Which GU problems arise?

Kidneys
Renal parenchyma

Ureters

Collecting system

Bladder

Urethra
Urinary Tract Infection
 Acute Urethritis
Incidence unknow
Risk factor:
Trauma
Sexual intercourse
Microbiology:
Coliform
N. Gonorrhea
C. Trachomatis
Trichomonas
 Acute urethritis
Symptoms:
Dysuria

Frequency

Urgency

Urethral discharge
Diagnosis:
Urinalysis:leukocyte, bacteria
Urine culture
Acute urethritis treatment
N.Gonorrhoe:
Coliforms: Ceftriaxon
Sulfonamide
Cefuroxim
Smx-tmp
Probenicid
Ampicillin C. trachomatis:
Cephalosporin Erythromycin
Nitropurantoin Azithromycin
Ampicillin
 Acute Cystitis
Uropathogen: Symptoms:
E.Coli Dysuria
S.sappropiticus Frequency
P.mirabilis Urgency
K.pneumonia Dribbling
Trichomonas Hematuria
Suprapubic discomport
 Acute cystitis
Diagnosis:
Urinalysis

Urine culture
Treatment:
SMX-TMP

Cephalosporin

Ampicillin
Glomerulus Anato / Histo
Acute or chronic
glomerulonephritis

Secondary to streptococcal or other

infection
Presentation:

renal
Haematuria BP
function

Probably need to treat infection to

enable resolution
Acute or chronic
glomerulonephritis

Despite treatment may lead to

Chronic
renal
failure
 Nephr I / O tic ????
NephrOtic (PrOtein) NephrItic (RBC +/-casts)
3 Systemic Diseases 3 Autoimmune
Diabetes Poststrep GN (Type III)

SLE IgA Nephropathy (Type III)

Amyloidosis Goospastures (Type II)

1 membrane 1 membrane
Membranous GN Membranoproliferative

2 others 2 others
Minimal Change Crescentic

Focal Segmental Alports (collagen IV defect)

Hypersensitivity
Essentials of GN
Type I IgE cross-linking on presensitizes mast cells
inflammatory mediators released
Type II Antibodies directed against specific
enemies. Damage cells via complement
mediated MAC Inflammatory response NOT
necessarily present
Type III Immune complex deposits (eg SLE)
activates complement C5a chemotactic to
neutrophils damage
Type IV T-cell mediated
NephrOtic
Membranous (1) Type III HS
Immune deposits IN the GBM
Assoc w/ hepatitis B antigenemia, autoimmune diseases,
thyroiditis, malignancies, pharm (gold, penicillamine, captopril,
NSAIDs).
Minimal Change Disease ( Kids)
lipoid nephrosis (why???)
Tx w/ steroids
Focal Segmental Glomerulosclerosis
Presents w/ acute onset; Glomerular scarring
Mutliple etiology: Podocyte injury, Nephron loss, Renal
vasodilatation (diabetic nephropathy, sickle cell, obesity, Von
Gierkes, Pregnancy, Obesity, Healing of prior inflammatory
injury)
NephrOtic Systemic Disease
Diabetes (1) GBM thickening,
(2) Nodules, (3) DIFFUSE glomerular
sclerosis
SLE (Type III) SubENDOthelial deposits
Amyloidosis

apple green
NephrItic Autoimmune
Poststrep GN (acute) type III (small
subepithelial humps) follows sore
throat or cellulitis
Peripheral & periorbital edema (autoimmune)
IgA post-infectious type III
Mild, self-limiting, assoc w/ Henoch-Sch
Goodpastures type II
Men in mid 20s
NephrItic Other 3
Membranoproliferative MESANGIAL
CELLS proliferate. Assoc w/ Hep C, SLE,
a1-antitrypsin.
Crescentic GN Fibrin deposition in
Bowmans. Assoc w/ post-strep &
membranous GN.
Alports Hereditary, type IV collagen
defect, CN VIII defective
Membranoproliferative
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