Ch. 33 Disorders of Renal Function

Question 1

Polycystic Kidney Disease

Answer 1

can be acquired or inherited. condition characterized by growth of fluid filled sacs in the kidney tissue leading to the loss of renal nephrons. functional tissue replaced. reduced perfusion. tubule obstruction.
the most common GENETIC cause of chronic kidney disease.
Autosomal dominant is most common. manifests between 30-40. one of the earliest manifestations is HTN from compression of the renal vessels and activation of the RAAS.

Question 2

Obstructive disorders

Answer 2

:causes can be anything. calculi, pregnant, prostate, scar tissue resulting from infection and inflammation. tumors. neurologic disorders.
Manifestations: depends on site, cause, and rapidity of condition development.
Common symptoms: pain S&s of UTI, manifestations of renal dysfunction
Damaging effects: stasis of urine, development of backpressure

Question 3

Hydronephrosis

Answer 3

increase in size, hydroureter as well, there is a dilatation and it backs up to the kidney, leading to a pressure on the kidney leading to edema or scarring if not relieved.

Question 4

Renal Calculi

Answer 4

Definition: crystalline structures that form from components of urine.
Requirements: a nidus (wdk what it is) to form. a urinary environment that supports continued crystallization of stone components
Factors Influencing: concentration of stone components in urine. ability of stone components to complex and form stones. the presence of substances that inhibit stone formation

Question 5

UTIS

Answer 5

asymptomatic bacteriuria. symptomatic infections.
This is just a term saying there is an infection in the urinary tract.
Cause: most caused by E. coli. most are caused by bacteria entering the urethra.
S. auerus: blood borne
LUTI: cystitis, prostatis, urethritis (usually associated with STIs)
UUTI: pyelonephritis.

Question 6

Cystitis

Answer 6

infection of the bladder.
more common in women than men.
frequency of urination, lower abdominal or back discomfort, burning and pain on urination, cloudy and foul smelling urine on occasion.
Special considerations: sexually active women, pregnant women, age related effects: infants, toddlers, adolescents, adults, elderly

Question 7

Pyelonephritis

Answer 7

infection of the kidney.

Question 8

Glomerulonephritis

Answer 8

an inflammatory process that involves the glomerular structures.
Immune mechanisms: glomerular antibodies, circulating antigen-antibody complexes,

Question 9

Diagnosis and Treatment of UTIs

Answer 9

diagnosis based on symptoms and on examination of the urine for the presence of microorganisms and leukocytes. urine dipstick. x-ray films, ultrasonography and CT and renal scans if complicated.
treatment of UTI is based on the pathogen causing the infection.

Question 10

Nephritic Syndrome

Answer 10

produce a decrease in glomerular permeability and manifestation related to a decrease in GFR, fluid retention and nitrogenous waste accumulation.
characteristics: hematuria with red cell casts, a diminished glomerular filtration rate, azotemia (presence of nitrogenous wastes in the blood), oliguria, HTN

Question 11

Nephrotic Syndrome

Answer 11

produces an increase in glomerular permeability and manifestations of altered body function related to a massive loss of plasma proteins in the urine.
Characteristics: massive proteinuria (>3.5 g/day), lipiduria, hypoalbuniemia, generalized edema and hyperlipidemia

Question 12

Designation of glomerular disorders

Answer 12

nephritic syndromes
rapidly progressive glomerulonephritis, the nephrotic syndromes, asymptomatic disorders of urinary sediment, g chronic glomerulonephritis

Question 13

Nephritic Syndrome

Answer 13

produce a decrease in glomerular permeability and manifestation related to a decrease in GFR, fluid retention and nitrogenous waste accumulation.
classically hematuria
characteristics: hematuria with red cell casts, a diminished glomerular filtration rate, azotemia (presence of nitrogenous wastes in the blood), oliguria, HTN

Question 14

Nephrotic Syndrome

Answer 14

produces an increase in glomerular permeability and manifestations of altered body function related to a massive loss of plasma proteins in the urine.
classically massive proteinuria.
Characteristics: massive proteinuria (>3.5 g/day), lipiduria, hypoalbuniemia, generalized edema and hyperlipidemia

Question 15

Glomerular Lesions associated with systemic diseases

Answer 15

systemic erythematosus glomerulonephritis, diabetic glomerulosclerosis, HTN glomerosclerosis

Question 16

Tubulointerstitial disorders

Answer 16

acute or chronic.
Acute: sudden onset and signs and symptoms of interstitial edema. acute pyelonephritis and acute HTN to drugs
Chronic: interstitial fibrosis, atrophy and mononuclear infiltrates. most are asymptomatic

Question 17

Renal Tubular Acidosis

Answer 17

group of tubular defects in reabsorption of HCO3 or excretion of h ions that result in metabolic acidosis and its subsequent complications, including metabolic bone disease, kidney stones, and growth failure in children.

Question 18

Acute Pyelonephritis

Answer 18

upper UTI, renal parenchyma nd renal pelvis.
gram negative bacteria. e. coli
infection usually ascends from the lower UT.
factors: catheterization, vesicoureteral reflux, pregnancy, neurogenic bladder
Characteristics: abrupt onset of chills, high fever, ache or tender in CVT, lower UT symptoms, n/v, abdominal pain. pyruia. is not diagnostic.

Question 19

Wilms Tumor

Answer 19

childhood and renal neoplasms. onset a 3-5 years. one or both kidneys. genetic. chromosome 11.
well demarcated, can get large, HTN is shown for their age group.

Question 20

Renal Cell Carcinoma

Answer 20

adult kidney cancers.
90% of primary renal cancer
60-70 yo
hematuria.

Question 21

Renal Cell Carcinoma

Answer 21

adult kidney cancers.
90% of primary renal cancer
60-70 yo
hematuria.  gross or microscopic.
no pain, 
ultrasound or CT