ch30: alterations of renal and urinary tract Flashcards
what is ADH?
antidiuretic hormone
- helps to retain water
what can a patient exhibit if they have metabolic acidosis?
kussmaul’s respirations/hyperventilation
what are 2 causes of metabolic acidosis?
- proximal renal tubular acidosis
2. distal renal tubular acidosis
proximal renal tubular acidosis
contributes to metabolic acidosis with HCO3- (bicarbonate) loss = acidosis
distal renal acidosis
contributes to metabolic acidosis by decreased H+ secretion = acidosis
urinary stasis
urine not moving or being released
hydroureter
water obstructing the ureters (can be a kidney stone)
what is renal colic?
lower back (flank) pain associated with kidney problems
hydronephrosis and ureterhydronephrosis
water backing up –> starts to affect the kidney –> fluid build up in the kidney can lead to tubulointerstitial fibrosis
tubulointerstitial fibrosis
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
t/f: there is a lower likelihood of a UTI when there is urine obstruction
false
low bladder wall compliance
bladder loses elasticity and can’t stretch as much
- loss of accommodation with a gradual pressure increase during filling
hematuria
blood in the urine
proteinuria
protein in the urine
____ levels can rise in proteinuria
nitrogen
compensatory hypertrophy
unaffected kidney tries to pick up the workload = over develop and thickening
postobstructive diuresis
when obstruction is resolved = sudden increase in urinary output
calculi
kidney/urinary stones
increased concentration of salts in urine
what is the “nidus” of calculi (what is the development of calculi?)
an agglomeration of calcium phosphate/oxalate crystals allow kidney stones to form around
idiopathic calcium urolithiasis (ICU)
when cause of kidney stones is idiopathic
what is used to treat kidney stones and describe its process?
lithotripsy: noninvasive procedure in which the stones are zapped with concentrated sound waves –> shatter crystal –> easier passing
neurogenic bladder dysfunction
nervous system that innervates the bladder is impaired
- this is the common cause of urinary incontinence in older age
urethral stricture
narrowing of the urethra
- can be bc of UTI or genetics
overactive bladder syndrome (OAB)
largely idiopathic, very common
pelvic organ prolapse
bladder protrusion into the vagina to the point where you can see it out of the vagina
cystocele
when the wall between bladder and vagina weakens
prostatitis
inflamed prostate –> impaired ability to void urine
what are three types of tumors that can occur in the urinary tract?
- renal adenomas
- renal cell carcinoma
- bladder tumors
renal adenomas
least common; almost always benign
adenoma = cancer that affects the glands of organs
renal cell carcinoma (RCC)
more common; due to lifestyle, smoking, poor diet, alcohol
- can remove kidney if detected, prognosis depends on if you catch it in time
why is it more common for women to get a UTI?
anus and urethra closer (perineum structure)
uncomplicated UTI
does not go past urethra, responds better to treatment and does not come back
complicated UTI
gets past urethra and spreads to other parts of the urinary system
why is cystitis more common in women?
shorter urethra
recurring UTI
treat, goes away, comes back
- higher chance of complicated UTI
persistent UTI
treat, does not go away
- higher chance of complicated UTI
pyelonephritis
UTI travels up to the ureters into the kidneys
how to prevent UTI?
cranberry juice has EPICATECHIN: molecule that can cleanse the fimbriae and cillia and washes out the bacteria stuck
what are some glomerular disorders?
- glomerulonephritis
- nephrotic syndrome
- nephritic syndrome
- diabetic neuropathy/glomerulopathy
t/f: glomerular disorders are usually inflammatory disorders that lead to a decrease in GFR
true
glomerulonephritis (GN)
- -> acute glomerulonephritis
- -> chronic glomerulonephritis
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
rapidly progressive glomerulonephritis (RPGN) is cased by _____ and _____
type III hypersensitivity (Ag-Ab complexes deposit in tissues)
and
group a strep (streptococcal capsules)
nephrotic syndrome
physical damage to kidney that leads to an increase of protein in urine (>3.5g/day)
nephritic syndrome
acute, infectious disease that leads to protein AND blood in urine with possible purulent exudate
hematuria + proteinuria + pus
diabetic neuropathy/glomerulopathy
glomerulus begins to thicken and fibrose, lots of CARBS and SUGARS in the urine
–> can start seeing scarring in kidney = impaired kidney function
renal insufficiency vs renal failure
insufficiency: around 25% of normal function
failure: significant loss of normal function and usually affects both kidneys
end stage renal failure (ESRF)
kidney is functioning at or less than 10%
what does ESRF usually present with?
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
acute kidney injury/acute renal failure
- -> prerenal arf?
- -> intrarenal arf?
- -> postrenal arf?
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
chronic kidney disease/chronic renal failure
progressive loss of renal function associated with systemic diseases and declining GFR
