Chapter 7 Pathos

Q1: What are the main organs of the urinary system and their functions?

• Kidneys: Filter blood, make urine, regulate water/electrolyte balance, BP, pH, vitamin D activation, and hormone production.

• Ureters: Transport urine from kidneys to bladder.

• Bladder: Stores urine until excretion.

• Urethra: Carries urine outside the body

Q2: How does blood flow through the kidneys?

• Renal artery → afferent arteriole → glomerulus → efferent arteriole → renal vein → inferior vena cava.

• Kidneys receive about 25% of cardiac output — critical for filtration

Q3: What is the nephron and its function?

• Functional unit of the kidney (1–2 million per kidney).

• Functions:

  • Filtration in the glomerulus (forms filtrate).

  • Reabsorption in proximal tubule (returns substances to blood).

  • Secretion in distal tubule (moves wastes into filtrate).

  • Excretion through collecting ducts → calyces → ureter

Q4: What is GFR and why is it important?

• Glomerular Filtration Rate (GFR): Amount of filtrate formed per minute.

• Normal: ~125 mL/min.

• Low GFR (<60) = kidneys not filtering → fluid and toxins accumulate

Q5: What hormones affect kidney function?

• ADH (Vasopressin): Retains water (acts on distal tubule).

• Aldosterone: Retains Na⁺ & water, excretes K⁺.

• Renin: Released with low BP → activates RAAS to raise BP.

• Erythropoietin: Stimulates RBC production.

• Vitamin D (active form): Aids calcium absorption

Q6: What are normal daily urine output and composition?

• Output: 1.5–2.5 L/day.

• Urinalysis normal values:

  • pH: 4.5–8

  • Specific gravity: 1.010–1.025

  • No glucose, blood, protein, or ketones

  • Negative for nitrites & leukocyte esterase

  • No bacteria or large # WBCs/RBCs

Q7: What is the prostate gland and its role?

• Located below bladder, surrounds urethra.

• Produces seminal fluid that nourishes sperm.

• Enlargement (BPH) compresses urethra, causing urinary obstruction

Q8: What is urinary incontinence?

Loss of bladder control resulting in involuntary urine leakage

Q9: What is enuresis?

Involuntary urination in a child >4–5 years old.

• Nocturnal enuresis: bedwetting.

• Often resolves without treatment

Q10: What is stress incontinence and what causes it?

• Definition: Leakage of urine from pressure on the bladder (laughing, sneezing, lifting).

• Causes: Weakened sphincter, pregnancy, childbirth, menopause, obesity, chronic cough

Q11: What is urge (overactive bladder) incontinence?

Sudden strong urge to urinate followed by leakage.
Causes: UTIs, bladder irritants, neurological disorders, or idiopathic

Q12: Define reflex, mixed, overflow, functional, transient, and gross total incontinence.

Type	Description	Causes
Reflex	No urge; bladder contracts due to nerve damage	Spinal cord injury
Mixed	Combo of stress + urge	Common in women
Overflow	Bladder cannot empty → dribbling	BPH, obstruction, nerve damage
Functional	Due to mobility/cognitive issues	Elderly, dementia
Transient	Temporary condition	Infection, meds, delirium
Gross total	Continuous leakage	Fistulas, structural defects.

Q13: How is incontinence treated?

Bladder training, pelvic exercises (Kegels), scheduled toileting, meds (anticholinergics), devices (pessaries), surgery (slings, artificial sphincter), hygiene care

Q14: What is a neurogenic bladder?

Bladder dysfunction caused by nerve damage → either overactive or underactive bladder.
Causes: Spinal cord injury, diabetes, stroke, Parkinson’s, MS, childbirth.
Treatment: Catheterization, bladder training, medications

Q15: What are common causes and risk factors for UTIs?

• Causes: Bacteria (especially E. coli), poor hygiene, catheters.

• Risks: Female anatomy, sexual activity, urinary retention, tight clothing, diabetes, pregnancy, BPH

Q16: What are UTI symptoms?

Dysuria, frequency, urgency, hematuria, cloudy urine, pelvic pain, low back pain, fever

Q17: Differentiate between cystitis and pyelonephritis.

Feature	Cystitis (Bladder)	Pyelonephritis (Kidney)
Site	Bladder/urethra	One or both kidneys
Symptoms	Dysuria, frequency, suprapubic pain	Fever, chills, flank pain, malaise, ↑BP
Complications	Recurrent infection	Renal failure, sepsis
Treatment	Short antibiotics, fluids	Long-term IV antibiotics (4–6 weeks)

Q18: How are UTIs diagnosed?

• Urinalysis: +WBCs, nitrites, leukocyte esterase, bacteria.

• Urine culture: Identifies causative organism and antibiotic sensitivity

Q19: How can UTIs be prevented?

Hydration, void after sex, avoid tight clothing, wipe front-to-back, avoid irritants (bubble baths, sprays), don’t delay urination

Q20: What is nephrolithiasis (renal calculi)?

Kidney stones = hardened mineral crystals (usually calcium + oxalate or phosphate) in kidneys, ureters, or bladder

Q21: What are risk factors for kidney stones?

Dehydration, high salt/protein diet, urinary stasis, pH changes, obesity, hypertension, family history

Q22: How do kidney stones cause problems?

They obstruct urine flow → pain, infection, or hydronephrosis (dilated kidney pelvis)

Q23: What is BPH?

Noncancerous enlargement of the prostate gland in older men

Q24: What causes BPH?

• Hormonal changes: ↓ testosterone, ↑ estrogen.

• Cellular hyperplasia: Prostate cells fail to die → enlarged gland compresses urethra

Q25: What are symptoms of BPH?

• Weak urinary stream, dribbling, hesitancy, retention.

• Nocturia, urgency, incomplete emptying, overflow incontinence.

• Risk of UTIs, bladder distention, hydronephrosis

Q26: How is BPH diagnosed?

History, physical, digital rectal exam (DRE), PSA level, urinalysis, bladder scan, ultrasound, biopsy

Q27: What are treatments for BPH?

• Lifestyle: Avoid alcohol/caffeine, timed voiding.

• Meds: Alpha-blockers, 5-alpha reductase inhibitors, herbal (saw palmetto).

• Surgery: TURP (Transurethral Resection of the Prostate)