Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

understanding human disease > chap 15 - kidney and lower urinary tract (start of unit 5) > Flashcards

chap 15 - kidney and lower urinary tract (start of unit 5) Flashcards

1
Q

function of the kidney

A
  • Filters the blood
  • Remove water-soluble wastes
  • Help control blood pressure and composition
  • Help maintain red blood cell levels
  • Requirements for normal renal function
    • Blood (25% CO
    • Free flow of blood through the glomerular capillaries
    • Normally functioning filter that restricts passage of blood cells and protein
    • Normal outflow of urine
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

urinary tract

A

bilateral, retroperitoneal, kidneys
- divided into crotex and medulla

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

nephron

A

functional unit
components = glomerulus and renal tubule

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

tubules

A

flow of filtrate, ultimately becomes urine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

components of urine formation

A

filtration, reabsorption, secretion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

filtration barrier

A

endothelium, basement membrane, podocytes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

normal urine

A

Characteristics
- Bile pigments
- Protein absent or very small amounts
- Glucose absent
- Ketones absent
- Odorless
- pH 6.0
- Not cloudy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

most frequent and serious problems

A

UTIs, kidney stones, end-stage renal disease, malignancies of the urinary tract

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

common urination issues

A

polyuria, dysuria, nocturia, hematuria, anuria, oliguria

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

polyuria

A

increased frequency of urination

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

dysuria

A

painful urination

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

nocturia

A

increased urge to urinate at night

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

hematuria

A

blood in the urine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

anuria

A

complete absence of urination

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

oliguria

A

decreased urinary output

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

other signs and symptoms of urinary disorder

A

back or flank pain, fever, edema, hypertension

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

physical examination

A

palpation of flank and abdomen may detect tumors or distention of the bladder

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

microscopic examination of urine

A
  • red blood cells (glomerular injury)
  • white blood cells (infection in kidneys)
  • bacteria
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

urinalysis can detect

A
  • specific gravity
  • pH
  • presence of protein, sugar, nitrate, ketones, or leukocyte esterase
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

creatinine and blood urea nitrogen (BUN)

A
  • waste products in blood removed by kidneys
  • increase in blood volume would indicate kidney dysfunction
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

cystoscopy allows

A

inspection of mucosal lining of lower urinary tract, removal of stones, collection of biopsies for microscopic examination

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

urine assessment

A

urinalysis, urine culture, blood chemistry

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

genetic/developmental diseases

A

urinary tract anomalies, renal dysplasia, polycystic kidney disease, vesicoureteral reflux, anomalies of the kidney

24
Q

renal agenesis

A

failure of one or both kidneys to develop

25
Q

bilateral renal agenesis

A

rare, associated with other congenital anomalies, incompatible with life

26
Q

unilateral renal agenesis

A

common, asymptomatic, other kidney enlarges to compnesate

27
Q

malposition

A

associated with fusion of kidneys, horseshoe

28
Q

renal hyperplasia

A

Kidney does not fully develop during embryonic period
Small kidney, normal nephron, less #
Relatively common
1 in 200 babies
Unilateral or bilateral
Small kidney, disorganized and malformed tissue
Develop into cysts, not kidneys
Unilateral or bilateral
Severe bilateral dysplasia generally do not survive until birth

29
Q

hereditary polycystic kidney diseases

A

Kidney contains many cysts
- Cysts grow and replace normal kidney function
Caused by two genetic diseases
- Autosomal recessive polycystic kidney disease
- Autosomal dominant polycystic kidney disease

30
Q

autosomal recessive polycystic kidney disease

A

Infancy and early childhood
Always has associated liver involvement
Involves large gene called PKHD1
Rare = 1 in 20,000 births
Can be seen on prenatal ultrasound if severe

31
Q

autosomal dominant polycystic

A

Does not manifest until adulthood
Fairly common
Liver involvement less severe
More result from mutations in PKD1 or PKD2
Cysts develop insidiously
Reduced life expectancy
Can cause hypertension and chronic renal failure

32
Q

vesicoureteral reflux

A
  • Urine normally prevented from flowing back into the ureters during urination
  • Retrograde flow of urine
  • Failure of mechanisms allow urine to reflux into ureter during voiding
    • Predisposes to urinary tract infection
      • Pyelonephritis
33
Q

urinary tract infections

A

Very common
Bacteria contaminate perianal and genital areas and ascend urethra
Host defenses include:
- Washout phenomenon
- Complete bladder emptying
- Free urine flow
- Normal bacterial flora
- Acid urine
Symptoms?
Treatment?
Risk factors
- Any conditions that impairs free drainage of urine
- Female
- Sexual activity
- Diabetes
- Vesicoureteral reflux
- Catheterization

34
Q

pyelonephritis

A

Infection of the kidneys
- Usually develops from infection spreading from lower urinary tract
- Infection can also occur from bacteria spread through bloodstream to kidneys
Symptoms of pyelonephritis include sudden onset of:
- Flank pain
- Fever
- Leukocytosis
Gently thumping flank on affected side can elicit excruciating pain
Diagnosis
- Urinalysis shows kidney has white cells
- Urine may also have pus
Treatment
- Antibiotic therapy
- Alleviation of factor that has predisposed its development

35
Q

urolithiasis (kidney stones, renal calculi)

A

May form anywhere in urinary tract
Stones composed of calcium, uric acid
Symptoms
- Hematuria
- Flank pain
Risk factors
- Dehydration
- Metabolic disorders = gout
Diagnosis
- X-ray
- Ultrasound
Treatment
- Time to pass
- Cystoscopy: snares and removes stones lodged in distal ureter
- Pain medication and large volumes of water
- Shock wave lithotripsy: stones lodged in proximal ureter are broken into fragments that are readily excreted

36
Q

urinary obstruction

A

Blockage of urine outflow leads to dilation of urinary tract upstream, eventually causes compression and atrophy of kidneys
Causes
- Bilateral: obstruction by enlarged prostate
- unilateral: kidney stones, tumor
Complications
-Stone formation; infections

37
Q

glomerular diseases

A

Group of diseases
Due to damage of major components of the glomerulus
Endothelium
Podocytes
Basement membrane
Immunologically mediated
Immune complexes form in blood in response to non-kidney related disease and are deposited on basement membrane of glomerulus
Antibodies are formed against components of glomerulus
Basement membrane of glomerulus
Can be considered in terms of whether they are primary or secondary to some other systemic disease → diabetes mellitus, hypertension, SLE
Patterns of injury can be further defined by:
Chronic or acute
Whether injury involves majority of glomeruli or some glomeruli
Whether the entire glomerulus or only parts of it are involved
What anatomic part of the glomerulus is affected
First layer is the endothelial cells
Sit on basement membrane
Podocytes

38
Q

clinical hallmarks of glomerular diseases

A

loss of kidney function, edema

39
Q

nephrotic syndome

A

classification of glomerular disease
Massive proteinuria
The protein comes from albumin in the blood
Leads to hypoalbuminemia
Lost in osmotic pressure which is what results in edema
Results in edema

40
Q

nephritic syndrome

A
  • inflammation induced injury of capillary
  • less severe proteinuria
  • hematuria
    classification of glomerular disease
41
Q

focal segmental glomerulosclerosis

A

Not all glomeruli are affected
Only parts of affected glomeruli are sclerotic
Epithelial cell foot processes are disrupted
Protein deposits occlude capillaries
Glomeruli become progressively sclerotic
Can lead to end-stage renal disease
Where your kidneys aren’t able to do their job – dialysis
-Sclerosis = hardening
Focal = one small part of the whole thing

42
Q

glomerulonephritis

A

Acute post infectious glomerulonephritis
Inflammation of the glomerulus (break down the word)
Usually follows a bacterial infection
Circulating antigen and antibody complexes deposit on glomeruli
Leukocytes release enzymes, causing inflammation

43
Q

acute post infections: glomerulonephritis

A

Clinical course
Sudden onset in child
Edema
Nausea, malaise, fever
Oliguria - urinating less than normal - tells you the kidneys are starting to not work as well
Hypertension - because you aren’t getting rid of the fluids that you would during urination, so the fluids just stay in your body, blood volume goes up – blood pressure goes up
Elevation of BUN = blood urea nitrogen - what is filtered most by the kidney
Urine
RBC
Protenuria
Prognosis = 95% children recover - if caught on time, if not then waste products can accumulate

44
Q

glomerulusclerosis

A

Nephrosclerosis, sclerosis = hardening
Complication of hypertension, diabetes
If you have both of these it can make it even worse
Renal arteries undergo thickening, scarring
Glomeruli and tubules undergo secondary degenerative changes
Narrowing of lumen and reduction in blood flow
Reduced glomerular filtration
Kidneys shrink - atrophy
Supplying it with less blood
May lead to chronic renal failure
Treatment? Dialysis

45
Q

diabetic nephropathy

A

Pathology of the nephron due to diabetes (breaking down the word)
Complication of long-standing diabetes (type I and type II)
Damage to micro vessels (due to sugar getting attached to the blood vessels and leading to damage)
Most common cause of renal failure
Glomerulosclerosis
Decreased surface area for filtration
Manifestations
Progressive impairment of renal function
No specific treatment can arrest progression of disease
Controlling blood sugars, know that you are diabetic
Progressive impairment of renal function may lead to renal failure

46
Q

interstitial disease

A

Interstitial nephritis = inflammation
Spaces between tubules become inflamed
Most commonly caused by allergic reaction to drug
Your kidneys filter out the antibiotics, so they are exposed to high levels of the drug that you are taking so if you are allergic it can have a negative impact
May be completely asymptomatic or may cause
Fever
Nausea and vomiting
Skin rash
Edema and hematuria

47
Q

bladder cancer

A

Urothelial carcinoma
Smoking = most common risk factor
Exposed to high levels of toxins

48
Q

cancer of the kidney in children

A

Nephroblastoma = wilms tumor (of the kidneys)
Rare, highly malignant

49
Q

cancer of the kidney in adults

A

renal cell carcinoma
Risk factors
Smoking
Age
Males
Chronic kidney disease
Hematuria often first symptom

50
Q

organ failure

A

Does not occur until both kidneys are severely compromised
Less waste is removed - waste starts to build up
Types
Acute - often reversible
Chronic
Problem = more waste remains in the blood

51
Q

renal failure

A

Manifested as uremia = urine in the blood
Renal filtering function decreases
Altered fluid and electrolyte balance
Acidosis, hyperkalemia, salt wasting, hypertension
Wastes build up in blood
Increaseed creatinine and BUN
Toxic to CNS, RBCs, platelets
Kidney metabolic functions decrease
Decreased erythropoietin
Less red blood cells → anemia
Decreased vitamin D activation
Vitamin D → bone building, have to activate vitamin D in order for it to be used by the body, so no matter how much you consume the kidneys are required to bind it and make it work

52
Q

acute renal failure

A

Sudden and rapidly progressive within hours (often reversible) abrupt reduction in renal function
Oliguria, anuria

53
Q

chronic renal failure

A

Chronic, slowly progression to end-stage renal failure over months or years

54
Q

acute tubular necrosis

A

damage to tubules
Pathogenesis
Impaired renal blood flow
Shock
DIC
Toxic drugs or chemicals
Antifungal medications
Antibiotics
Clinical manifestation
Acute renal failure
Oliguria, anuria
Survival rate 50%
Tubular function may gradually recover
Treated by dialysis until function returns

55
Q

chronic renal disease

A

The irreversible loss of renal function that affects nearly all organ systems
Little bit lost at a time and continues to be lost
Main causes in U.S
Hypertension
Diabetes
Progression
Reduced renal reserve
Renal insufficiency
Renal failure
End-stage renal disease

56
Q

treatment for renal fialure

A

dialysis
- peritoneal or extracorporeal
kidney transplant

understanding human disease (25 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions