WEEK 3 - Renal Calculi & Prostate Cancer
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What are the four main types of renal calculi?
• Calcium stones • Struvite stones • Uric acid stones • Cystine stones
Which form of stone is most common?
Calcium stones
What leads to calcium stone formation?
High levels of Ca in blood and urine - may lead to decreased Ca in the body
What are the four causes of Calcium stones?
• Idiopathic • Intestinal hyperabsorption of calcium • Hyperparathyroidism • Bone demineralisation
How do struvite calculi form?
Form in alkaline urine and in the presence of urease-producing bacteria such as Klebsiella or Pseudomonas
Struvite calculi are more common in?
People who frequently have infections - women are more prone to UTIs and so are more prone to having struvite calculi
When do uric acid calculi develop?
In gout and when there is a high concentration of uric acid in urine (genetic disorder of amino acid disorders)
Are uric acid calculi visible on imaging? Why or why not?
NOP This is because uric acid calculi form in the urinary epithelium
What period of time in the lifespan are cystine calculi most common?
Childhood
Cystine calculi are due to?
Genetic defect in the renal transport of cystine, leads to cystinuria
List some risk factors for renal calculi development
• Being male • Being old • Being indigenous Australian • Having a family history of kidney stones • Living in tropical, hot weather
What are three factors influencing calculus growth?
• Crystal growth-inhibiting factors • Crystal particle retention • Tissue damage from urea-splitting pathogens
Primary manifestation of renal calculi?
Renal colic (pain that comes and goes) due to peristalsis of the ureters in an attempt to remove calculi Pain is also associated with nausea and vomiting
Sign of renal calculi mid ureter?
Flank pain or pain in the groin or lower abdomen
Sign of renal calculi in the lower ureter?
Urinary urgency and incontinence
What is non colicky pain caused by?
Renal calculi distending the renal calyces or renal pelvis
Two tests for diagnosis of renal calculi?
• Urinalysis 2. Intravenous pyelography
Treatment for renal calculi?
• Calculus removal via surgery - Prevention via increased fluid intake and increased dietary fibre
Risk factors for prostate cancer?
• Age (older than 65) • Race (African men more susceptible) • Family Hx (causes 8x increase in risk) • Hormones (increased [T]) • Diet (high fat intake increases sex hormones and growth factors)
Protective factor against prostate cancer development?
Diet rich in selenium, vitamin E, lycopene. Delays development of PCa until 75-85 years of age.
What is degree of differentiation and how is it related to cancer?
Degree of differentiation = degree to which cancer cells are developed • Poorly differentiated cells = more aggressive cancer cells • Well differentiated = less aggressive cancer cells
Metastasis is most likely to occur in which areas of the body?
• Bone, followed by • Lung • Liver • Pleura
Where is testosterone found and what are its effects?
Found in circulation - primary circulating androgen Effects = increased muscle tone, increased libido (desirable effects)
Where is DHT found and what are its effects?
Found in the prostate - primary prostatic androgen Effects - decreased muscle tone, decreased libido, increased acne (undesirable effects)