Ch. 30 Renal - Book/3 Flashcards

1
Q

struvite stones primarily contain

3

A
  1. magnesium
  2. ammonium
  3. phosphate
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2
Q

CKD decreases what

2

A
  1. GFR

2. tubular functions

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3
Q

CKD is the

A

progressive loss of renal function associated with systemic disease

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4
Q

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

A

renal colic

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5
Q

urinary stone dx test

A

24 hour urine to identify which stone and pH test

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6
Q

colic that radiates to the lateral flank or lower abdomen typically indicates

A

obstruction of the midureter

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7
Q

renal colic usually indicates

A

obstruction of the renal pelvis or proximal ureter

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8
Q

most common stone types

4

A
  1. calcium oxalate or phosphate
  2. struvite
  3. uric acid
  4. cystine (rare)
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9
Q

angiotensin II promotes

A

glomerula HTN and hyperfiltration caused by efferent arteriolar vasoconstriction and promotes systemic HTN

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10
Q

contributes to tubulointersitial injury by accumulating int he interstitial space of the nephron tubule and activating complement proteins and other mediators and cells

A

proteinuria

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11
Q

two systemic issues associated with calcium stones

A
  1. hyperparathyroidism

2. bone demineralization

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12
Q

calculi can be located in the

3

A
  1. kidneys
  2. ureters
  3. urinary bladder
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13
Q

uremia and azotemia is to

A

CKD

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14
Q

dilation of the upper urinary tract is an early response to

A

obstructions

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15
Q

proteinuria contributes to

A

tubulointersitial injury by accumulating int he interstitial space of the nephron tubule and activating complement proteins and other mediators and cells

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16
Q

usually indicates obstruction of the renal pelvic or proximal ureter

A

renal colic

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17
Q

kidney stones aka

A

calculi

urinary stones

18
Q

risk of urinary calculi formation is influenced by

8

A
  1. age
  2. sex
  3. race
  4. geographic location
  5. seasonal factors
  6. fluid intake
  7. diet
  8. occupation
19
Q

kidney damage defined as GFR at

A

<60 ml/min for 3 months or more

20
Q

renal stone - acidic urine

A

increases the risk of uric acid stone formation

21
Q

what is associated with calcium stones

7

A
1. hypercalciuria
2 hyperoxaluria
3. hyperuricosuria
4. hypocitraturia
5. mild renal tubular acidosis
6. crystal growth inhibitor deficiencies
7. alkaline urine
22
Q

clinical manifestations of CKD

2

A
  1. uremia

2. azotemia

23
Q

the chronically high intraglomerular pressures increases

A

glomerular capillary permeability, contributing to proteinuria

24
Q

dilation of the renal pelvic and calyces proximal to blockage is referred to as

A

hydronephrosis/ureterohydronephrosis

25
Q

uric acid stone formation is affected by consumption of

A

purines (meat and beer) in diet

26
Q

renal stone - alkaline urine

A

increases the risk of calcium phosphate stone formation

27
Q

renal colic

A

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

28
Q

two factors that have been recognized to advance renal disease

A
  1. proteinura

2. angiotensin II activity

29
Q

CKD - intact nephron hypothesis proposes that

A

loss of nephron mass with progressive kidney damage causes the surviving nephrons to sustain normal kidney function

30
Q

kidney stones - men vs women

A

slightly more common in men

31
Q

renal stone - cystallization is the process by which

A

crystals grow from a small nidus or nucleaus to larger stones in the presence of supersaturated urine

32
Q

kidney stones are

A

masses of crystals, protein, or other substances that are a common cause of UTO in adults

33
Q

what leads to proteinuria

A
  1. glomerular hyperfiltration
  2. increased glomerular capillary permeability
  3. loss of negative charge
34
Q

CKD - tubular interstitial diseases damage primarily the tubular or medullary parts of the nephron, producing problems such as
3

A
  1. renal tubular acidosis
  2. salt wasting
  3. difficulty diluting or concentrating urine
35
Q

most renal stones are __lateral

A

uni

36
Q

can AKI progress to CKD

A

yes

37
Q

CKD - damage is vascular or glomerular, what results

3

A
  1. proteinuria
  2. heamturia
  3. nephrotic syndrome
38
Q

calculus formation is related to

4

A
  1. supersaturation of one or more salts in the urine
  2. precipitation of the salts from a liquid to a solid state
  3. growth through crystallization or agglomeration (aggregation)
  4. presence/absence of stone inhibitors
39
Q

CKD systemic diseases include

4

A
  1. DM #1
  2. HTN
  3. systemic lupus erythematosus
  4. intrinsic KDs (AKI, chronic glomerulonephritis, chronic pyelonephritis, obstructive uropathies, vascular disorders)
40
Q

dilation of the ureter is referred to as

A

hydroureter (accumulation of urine in the ureter)

41
Q

uric acid stones occur in persons who

A

excrete excessive uric acid in the urine, such as those with gouty arthritis

42
Q

CKD - systemic changes result from increased levels of

3

A
  1. creatinine
  2. urea
  3. potassium