Page 126 - Physiology and Pathophysiology MNU 2024-2025 نظرى

Clinical pharmacy 2024/2025 Level 2 Pharm D Physiology and Pathophysiology
(MD303)

✓ Hyperlipidemia, especially hypercholesterolemia, also
occurs but the cause is unknown.

✓ Hypoproteinemia stimulates protein synthesis in the
liver, resulting in the overproduction of lipoproteins.
✓ Lipid catabolism is decreased due to lower levels
of lipoprotein lipase, the main enzyme involved in
lipoprotein breakdown

Disorders of the ureters, bladder, and urethra

I- Infections of the urinary tract:
Infection of any part of the tract may spread upwards causing pyelonephritis and severe kidney
damage.
1.Ureteritis:

Inflammation of a ureter is usually due to the upward spread of infection in cystitis.

2- Cystitis:
A) Acute cystitis: B) Chronic cystitis:
▪ This is inflammation of the bladder. ▪ Chronic inflammation of the
▪ may be due to: Urinary bladder.
1. Spread of microbes that are commensals of the bowel ▪ May be due to:
(Escherichia coli and Streptococcus faecalis) from the ✓ This may follow repeated attacks
perineum, especially in women because of the short wide of acute cystitis.
urethra, its proximity to the anus and the moist perineal ✓ It occurs most commonly in
conditions). males over 60 years of age when
2. A mixed infection of coliform and other organisms which compression of the urethra by
may follow the passage of a urinary catheter or other an enlarged prostate gland
instrument. prevents the bladder from
3. Inflammation in the absence of microbes, e.g. following emptying completely.
radiotherapy or passage of a catheter or other instrument.
▪ The effects are: ▪ Calculus formation is common,
1- Inflammation. especially if the normally acid
2- Edema. urine becomes alkaline due to
3- Small hemorrhages of the mucosa, which may be microbial action or kidney
accompanied by hematuria. damage.
4- There is hypersensitivity of the sensory nerve endings
in the bladder wall, which are stimulated before the
bladder has filled leading to frequency of micturition
and dysuria (a burning sensation on micturition).
5- The urine may appear cloudy and have an unpleasant
smell.
6- Lower abdominal pain.

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