ch30: alterations of renal and urinary tract

Question 1

what is ADH?

Answer 1

antidiuretic hormone

- helps to retain water

Question 2

what can a patient exhibit if they have metabolic acidosis?

Answer 2

kussmaul’s respirations/hyperventilation

Question 3

what are 2 causes of metabolic acidosis?

Answer 3

1. proximal renal tubular acidosis

2. distal renal tubular acidosis

Question 4

proximal renal tubular acidosis

Answer 4

contributes to metabolic acidosis with HCO3- (bicarbonate) loss = acidosis

Question 5

distal renal acidosis

Answer 5

contributes to metabolic acidosis by decreased H+ secretion = acidosis

Question 6

urinary stasis

Answer 6

urine not moving or being released

Question 7

hydroureter

Answer 7

water obstructing the ureters (can be a kidney stone)

Question 8

what is renal colic?

Answer 8

lower back (flank) pain associated with kidney problems

Question 9

hydronephrosis and ureterhydronephrosis

Answer 9

water backing up –> starts to affect the kidney –> fluid build up in the kidney can lead to tubulointerstitial fibrosis

Question 10

tubulointerstitial fibrosis

Answer 10

fluid back up into the kidneys can cause fibrosis and scarring (lots of fiber and collagen)
- can be irreversible and may lead to removal of kidney

Question 11

t/f: there is a lower likelihood of a UTI when there is urine obstruction

Answer 11

false

Question 12

low bladder wall compliance

Answer 12

bladder loses elasticity and can’t stretch as much

- loss of accommodation with a gradual pressure increase during filling

Question 13

hematuria

Answer 13

blood in the urine

Question 14

proteinuria

Answer 14

protein in the urine

Question 15

____ levels can rise in proteinuria

Answer 15

nitrogen

Question 16

compensatory hypertrophy

Answer 16

unaffected kidney tries to pick up the workload = over develop and thickening

Question 17

postobstructive diuresis

Answer 17

when obstruction is resolved = sudden increase in urinary output

Question 18

calculi

Answer 18

kidney/urinary stones

increased concentration of salts in urine

Question 19

what is the “nidus” of calculi (what is the development of calculi?)

Answer 19

an agglomeration of calcium phosphate/oxalate crystals allow kidney stones to form around

Question 20

idiopathic calcium urolithiasis (ICU)

Answer 20

when cause of kidney stones is idiopathic

Question 21

what is used to treat kidney stones and describe its process?

Answer 21

lithotripsy: noninvasive procedure in which the stones are zapped with concentrated sound waves –> shatter crystal –> easier passing

Question 22

neurogenic bladder dysfunction

Answer 22

nervous system that innervates the bladder is impaired

- this is the common cause of urinary incontinence in older age

Question 23

urethral stricture

Answer 23

narrowing of the urethra

- can be bc of UTI or genetics

Question 24

overactive bladder syndrome (OAB)

Answer 24

largely idiopathic, very common

Question 25

pelvic organ prolapse

Answer 25

bladder protrusion into the vagina to the point where you can see it out of the vagina

Question 26

cystocele

Answer 26

when the wall between bladder and vagina weakens

Question 27

prostatitis

Answer 27

inflamed prostate --> impaired ability to void urine

Question 28

what are three types of tumors that can occur in the urinary tract?

Answer 28

1. renal adenomas 2. renal cell carcinoma 3. bladder tumors

Question 29

renal adenomas

Answer 29

least common; almost always benign | adenoma = cancer that affects the glands of organs

Question 30

renal cell carcinoma (RCC)

Answer 30

more common; due to lifestyle, smoking, poor diet, alcohol | - can remove kidney if detected, prognosis depends on if you catch it in time

Question 31

why is it more common for women to get a UTI?

Answer 31

anus and urethra closer (perineum structure)

Question 32

uncomplicated UTI

Answer 32

does not go past urethra, responds better to treatment and does not come back

Question 33

complicated UTI

Answer 33

gets past urethra and spreads to other parts of the urinary system

Question 34

why is cystitis more common in women?

Answer 34

shorter urethra

Question 35

recurring UTI

Answer 35

treat, goes away, comes back | - higher chance of complicated UTI

Question 36

persistent UTI

Answer 36

treat, does not go away | - higher chance of complicated UTI

Question 37

pyelonephritis

Answer 37

UTI travels up to the ureters into the kidneys

Question 38

how to prevent UTI?

Answer 38

cranberry juice has EPICATECHIN: molecule that can cleanse the fimbriae and cillia and washes out the bacteria stuck

Question 39

what are some glomerular disorders?

Answer 39

- glomerulonephritis - nephrotic syndrome - nephritic syndrome - diabetic neuropathy/glomerulopathy

Question 40

t/f: glomerular disorders are usually inflammatory disorders that lead to a decrease in GFR

Answer 40

true

Question 41

glomerulonephritis (GN) - -> acute glomerulonephritis - -> chronic glomerulonephritis

Answer 41

inflammation of the glomerulus, can be a sequelae left behind by another disease - -> acute: because of an infectious disease or hypersensitivity - -> chronic: more common in diabetics

Question 42

rapidly progressive glomerulonephritis (RPGN) is cased by _____ and _____

Answer 42

type III hypersensitivity (Ag-Ab complexes deposit in tissues) and group a strep (streptococcal capsules)

Question 43

nephrotic syndrome

Answer 43

physical damage to kidney that leads to an increase of protein in urine (>3.5g/day)

Question 44

nephritic syndrome

Answer 44

acute, infectious disease that leads to protein AND blood in urine with possible purulent exudate hematuria + proteinuria + pus

Question 45

diabetic neuropathy/glomerulopathy

Answer 45

glomerulus begins to thicken and fibrose, lots of CARBS and SUGARS in the urine --> can start seeing scarring in kidney = impaired kidney function

Question 46

renal insufficiency vs renal failure

Answer 46

insufficiency: around 25% of normal function failure: significant loss of normal function and usually affects both kidneys

Question 47

end stage renal failure (ESRF)

Answer 47

kidney is functioning at or less than 10%

Question 48

what does ESRF usually present with?

Answer 48

uremia: urea + urine components in the bloodstream azotemia: high levels of nitrogen in bloodstream bc of protein breakdown oliguria: abnormally small amounts of urine anuria: lack of urination kussmaul's respiration

Question 49

acute kidney injury/acute renal failure - -> prerenal arf? - -> intrarenal arf? - -> postrenal arf?

Answer 49

sudden decline in kidney function with decrease GFR and urine output - -> prerenal arf: most common; obstruction or physiological imbalances before the kidney itself - -> intrarenal arf: problem within the kidney - -> postrenal arf: most rare; obstructive uropathy occuring in the bladder or later

Question 50

chronic kidney disease/chronic renal failure

Answer 50

progressive loss of renal function associated with systemic diseases and declining GFR