones) anywhere in the urinary tract.

Which mineral makes up most kidney stones?

Calcium.

Give three conditions that favor stone formation in urolithiasis.

Urinary stasis, elevated urinary solute (salt/acid) levels, and renal tubular obstruction.

Differentiate colic pain from non-colic pain in urolithiasis.

Colic is acute, intermittent, radiating, excruciating flank pain from ureteral distention; non-colic is dull, deep pain from renal calyx or pelvic distention.

Define urinary incontinence.

Accidental or involuntary loss of urine.

What distinguishes stress incontinence from urge incontinence?

Stress incontinence is leakage with increased abdominal pressure (cough, sneeze); urge (overactive bladder) is leakage accompanied by a strong, sudden need to void due to detrusor overactivity.

Explain overflow incontinence.

Urine leakage caused by detrusor underactivity or bladder outlet obstruction, leading to over-filled bladder.

What is functional incontinence?

Normal bladder function but impaired ability to reach the toilet (e.g., due to mobility or cognition problems).

Describe neurogenic bladder incontinence.

Little or no communication between brain and bladder, impairing voluntary control.

What genetic disorder is the most common inherited cause of chronic kidney disease?

Polycystic kidney disease (PKD).

Characterize the basic pathology of PKD.

Multiple fluid-filled cysts grow in kidney tissue, compressing blood vessels, obstructing tubules, and replacing functional nephrons.

List the three main categories of PKD.

Autosomal dominant, autosomal recessive, and acquired polycystic kidney disease.

Why is uncontrolled hypertension an early finding in PKD?

Enlarged cystic kidneys compress renal arteries and veins, activating mechanisms that raise blood pressure.

Give three additional early manifestations of PKD besides hypertension.

Flank pain, altered fluid/electrolyte balance, and hematuria or renal calculi.

Define diverticulum and diverticula.

Diverticulum: single small, sac-like outpouching of colonic wall; diverticula: presence of multiple diverticula.

What is diverticulitis?

Inflammation/infection of a diverticulum due to trapped fecal material, representing a complication of diverticulosis.

Identify the most common colonic region affected by diverticular disease.

Sigmoid and descending colon (left lower quadrant).

List four typical clinical manifestations of diverticulitis.

Left lower-quadrant abdominal pain, fever, nausea/vomiting, and possibly altered bowel habits.

Why are obesity and diabetes mellitus considered emerging risk factors for renal calculi?

They are associated with metabolic changes that increase urinary solute concentration and stone formation.

Name two general pathophysiologic mechanisms that can cause urinary incontinence.

Impaired muscle contraction of the detrusor and altered neural transmission.

What treatment options exist once PKD progresses to end-stage renal disease?

Renal dialysis or kidney transplantation.

How can incomplete bladder emptying promote both UTIs and pyelonephritis?

Residual urine acts as a medium for bacterial growth and allows ascending infection toward the kidneys.