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Pathophysiology > 27 Intrarenal Disorders > Flashcards

27 Intrarenal Disorders Flashcards

1
Q

Intrarenal Disorders

A

occurs within kidney

-potential to result in renal insufficiency or failure

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2
Q

5 types of Intrarenal Disorders

A 
1 Congenital
2 Neoplastic
3 Infectious
4 Obstructive
5 Glomerular
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3
Q

Nephralgia

A

kidney/renal pain

  • generally felt at COSTOVERTEBRAL ANGLE
  • –recorded as CVA tenderness or flank pain
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4
Q

nephralgia is due to…

A

distention/inflammation of renal capsule

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5
Q

dermatome

A

area of skin innervated by a specific spinal cord segment

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6
Q

nephralgia is transmitted to T10 + L1 via…

A

sympathetic afferent neurons

-mat be felt throughout dermatomes

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7
Q

Urinalysis

A
  • DIPSTICK + MICROSCOPIC URINALYSIS

- –results provide clues to intrarenal pathologies

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8
Q

Abnormal Urinalysis Findings

A

dark, strong smell: DECR RENAL FUNCTN

cloudy, pungent: INFECTIOUS PROCESS

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9
Q

Diagnostic/Imaging Tests

A

1 KUB
2 Renogram/Renal Scan
3 Ultrasonography
4 CT/MRI

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10
Q

KUB

A

ID gross abnormalities related to size, position, + shape

-may show renal calculi

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11
Q

Renogram/Renal Scan

A

reveals renal vasculature + tumors

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12
Q

Ultrasonography

A

differentiates bw diff tissue characteristics

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13
Q

CT/MRI

A

detailed info about vasculature + tissue

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14
Q

Renal Agenesis

A

kidneys don’t dvlp in fetus

-either bilateral or unilateral

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15
Q

BILATERAL AGENESIS of kidney

A

NOT COMPATIBLE W LIFE

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16
Q

unilateral agenesis of kidney

A

compensatory hypertrophy of functional kidney

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17
Q

Renal Hypoplasia

A

some fetal kidney dvlpt

  • can lead to pediatric end-stage renal failure
  • SINGLE NORMAL KIDNEY CAN MAINTAIN NORMAL RENAL FUNCTION
  • requires lifelong kidney monitoring
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18
Q

Cystic Kidney Disease

A

genetically transmitted renal disorder

  • results in FLUID-FILLED CYSTS that can expand + disrupt urine formation + flow
  • may be localized to one area or affect both
  • can lead to renal failure
  • may require dialysis or transplant in late stage
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19
Q

2 types of Cystic Kidney Disease

A

1 Autosomal RECESSIVE: at birth

2 Autosomal DOM: later in life

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20
Q

Renal Carcinoma

A
  • metastatic disease

- ASYMPTOMATIC until advanced

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21
Q

Hematuria

A
  • presence of blood in urine
  • a sign of renal carcinoma, nephroblastoma (Wilms Tumor), or bladder cancer
  • sometimes in chronic glomerulonephritis
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22
Q

Renal Carcinoma

S/S + staging

A

ASYMPTOMATIC until advanced

  • CVA tenderness
  • hematuria
  • palpable mass

Staging: I-IV

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23
Q

Renal Carcinoma

treatment

A
  • NEPHRECTOMY

- resistant to radiatoin, immunotherapy, + chemotherapy (p53 mutation)

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24
Q

Nephroblastoma

A

aka Wilms Tumor

-most common kidney cancer in children

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25
Q

Nephroblastoma

clinical manifestation

A
  • palpable abdominal mass
  • abdominal pain
  • HYPERTENSION
  • hematuria
26
Q

Nephroblastoma

treatment

A
  • nephrectomy
  • radiatoin
  • chemotherapy
  • **excellent cure rate!
27
Q

Pyelonephritis

A

infection of the kidney

28
Q

most common Pyelonephritis

A

ascending infection fr lower urinary tract

-effective preventative measure is early removal of caterers

29
Q

Acute Pyelonephritis

A

infection of renal pelvis or parenchyma

–usually fr ascending UTI

30
Q

Renal Cell Carcinoma

risk factors

A

familial pattern:

smoking, obesity, hypertension

31
Q

Acute Pyelonephritis

clinical manifestations

A
  • CVA tenderness
  • fever
  • chills
  • N/V
  • anorexia
32
Q

Acute Pyelonephritis

diagnosis

A

presence of WBC casts

–indicative of upper UTI

33
Q

Acute Pyelonephritis

treatment

A

antimicrobials avoids decreased renal function

34
Q

classic sign of Acute Pyelonephritis

A

CVA tenderness

35
Q

anorexia in acute pyelonephritis will…

A

increase fever-induced hydration

36
Q

Obstruction

A

conditions that interfere w the flow of urine

37
Q

Urine Stasis

A

predisposes to infections + structural damage

-caused by renal obstruction

38
Q

Obstruction

common causes

A

1 Stones
2 Tumors
3 Prostatic Hypertrophy
4 Strictures of the ureters or urethra

39
Q

Stones

A

most common cause of renal obstruction

-composed of Ca crystals, uric acid, struvite, cystine

40
Q

Complete renal obstruction results in

A 
1 Hydronephrosis
2 Decreased GFR
3 Ischemic kidney damage
4 Acute Tubular Necrosis
5 Chronic Kidney Disease
41
Q

how does complete renal obstruction cause ischemic kidney damage?

A

because of increased intraluminal pressure

42
Q

Acute Tubular Necrosis

A

intrarenal acute renal failure

—self limiting disorder

43
Q

Acute Glomerulonephritis

A

immune response to variety of potential triggers

-attraction of immune cells to area of inflammation results in LYSOSOMAL DEGRADATION OF THE BASEMENT MEMBRANE

44
Q

In acute glomerulonephritis, why might GFR fail?

A

contraction of mesangial cells results in decreased surface area for filtration

45
Q

what happens when immune cells come to an area of inflammation (acute glomerulonephritis)?

A

lysosomal degradation of basement membrane

46
Q

Acute Glomerulonephritis

clinical manifestations

A

1 proteinura
2 oliguria + azotemia
3 edema + hypertension

47
Q

Acute Glomerulonephritis

treatment

A

1 steroids
2 plasmapheresis
3 supportive measures (diet + fluid)
4 mgmt of systemic + renal hypertension

48
Q

Chronic Glomerulonephritis

A
  • progressive course that ultimately dvlps to END-STAGE RENAL DISEASE
  • sclerosis + fibrosis of kidney
49
Q

Chronic Glomerulonephritis

clinical manifestation

A
  • persistent PROTEINURA
  • w/ w/o hematuria
  • slowly declining renal function
50
Q

Chronic Glomerulonephritis

treatment

A

dialysis or kidney transplant is necessary

-supportive interventions throughout course of disease

51
Q

Nephrotic Syndrome

A

occurs due to INCREASED flomerular permeability to proteins

-urinary loss of 3-3.5g of protein/day

52
Q

proteinuria leads to…

A

1 HYPOALBUMINEMIA
2 generalized EDEMA
3 decr blood colloid osmotic pressure

53
Q

increase in liver activity can cause…

A

1 Hyperlipidemia

2 Hypercoagulability

54
Q

most common finding in nephrotic syndrome?

A

Edema

55
Q

Nephrotic Syndrome

clinical manifestation

A 
1 proteinuria (3-3.5g)
1a hypoalbuminemia
1b edema
1c decr blood colloid osmotic pressure
2 incr liver activity
2a hyperlipidemia
2b hypercoagulability
56
Q

Nephrotic Syndrome

treatment

A 
conservative symptom mgmt
1 diuretics
2 lipid-lowering agents
3 antihypertensives
4 immunosuppression/immunomodulation
  • mgmt of underlying process when IDd
  • may resolve spontaneously or progress to end-stage renal disease
57
Q

child w hypertension is a sign of

A

nephroblastoma/wilm tumor

58
Q

types of kidney infections

A 
acute pyelonephritis (pelvic/parenchyma infection, FEVER, WBC cast)
acute glomerulonephritis (immune, infection, inflammation, lysosomal degradation)
59
Q

wbc cast

A

acute pyelonephritis

60
Q

hydronephrosis

A

build-up of urine in kidney from backflow due to obstruction below.

Pathophysiology (32 decks)

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