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Pathophysiology > 30. Renal and Urinary Tract > Flashcards

30. Renal and Urinary Tract Flashcards

1
Q

irreversible loss of renal function that affects nearly all organ systems

A

chronic renal failure (CRF)

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2
Q

symptoms of stage 4 and stage 5 CRF

A
  • moderate HTN - EPO deficiency anemia - hyperphosphatemia and hyperkalemia - hyperlipidemia - metabolic acidosis - salt/water retention
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3
Q

Explain why acute renal failure has oliguria present

A

decreased GFR due to possible glomerular injury (decreased permeability and surface area) or tubular injury that causes obstruction

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4
Q

process causes unobstructed kidney to increase the size of the individual glomeruli and tubules but not the total number of functioning nephrons

A

compensatory hypertrophy (hyperfunction)

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5
Q

symptoms of acute cystitis

A
  • urinary frequency - dysuria - urinary urgency - lower ABD pain and/or suprapubic pain
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6
Q

most common cause of end-stage renal failure

A

glomerulonephritis

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7
Q

How are kidney stones evaluated?

A
  • imaging studies determine location of stone (KUB/CT/IVP) - UA to analyze contents of stone
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8
Q

nonbacterial or noninfectious cystitis

A

interstitial cystitis

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9
Q

incontinence as a result of functional limitations (mobility, arthritis, stroke etc.)

A

functional incontinence

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10
Q

dilation of the renal pelvis and calyces proximal to the blockage

A

hydronephrosis

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11
Q

most common cause of intra renal kidney injury/failure

A

acute tubular necrosis (ATN)

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12
Q

no urgency, occurs with activity (ex. exercise, coughing, lauding, sneezing); more common in women

A

stress incontinence

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13
Q

excretion of 3.5 g or more of protein in the urine per day; due to glomerular injury

A

nephrotic syndrome

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14
Q

Common causes of glomerulonephritis

A
  • type II, III, or IV hypersensitivity - drugs or toxins - vascular disorders (vasculitis) - systemic disorders (DM - post-strep infection
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15
Q

risk factors for RCC

A
  • smoking - obesity - analgesic use
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16
Q

urine output less than 400ml/day

A

oliguria

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17
Q

dilation of the ureter (accumulation of urine in the ureter)

A

hydroureter

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18
Q

inflammation of the bladder

A

acute cystitis

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19
Q

Elevated levels of urea and other nitrogen compounds in the blood.

A

azotemia

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20
Q

causes of decreased renal perfusion

A
  • hypotension - hypovolemia (hemorrhage or fluid loss) - sepsis - inadequate cardiac output - renal artery stenosis
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21
Q

What causes nephrolithiasis

A
  • supersaturation of one or more salts - precipitation of a salt from liquid to solid state - growth into a stone via crystallization or aggregation
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22
Q

inflammation of the urinary epithelium caused by bacteria

A

urinary tract infection (UTI)

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23
Q

most common cause of UTI

A

escherichia coli (E. coli)

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24
Q

hits suddenly without warning, no holding time and leakage on the way to the bathroom

A

urgency incontinence

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25
Q

Stage of CRF w/ normal kidney function (GFR >90 ml/min); HTN

A

stage 1 CRF

26
Q

systemic manifestations seen due to urea accumulation because of renal dysfunction

A

uremic syndrome/uremia

27
Q

What lab work will be seen w/ glomerular disease?

A
  • decreased GFR - increased plasma creatinine and urea - reduced creatinine clearance
28
Q

Treatment of kidney stone

A
  • high fluid intake - decreased dietary intake of stone-forming substances - stone removal
29
Q

persistent or recurring episodes of acute pyelonephritis that leads to scarring

A

chronic pyelonephritis

30
Q

Stage of CRF w/ mild kidney damage (GFR 60-89 ml/min); possible elevation of BUN and creatinine and HTN

A

stage 2 CRF

31
Q

most common metastasis sites of RCC

A
  • lung - liver - bone - thyroid - CNS
32
Q

inflammation of the glomeruli

A

glomerulonephritis

33
Q

occurs with urinary tract obstructions that affect the kidneys bilaterally

A

post renal acute kidney injury/failure

34
Q

Stage of CRF w/ moderate kidney damage (GFR 30-59 ml/min); mild w/ HTN

A

Stage 3 CRF

35
Q

clinical manifestations of nephrotic syndrome

A
  • hypoalbuminemia -> edema - hyperlipidemia and lipiduria (low albumin stimulates lipoprotein synthesis by liver) - vitamin D deficiency (decreased D activation by kidneys) - proteinuria - microscopic hematuria and RBC casts
36
Q

3 causes of urinary tract obstruction

A
  • stones (calculi) - stricture (narrowing of structures) - tumor
37
Q

ESRF w/ GFR < 15 ml/min

A

Stage 5 CRF

38
Q

benign encapsulated tumors located near the cortex of the kidney

A

renal adenoma

39
Q

symptoms of pyelonephritis

A
  • fever/chills - flank or groin pain - other symptoms characteristic of a UTI
40
Q

Stage of CRF w/ severe kidney damage (GFR 15-29 ml/min)

A

Stage 4 CRF

41
Q

moderate to severe pain often originating in the flank and radiating to the groin

A

renal colic

42
Q

symptoms of interstitial cystitis

A
  • bladder fullness - urinary frequency - small urine volume - chronic pelvic pain - dyspareunia
43
Q

mechanical forces on an over-distended bladder (ex. BPH or DM)

A

overflow incontinence

44
Q

most common renal neoplasm

A

renal cell carcinoma (RCC)

45
Q

glomerular damage causes what 2 things

A
  • decreased glomerular membrane surface area - decreased glomerular capillary blood flow
46
Q

continuous loss of urinary control; bladder is incapable of holding any urine; most severe type of incontinence

A

total incontinence

47
Q

how long after obstruction does renal function begin to be affected?

A

about 7 days

48
Q

kidneys can adapt until function decrease to what?

A

less than 25% of function

49
Q

acute kidney failure can cause what kind of metabolic dysfunction

A

metabolic acidosis

50
Q

organisms associated w/ acute pyelonephritis

A
  • E. coli - Proteus - Pseudomonas
51
Q

most common bladder malignancy

A

transitional cell carcinoma

52
Q

acute infection of the renal pelvis and interstitium; most common cause is vesicoureteral reflux

A

acute pyelonephritis

53
Q

narrowing of the lumen of the urethra and occurs when infection, injury, or surgical manipulation produces scar tissue; more common in men

A

urethral stricture

54
Q

symptoms are renal cancers

A
  • usually no early symptoms - later sxs include gross, painless hematuria and dull, achy flank pain
55
Q

sudden decline in kidney function w/ decrease in GFR and urine output and accumulation of nitrogenous waste produces in blood (elevated BUN and creatinine)

A

acute kidney failure/acute kidney injury

56
Q

most common types of urinary calculi

A
  • calcium oxalate or calcium phosphate - struvite - uric acid
57
Q

Explain how glomerular disorders can lead to edema

A

increased glomerular capillary permeability -> passage of plasma proteins into urine -> hypoalbuminemia -> decreased vessel oncotic pressure and fluid moves into interstitial space -> edema

58
Q

most common cause of acute kidney injury/failure and caused by sudden and severe drop in renal blood flow

A

prerenal acute kidney injury/failure

59
Q

What determines the severity of urinary tract obstruction

A
  • location - involvement of upper urinary tract - completeness - duration - cause
60
Q

urine output less than 50 ml/day

A

anuria

61
Q

rare tumor that arises in the renal parenchyma and renal pelvis

A

renal transitional cell carcinoma (RTCC)

Pathophysiology (20 decks)

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