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Patho Exam 3 > Alterations of Renal Function > Flashcards

Alterations of Renal Function Flashcards

1
Q

Percentage of Cardiac Output in the kidney. How many mL per minute?

A

25% (1200 mL/minute)

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2
Q

Prerenal

A

issue the happen before the kidney

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3
Q

Intrarenal

A

issues that happen inside the kidney

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4
Q

Postrenal

A

issues that happen after the kidney

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5
Q

Prerenal (reasons and example)

A

reasons: hypotension, hypovolemia, sepsis, low cardiac output
example: acute kidney injury

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6
Q

Intrarenal (reason and examples)

A

Reason: ischemic acute tubular necrosis, surgery sepsis, obstruction
Examples: UTI, pyelonephritis, antibiotic toxicity

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7
Q

Postrenal (reason and examples)

A

Reason: urinary tract obstruction (bilateral)
Ex: bilateral ureteral obstruction, urethral obstruction, tumors or neurogenic bladder

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8
Q

What is Mean Arterial Pressure

A

the average pressure in the arteries throughout the cardiac cycle

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9
Q

Normal values of mean arterial pressure

A

70-90

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10
Q

Normal urine diagnostics - color

A

pale yellow to light amber

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11
Q

Normal urine diagnostics - turbidity

A

clear with no sediment

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12
Q

Normal urine diagnostics - pH

A

4.6-8

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13
Q

What does more basic/alkaline urine mean

A

bacteria is present

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14
Q

Normal urine diagnostics - specific gravity: normal values

A

1.0 - 1.02

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15
Q

Is specific gravity increased or decreased with protein and glucose present

A

increased

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16
Q

When is specific gravity low

A

when it is dilute

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17
Q

Normal urine diagnostics - blood

A

negative

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18
Q

Normal urine diagnostics - bacteria

A

yes or no

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19
Q

What are ketones? normal value?

A

keto acids that are given off when body is burning fat instead of glucose (increase in fat metabolism)
normal value: negative

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20
Q

What two lab values do we look at to judge kidney function?

A

BUN and creatinine

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21
Q

Look at BUN/creatinine via blood or urine?

A

blood is more accurate

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22
Q

Definition of specific gravity(AKA?)

A

an estimated measure of the solute concentration of the urine
AKA : weight of urine

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23
Q

Specific gravity : ratio

A

ratio of density of substance to density of water

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24
Q

What is urine composed of?

A

waste product and fluid

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25
Q

What are the two waste products in urine

A

urea and creatinine

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26
Q

What is BUN and what does it measure?

A

blood, urea, nitrogen: end product of protein metabolism, circulates in the blood, removed by the kidneys in urine
measures the amount of urea in the blood

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27
Q

What is the predominant waste product in blood?

A

urea

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28
Q

where is urea formed?

A

in the liver

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29
Q

Normal value for BUN

A

10 - 20

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30
Q

critical value for BUN

A

greater than 100

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31
Q

What is the job of kidneys?

A

to remove urea

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32
Q

What is creatinine?

A

serum and urine; nitrogenous compounds formed from metabolism of creatine

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33
Q

Where is creatine found?

A

blood, urine, muscle tissue

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34
Q

Normal values for creatinine

A

0.5-1.1 mg/dL

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35
Q

What is the creatinine clearance test and what does it measure?

A

24 hour diagnostic test for kidney function: measures the rate at which creatinine is cleared from the blood by the kidneys

36
Q

Creatinine clearance test 7 steps

A
  1. get order for 24 hour clearance test
  2. go to lab and get red biohazard container
  3. put container in bucket of ice (to keep urine from smelling and prevent bacterial growth)
  4. tell pt whats happening and to call every time they go to the BR
  5. have pt discard the first sample
  6. keep all other samples for 24 hours
  7. Have pt void one last time right at the end of 24 hours
37
Q

Hydroureter (definition) (is it prerenal, intra or post?)

A

dilation of one of the ureters filled with urine

post renal: bladder infection

38
Q

Hydronephrosis (definition) (prerenal, intra, or post?)

A

dilation of renal pelvis and calyces, results in enlargement of the kidney: intrarenal

39
Q

Post-obstructive diuresis (definition) (prerenal, intra or post?)

A

body is catching up on filtration and waste removal after you clear the obstruction (kidney does double work to catch up on filtration)

40
Q

Risk factors of renal stones

A

fluid intake and diet, age, gender, race, geographic location, seasonal factors, occupation

41
Q

Clinical manifestations of renal stones

A

moderate to severe pain in the flank area radiating to the groin
colic pain (achy on and off pain)
some people may not hurt until pushing urine
urinary urgency
frequent voiding(peeing few drops)

42
Q

Evaluation of renal stones (what tests would you do…cheapest to most expensive)

A
  1. stone and urinary analysis
  2. Intravenous pyelogram (IVP)
  3. KUB (kidney, ureter, bladder xray)
  4. Spiral abdominal CT
43
Q

What is a UTI?

A

Urinary tract infection: inflammation of urinary epithelium from pathogen

44
Q

What is the most common bacteria found in a UTI?

A

Escherichia coli

45
Q

Clinical manifestations of a UTI: young adult

A 
differ with age and urinary function:
dysuria
frequency
suprapubic and lower back pain
foul  smelling
cloudy
46
Q

clinical manifestations of UTI in elderly

A

confused, septic, abdominal discomfort

47
Q

uncomplicated UTI definition, most common in?

A

healthy individual with normal urinary system
- first infection or one year after UTI
Most common in women

48
Q

Complicated UTI (who is it most common in? what is elevated?)

A

Individual with abnormal urinary system or compromised health
- older folks, BUN and creatinine are elevated

49
Q

Recurring UTI definition

A

initial infection that is successfully treated but reinfected within 5 to 10 days after resolution

50
Q

Persistent UTI definistion

A

persistent infection despite 3 days of treatment

51
Q

Cystitis definition

A

type of UTI: inflammation of the bladder

52
Q

Clinical manifestations of cystitis

A 
frequency
dysuria (difficulty peeing)
urgency
lower abdominal pain
pain in suprapubic area over the bladder
53
Q

More serious symptoms of cystitis

A

hematuria
cloudy and foul smelling urine
flank pain

54
Q

Interstitial cystitis definition

A

an unpleasant sensation (pain, pressure, discomfort) perceived to be related to the urinary bladder

55
Q

Is Interstitial cystitis bacterial or nonbacterial?

A

nonbacterial

56
Q

What is the cause of interstitial cystitis?

A

cause is unknown: autoimmune reaction may be responsible for the inflammatory response

57
Q

Interstitial Cystitis is associated with…

A

dysfunction of the external sphincter, vaginitis, urethritis, inflammation of the vaginal glands and urethra

58
Q

Interstitial Cystitis is most common in

A

women 20-30 years of age (usually that have multiple sexual encounters)

59
Q

Clinical manifestations of interstitial cystitis

A

bladder fullness
increased frequency
small urine volume(output)
chronic lower pelvic pain

60
Q

Acute pyelonephritis definition

A

type of UTI: an infection of one or both upper urinary tracts

  • infection of renal pelvis and interstitium
  • intrarenal
61
Q

Acute pyelonephritis causes

A 
female sex trauma
pregnancy
kidney stones
neurogenic bladder
reflux
Escherichia coli, proteus, pseudomonas
62
Q

Clinical manifestations of acute pyelonephritis

A 
acute onset
fever
chills
flank or groin pain
frequency
dysuria
costovertebral tenderness
63
Q

chronic pyelonephritis definition

A

persistent or recurrent infection of the kidney leading to scarring of the kidney
- one or both kidneys involved bc kidney have trouble filtering and doing their job

64
Q

Causative agent of chronic pyelonephritis

A

difficult to determine: hypertension is a common cause

65
Q

Early symptoms of chronic pyelonephritis

A

hypertension
frequency
dysuria
flank pain

66
Q

Late symptoms of chronic pyelonephritis

A

renal failure

67
Q

Risk factors of chronic pyelonephritis

A

renal infections

obstructive pathologic conditions

68
Q

Glomerulonephritis definition

A

inflammation of the glomerulus

69
Q

Causes of glomerulonephritis

A

immunological abnormalities (most common)
ischemia
vascular disorders (low volume–> MAP <70)
hypotension related issues
drugs/toxins
systemic diseases

70
Q

What is the most common cause of chronic and end-stage renal disease

A

glomerulonephritis

71
Q

Acute glomerulonephritis definition

A

Streptococcal infection –> bacteria in urine

begins abruptly: 7 to 10 days after strep infection

72
Q

Clinical manifestations of acute glomerulonephritis

A 
hematuria
RBC casts
proteinuria
decreased GFR
oliguria
hypertension
edema in lower extremities
73
Q

What is oliguria

A

decreased urination (low urine)

74
Q

Chronic glomerulonephritis definition

A

caused by several diseases/conditions leading to chronic renal failure

75
Q

Clinical manifestations of chronic glomerulonephritis

A 
increased cholesterol (hypercholesterolemia)
protein spillover(proteinuria) / bleeding in uria (hematuria)
76
Q

Acute Renal Failure definition

A

sudden abrupt reduction in renal function

77
Q

Clinical manifestation of acute renal failure

A

elevated BUN and creatinine
oliguria
decreased GFR

78
Q

Is acute renal failure reversible

A

yes

79
Q

Prerenal definition

A

impaired renal blood flow (most common cause)

- GFR declines due to the low filtration pressure

80
Q

Intrarenal definition

A

tubular necrosis; surgery sepsis, obstruction

81
Q

Postrenal definition

A

urinary tract obstruction (bilateral)

82
Q

Chronic Renal failure definition

A

progressive and irreversible loss of nephrons

  • GFR affects all organ systems
  • does not become apparent until <25% function remains
83
Q

Clinical manifestations of chronic renal failure

A 
uremia/azotemia
    -  accumulation of toxins in plasma
Hypertension
anorexia
nausea
vomiting
diarrhea
weight loss
edema
anemia
pruritus
neurological changes
84
Q

Uremia definition

A

high level of urea in blood

85
Q

Azotemia definition

A

high level of urea and other toxins in blood

Patho Exam 3 (2 decks)

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