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PATHOPHYSIOLLOGY > Ch.25 & 27: Renal and Urinary > Flashcards

Ch.25 & 27: Renal and Urinary Flashcards

1
Q

functional unit of the kidney
works 24/7 continously
permeable to water and impermeable to protein or any large particles

A

nephron

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2
Q

final concentration of urine is located in

A

the distal tubule

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3
Q

What is the primary function of the kidney

A

to filter electrolytes, filter the waste, and homeostasis
maintain fluid/volume balance
hormones

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4
Q

where is urine formed?

A

glomerulus

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5
Q

how many mL does the kidney filter per minute

A

125 ml per minute
(250 ml of fluid in bladder- uncomfy)
(500 mL- needa pee)

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6
Q

Function of the kidney:

production include

A

renin
erythropoietin
vitamin D

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7
Q

Function of the kidney:

Regulation and excretion

A 
reg ECF
reg. osmolarity
reg. pH
reg. key ions
excrete waste and toxins
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8
Q

XXXX-Angiotensin-Aldosterone Mechanism System: BP regulation
Synthesized and stored in juxtaglomerular kidney cells
vital sign: low bp**, hypovolemia, diminished perfusion

A

renin

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9
Q

stimulates RBC production, kidneys send the signal. Hypoxia stimulation, by triggering RBC prod in bone marrow. leads to anemia

A

erythropoietin

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10
Q

Obtained via diet
Synthesized by UV radiation on cholesterol in skin
Metabolically activated in liver and kidney

A

activation of vitamin D (aids with calcium absorption)

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11
Q

Kidneys affect on body:

A 
waste products
bone
regulate blood acidity 
blood pressure
blood production
cardiac activity (potassium balance)
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12
Q

General examination of urine to establish a tentative diagnosis and determine whether further studies are to be ordered
Normal urine is clear, amber-colored fluid (no protein)

A

urinalysis

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13
Q

Ability of the kidney to filter and reabsorb and/or secrete substances in the blood.

A

Renal creatinine

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14
Q

Importance of protein

A

building/repairing muscle
immunity
blood clotting
if loss- third spacing

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15
Q

helps to visualize the kidneys, IV contrast (iodine) - allergy* do not wear any metal

A

MRI

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16
Q

Failure to store urine

Incontinence

A

Splastic bladder dysfunction

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17
Q

Failure to completely empty bladder

Urinary retention

A

flaccid bladder dysfunction

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18
Q

Causes of urinary obstruction with stasis or retention of urine include

A

Congenital

Acquired: BPH, Calculi, Tumors, scar tissue, spinal cord injury, enlarged prostate, and pregnancy

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19
Q

Major sites and causes of urinary obstruction:

A 
fibrous band 
dysplasia
prostate hypertrophy
stenosis
polycystic kidney
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20
Q 
increases with age
Hesitancy  (dribbling, weak urinary stream)
Frequency
Urgency
Dysuria Nocturia
Hematuria
Urinary retention
Enlarged prostate
Not infection-related
A

Benign Prostatic Hypertrophy

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21
Q

Inflammation of prostate
Prostate can be enlarged
Caused by infection
Curable in many patients
May experience pain with urination, ejaculations
May have constant pain related to inflammation
Can by asymptomatic

A

prostatitis

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22
Q

Crystalline structures that form from components of the urine

A

Nephrolithiasis-kidney stones

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23
Q

a general term referring to stones anywhere in the urinary tract, ureter, bladder, or urethra.

A

Urolithiasis-urinary stones

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24
Q

Causes of kidney/urinary stones:

A

Obstruction and urinary stasis
Hypercalcemia
Dehydration
Immobility

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25
Q

Clinical Manifestations of renal/ ureteral calculi

A

. Severe pain: depends on location of stone

  1. Diaphoresis
  2. Nausea/vomiting
  3. Fever
  4. Chills
  5. Hematuria,WBCs in urine
26
Q 
Pain: 
Acute
Extreme pain
 Colicky 	pain 
Location:
Flank, radiating to groin
A

Renal colic

27
Q

Pain:
Acute
Intermittent excruciating pain
Flank and upper outer quadrant of abdomen
Men:
May radiate to lower abdominal-bladder area and scrotum

A

Ureter colic

28
Q

Types of incontinence:

cough, laugh, dribble urine, lose of muscle tone- strength

A

stress incontinence

29
Q

Types of incontinence:

bladder oversensitivity from infection, neurologic

A

urge incontinence

30
Q

Types of incontinence:

bladder fills up, cannot get emptied, leaks out

A

overflow

31
Q

ELDERLY URINARY INCONTINENCE:

A 
Dementia
Infection 
Aatrophy
Pharmaceutical
Psychologic
Excessive excretion
Restrict mobility
Stool impaction
32
Q

Lower urinary tract

A

cystitis

33
Q

upper urinary tract

A

pyelonephritis

34
Q

special uti considerations include

A

sexually active women
pregnant women
diabetics
age-related

35
Q

Anatomic obstructions- UTI associated with stasis of urine flow

A

Urinary tract stones
Prostatic hyperplasia
Pregnancy
Malformations of the ureterovesical junction

36
Q

Functional obstructions - UTI associated with stasis of urine flow

A 
Neurogenic bladder
Infrequent voiding
Detrusor (bladder) muscle instability
Constipation
Increased pressure resulting in reflux
37
Q

Most common causes of UTI related to bacteria that enter the urethra:

A 
Escherichia coli
AKA: E. coli
Main causative organism
Staphylococcus aureus
Enterobacter
38
Q

urine bladder into the kidney

A

vesicouretreral reflux

39
Q 
Associated signs/symptoms:
        Urgency, frequency, dysuria, lower abdominal or 	back discomfort. Occasionally cloudy and foul-	smelling urine. Fever may or may not be present
B. Diagnosis:
      1. Inflammation of bladder
     2. Predisposing 	factors:
	a. Females more prone
	b. Catheterization
A

cystitis

40
Q

Pathogenesis of urinary tract infection

A 
colonization
uroepithelium penetration
ascension
pyelonephritis
acute kidney injury
41
Q

Upper urinary tract
Inflammation of kidney medulla, parenchyma, & renal pelvis, affecting tubules
Responds well to 2 weeks of organism-specific antibiotic therapy

A

Acute Pyelonephritis

42
Q

Persistent or recurrent infection of the kidney by the same organism associated with resulting inflammation and scarring of the kidney: Reflux
Structural abnormalities. Impairs the function of the kidneys and can lead to Chronic Kidney Disease

A

Chronic pyelonephritis

43
Q

Clinical manifestations of pyelonephritis:

A 
abrupt shaking
mod-high fever
ache in loin
malaise
CVA tenderness
bacteria and WBC in urine- uti symptomes
nausea and vomitting
44
Q

Bladder inflammation

E. coli, staph aureus, Enterobacter, Klebsiella

Bacterial contamination by vaginal secretions, sexual intercourse, close proximity to anus, neurogenic bladder, urinary catheters, prostatic hypertrophy, reflux

Frequency, urgency, burning w/urination, suprapubic & low back pain

Hematuria & cloudy urine (serious), foul odor

A

cystitis

45
Q

Inflammation of the kidney, medulla, parenchyma, & renal pelvis

E. coli, proteus, pseudomonas, fungi

Vesicoureteral reflux, vaginal secretions, kidney stones, neurogenic bladder, urinary catheters, sexual intercourse

Fever, chills, flank pain, WBCs in medulla, renal inflammation, renal inflammation, edema, purulent urine (foul odor), poss. hypertension

Urinalysis, urine culture, CBC

A

pyelonephritis

46
Q

Fluid filled cavities in the kidney
Cysts may be single or multiple
Mostly inherited, but may be acquired later in life
Autosomal dominant most common inherited kidney disease
May cause kidney failure

A

cystic kidney disease

47
Q

Complete failure of organ to develop
Bilateral agenesis = incompatible with extrauterine life
Unilateral agenesis = compatible w/life if no other abnormalities

A

renal agenesis

48
Q

Small kidneys
Less than normal # of calyces and nephrons
Can be unilateral or bilateral
Bilateral involvement progresses to renal failure
History of polyuria and polydipsia

A

renal hypoplasia

49
Q

Multidifferentiated primitive structures, primarily renal tubules
Can affect all or part of kidney
Palpable mass early in childhood
Risk of neoplasms
Annual follow-ups for BP, check for kidney function

A

renal dysplasia

50
Q

RENAL TUMORS:
Benign
Predisposition for malignancy

A

renal adenoma

51
Q

RENAL TUMORS:
Most common renal neoplasm
Classified according to cell type, extent of metastasis

A

renal cell carcinoma

52
Q

RENAL TUMORS:
Rare
Usually males, 50-60 years old
Risks: smoking, obesity, uncontrolled hypertension

A

renal transitional cell carcinoma

53
Q

BLADDER TUMORS:

A 
5th most common malignancy
>male 60 years
risk smoking, aromatic mines
metastasis to lymph nodes, live, bones, or lungs
gross painless hematuria
54
Q

most common bladder malignancy

A

transitional cell carcinoma

55
Q

the amount of blood filtered each minute in the glomerulus

A

GFR

56
Q

Glomerular injury causes

A

Infectious microorganisms
Immunologic mechanisms
Environmental agents
Drugs

57
Q 
Causes:
Systemic diseases (diabetes, lupus)

Damaged glomeruli
3+ grams of protein in 24 hours leaks into urine

Signs/Symptoms:
Weight gain, edema, fatigue, foamy urine, loss of appetite

A

nephrotic syndrome

58
Q

Symptoms of nephrotic syndrome include

A

proteinuria
hyperlipidemia
hypoalbuminemia

59
Q

Characteristic Manifestations of Nephrotic Syndrome

A 
Edema
Ascites
Massive proteinuria
Hypertension
Hyperlipidemia 
Hypoalbuminemia
Foamy urine
60
Q

Encompasses several glomerular diseases
Progressive, leading to chronic kidney failure
Primary cause may be difficult to establish
Secondary causes
DM
Lupus erythematosus
Renal insufficiency nephrotic syndrome accelerated progression ESRD

A

Chronic Glomerulonephritis

PATHOPHYSIOLLOGY (9 decks)

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