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Pathophysiology SU BSN > Ch. 39 > Flashcards

Ch. 39 Flashcards

1
Q

a blockage that inhibits the flow of urine through its normal path (the urinary tract), including the kidneys, ureters, bladder, and urethra.

A

Urinary Tract Obstruction (UTO)

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2
Q
  • Hydroureter: Dilation of the ureters
  • Hydronephrosis: Dilation of the renal pelvis and calyces
  • Ureterohydronephrosis: Dilation of both the ureters and the renal pelvis and calyces
  • Tubulointerstitial fibrosis: Deposition of excessive amounts of extracellular matrix by activated fibroblasts.

Kidney stones

A

Upper UTO complications

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3
Q
  • Neurogenic bladder

* Overactive Bladder Syndrome •Underactive Bladder Syndrome •Anatomic Obstructions to Urine Flow

A

Lower UTO

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4
Q
  • Renal Tumors

* Bladder Tumors

A

Tumors

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5
Q

Partially counteracts the negative consequences of unilateral obstruction.
➢ Compensatory growth of glomeruli

A

Compensatory hypertrophy and hyperfunction

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6
Q

➢ Due to relief of the obstruction.
➢≈ 10 L/ Day!
➢ May→ fluid and electrolyte imbalance

A

Postobstructive diuresis

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7
Q

􏰀 Are also called renal calculi or urolithiasis.
􏰀 Masses of crystals, protein, or mineral salts form
in the UT and may→ obstruction.

A

Kidney Stones

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8
Q

􏰀 Risk factors
➢ Male > female
➢ Most develop < 50 years of age
➢ Inadequate fluid intake: Most prevalent
➢ Geographic location: Temperature, humidity, rain fall
➢ Genetic
➢ Dietary patterns
➢ Infection
➢ Insulin resistance, T2DM, HTN, atherosclerosis, obesity,..

A

Risk factors of kidney stones

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9
Q

a. Calcium oxalate and calcium phosphate: 70-80%
• idiopathic calcium oxalate urolithiasis
b. Struvite (Mg ammonium phosphate): 1-5%, females
c. Uric acid: 5-10%, Gout

A

Mineral stones

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10
Q

Supersaturation

Precipitation

Crystallization or agglomeration (aggregation)

Presence or absence of stone inhibitors

A

Kidney stone Pathophysiology

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11
Q 
➢ Renal colic
➢ Hematuria (gross or microscopic) ➢ Urgency
➢ Frequency
➢ Urge incontinence
➢ Nausea and vomiting
A

Clinical manifestations of kidney stones

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12
Q

➢ Bladder dysfunction caused by neurologic disorders→

problems with urine storage or voiding

A

Neurogenic bladder

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13
Q

Overactive or hyperreflexive bladder.

A

Dyssynergia

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14
Q

Uninhibited or reflex bladder:

􏰁 Urine leakage and incontinence.

A

Detrusor hyperreflexia

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15
Q

􏰁 Both the bladder and the sphincter are contracting at the same time → functional obstruction of the bladder outlet
􏰁 ↓bladder relaxation→ ↑pressure→ overactive bladder- below

A

Detrusor hyperreflexia + vesicosphincter (detrusor sphincter)
dyssynergia

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16
Q

Underactive, hypotonic, or atonic bladder→ stress and overflow incontinence.

A

Detrusor areflexia

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17
Q
  1. Frequent daytime voiding: > every 2 hours while awake
  2. Nocturia: Night-time voiding
  3. Urgency: Often combined with hesitancy
  4. Dysuria
  5. Stream: poor force; intermittency
  6. Feelings of incomplete bladder emptying, despite micturition
A

Clinical manifestations of a lower UTO

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18
Q

A problem with bladder function that causes the sudden need to urinate.

A

Overactive bladder syndrome

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19
Q

↓ strength and/or duration of bladder contraction→ prolonged or incomplete emptying within a notmal time span.

A

Underactive Bladder Syndrome

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20
Q

➢ Spinal cord injury
➢ Stroke
➢ Multiple sclerosis
➢ Parkinson disease ➢ Diabetic neuropathy ➢ Aging

A

Causes of underactive bladder syndrome

21
Q

➢ Narrowing of lumen that occurs with infection, injury, or

surgical manipulation

A

Urethral stricture

22
Q

➢ Caused by acute inflammation, BPH, or prostate cancer

A

Prostate enlargement

23
Q

➢ Pessary: Rubber or silicone device designed to compensate

for vaginal wall prolapse

A

Pelvic organ prolapse

24
Q

➢ 4th most common in white men > 55 yrs

➢ Transitional cell carcinoma is the most common

A

Bladder tumors

25
Q

Premature newborns
• Prepubertal children
• Women:

  • Sexually active
  • Pregnant
  • Antibiotics (disrupt vaginal flora)
  • Spermicide users
  • Postmenopausal
  • Indwelling catheters
  • DM
  • Neurogenic bladder
  • UTO
  • Immunosuppressed
A

Risk factors of UTIs

26
Q

➢ Escherichia coli
➢ Staphylococcus saprophyticus
➢ Schistosoma haematobium the most common cause of parasitic invasion of the urinary tract on a global basis.

A

Most common pathogens of UTI

27
Q

➢ Ability to evade or overwhelm the host defense
mechanisms and cause disease in a host
➢ Adherence to the uroepithelium:
• Have pili or fimbriae or both
➢ Ability to resist the host’s defense mechanisms:
• Biofilms

A

Virulence of uropathogens

28
Q

➢ Inflammation of the bladder ➢ Acute or chronic

A

Cystitis

29
Q

➢ Acute infection of the ureter, renal pelvis, and/or

kidney interstitium

A

Acute pyelonephritis

30
Q

Persistent / recurrent kidney infection→ progressive inflammation, alterations of the pelvicalyceal system → destruction of the tubules → atrophy or dilation and diffuse scarring →→ impaired urine-concentrating ability → CKD

A

Chronic pyelonephritis (Ch interstitial nephritis)

31
Q

Autoimmune inflammation of glomeruli

A

Acute Glomerulonephritis

32
Q

Most common form of acute glomerulonephritis

Binding of abnormal IgA to mesangial cells in the glomerulus → injury and mesangial proliferation

A

IgA nephropathy (Berger Disease)

33
Q

Most common cause of acute glomerulonephritis

Complement-mediated glomerular injury → ↑ glomerular permeability
and glomerulosclerosis

A

Membranous nephropathy (GN)

34
Q

Rare injury that → proliferation of glomerular capillary endothelial cells → rapid RF.

A

Crescentic (Rapidly progressive) GN

35
Q

Immune complex in the mesangium → mesangial cell proliferation

A

Mesangial proliferative GN

36
Q

Involves mesangial cell proliferation, complement deposition, and crescent formation

A

Membranoproliferative GN

37
Q

Podocyte injury, progressive thickening and fibrosis of GBM, and expansion of the mesangial matrix.

A

Diabetic nephropathy

38
Q

A kidney disorder that causes the body to excrete too much protein in the urine.

A

Nephrotic Syndrome

39
Q

≈ 25% ↓ renal function

A

Renal insufficiency

40
Q

Significant loss of renal function

A

Renal failure

41
Q

<10% of renal function remains

A

End-stage renal failure

42
Q

A condition involving abnormally high levels of waste products in the blood.

􏰀 Syndrome of RF
􏰀 ↑serum urea and creatinine
􏰀 Fatigue, anorexia, nausea, vomiting, pruritus,
􏰀 Neurologic changes
􏰀 Retention of toxic waste
􏰀 Deficiency states
􏰀 Electrolyte disorders
􏰀 Proinflammatory state
A

Uremia

43
Q

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

􏰀 ↑serum urea and creatinine 􏰀 Renal insufficiency or RF→
azotemia

A

Azotemia

44
Q

Sudden ↓ in kidney function with a ↓GFR and accumulation of nitrogenous waste products in the blood
􏰀 ↑ serum creatinine and BUN

A

Acute Kidney Injury (AKI)

45
Q

a kidney disorder involving damage to the tubule cells of the kidneys, which can lead to acute kidney failure

A

Acute Tubular Necrosis

46
Q

urine output <0.5 mL/kg per hour and observed within the first 12 hours following recognition of septic shock

A

Oliguria in AKI

47
Q

Initiation

Extension

Maintenance

Recovery

A

Acute tubular necrosis phases

48
Q

Progressive loss of renal function associated with systemic diseases

A

Chronic Kidney Disease (CKD)

49
Q

➢ Proteinuria
• Promotes inflammation and progressive fibrosis → contributes to tubulointerstitial injury
➢ Angiotensin II
• Promotes glomerular HTN, and participates in
tubulointerstitial fibrosis and scarring.

A

Factors that advance CKD

Pathophysiology SU BSN (8 decks)

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