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chapter 33 and 35: disorders of renal function Flashcards

1
Q

__ remove excess water by the kidneys (not used if renal disease is present)

A

diuretics

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2
Q

diuretics __ urine

A

dilute

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3
Q

diuretics are used for __, __, ___, and __

A

htn; congestive heart failure; pulmonary edema; anascara (generalized edema)

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4
Q

diuretics are used for htn because it gets rid of __ and water. sodium takes water with it from the blood, __ (increasing/decreasing) the amount of fluid flowing through the blood vessels, which __ (lowers/increases) blood pressure

A

sodium; decreasing; lowers

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5
Q

diuretics are used for congestive heart failure because it removes unneeded __ and salt, which makes it __ (easier/harder) for the heart to pump. it eases __ and water ___.

A

water; easier; swelling; builup

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6
Q

diuretics are used for pulmonary edema and anascara to get rid of __ fluid

A

excess

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7
Q

the 4 diuretics are: __, __, __, and __

A

hydrochlorothiazide; furosemide; spironolactone; osmotic diuretic

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8
Q

hydrochlorothiazide is a __ (mild/potent) diuretic that leads to __ wasting

A

mild; potassium

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9
Q

furosemide is a __ (mild/potent) diuretic that leads to __ wasting

A

potent; potassium

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10
Q

furosemide can have the side effects of __ and __ hypotension

A

excessive loss of electrolytes; orthostatic hypotension

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11
Q

the side effect of excessive loss of electrolytes for furosemide can cause __ and __

A

muscle weakness; arrhythmias

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12
Q

spironolactone is a __ (osmotic/potassium sparing) diuretic

A

potassium sparing

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13
Q

these drugs lower K+ in spironolactone

A

aldosterone antagonists

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14
Q

a(n) __ (osmotic/furosemide) diuretic is given through an IV

A

osmotic

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15
Q

the relationship between creatinine and renal function are a(n) __ (direct/inverse) relationship

A

inverse

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16
Q

as renal function __ (increases/declines), creatinine levels __ (increase/decrease)

A

declines; increase or increases; decrease

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17
Q

__ is the loss of voluntary control of the bladder due to many causes

A

incontinence

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18
Q

the five types of incontinence are __, __, __, __, and __

A

stress; urge; mixed; overflow; functional (ACRONYM: SUMOF)

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19
Q

__ (overflow/stress/mixed/urge/functional) incontinence is where an increase in intra-abdominal pressure forces urine through the external sphincter due to things like coughing or laughing

A

stress

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20
Q

__ (stress/urge/mixed/overflow/functional) incontinence is the involuntary loss of urine associated with a strong desire to void

A

urge

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21
Q

__ (mixed/overflow/functional) incontinence is the combination of stress and urge incontinence

A

mixed

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22
Q

__ (stress/mixed/urge/overflow/functional) incontinence is urine loss when bladder pressure exceeds the maximum urethral pressure, causing __ distention in the absence of muscle contraction (outflow obstruction)

A

overflow; bladder

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23
Q

__ (stress/urge/mixed/combination/functional) incontinence is a physical/mental impairment that keeps you from making it to the toilet in time

A

functional

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24
Q

“bed wetting” is also known as __ (continuous urinary leakage/postmicturition dribble/nocturnal enuresis)

A

nocturnal enuresis

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25
Q

__ is where the urine remaining in the urethra after voiding the bladder slowly leaks out after urination

A

postmicturition dribble

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26
Q

__ is constant leakage of urine due to an inherited abnormality or sphincter (valve) injury

A

continuous urinary leakage

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27
Q

__ is the inability to empty the bladder

A

retention

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28
Q

__ blocks the micturition reflex and leads to the retention of urine where a catheter is needed

A

spinal damage at the sacral level or after anesthesia

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29
Q

when assessing bladder function, you must observe __, __, and __ for __ obstruction

A

frequency; hesitancy straining to urinate; weak/interrupted urine stream; out flow

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30
Q

__ gives us information about the amount of urine left in the bladder after voiding

A

post void urine residual volume

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31
Q

__ (renal agenesis/renal hypoplasia/renal dysplasia/horseshoe kidney) is the complete failure of the kidney to develop (born w/o one or both kidneys)

A

renal agenesis

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32
Q

__ (renal agenesis/renal hypoplasia/renal dysplasia/horseshoe kidney) are when the kidneys are smaller in size and have less calyces and nephrons

A

renal hypoplasia

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33
Q

__ (renal agenesis/renal hypoplasia/renal dysplasia/horshoe kidney) is the undifferentiated structures in the kidney

A

renal dysplasia

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34
Q

__ (renal agenesis/renal hypoplasia/renal dysplasia/horseshoe kidney) is when the patient’s kidneys fuse together to form a horseshoe-shape during development in the womb

A

horseshoe kidney

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35
Q

__ are epithelial lined cavities filled with fluid or semisolid material

A

renal cysts

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36
Q

renal cysts can be __, __, and __

A

single; multiple; symptomatic vs asymptomatic

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37
Q

polycystic kidney disease is __ (genetic/acquired)

A

genetic

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38
Q

polycystic kidney disease is __ (autosomal dominant/autosomal recessive) in adults and __ (autosomal dominant/autosomal recessive) in children

A

autosomal dominant; autosomal recessive

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39
Q

polycystic kidney disease is __ (autosomal dominant/autosomal recessive) in adults and __ (autosomal dominant/autosomal recessive) in children

A

autosomal dominant; autosomal recessive

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40
Q

an __ cystic disorder can have simple cysts

A

acquired

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41
Q

acquired cystic disorders __, produces __, __, __, and __

A

usually do not produce any s/s; flank pain; hematuria; infection; htn

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42
Q

__ and __ dialysis can cause the formation of renal cysts. its bleeding can cause __

A

end stage renal disease; prolonged; hematuria

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43
Q

antiglomerular membrane antibodies causes __ to the __ membrane leading to __ syndrome

A

damage; basement; nephrotic

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44
Q

circulating antigen-antibody complex deposition causes __ to the __ membrane and leads to __ syndrome

A

damage; glomerulus; nephritic

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45
Q

this kind of glomerular damage has an increase in the amount of extracellular matric

46
Q

glomerular damage __ (increases/decreases) permeability to glomerular membrane which allows __, __, or __ to pass into the urine

A

increases; blood cells; lipids; proteins

47
Q

acute nephritic syndrome, rapidly progressive glomerulonephritis, nephrotic syndrome, IgA nephropathy, herediatry nephritis, and chronic glomerulonephitis are __ of glomerular function

48
Q

acute nephritic syndrome = ___

A

acute postinfectious glomerulonephritis

49
Q

acute nephritic syndrome includes a __ inflammatory response, and acute __ glomerulonephritis, which develops around 7-10 days following strep infection (group A beta-hemolytic streptococcus)

A

proliferative; poststreptococcal

50
Q

acute nephritic syndrome is a __ (type 1/type 2/type 3/type 4) hypersensitivity reaction because after a strep infection, some of the antibodies are “hanging out” and are deposited into the glomerular vessels (activates complement)

51
Q

the s/s of acute nephritic syndrome include: 1) __ (swelling of the kidneys) 2) dark cola-colored and cloudy __ 3) __ (increased/decreased) urine production as GFR (increases/declines) leading to oliguria and 4) __ (increased/decreased) BP due to __ (increased/decreased) GFR and increased renin

A

flank pain; urine; decreased; declines; increased; decreased

52
Q

__, __, and __ can be signs of acute nephritic syndrome

A

proteinuria; hematuria; erythrocyte casts

53
Q

__ and __ result due to decreased urine production as GFR declines

A

azotemia (nitrogenous wastes in blood); edema

54
Q

acute nephritic syndrome can be tested with __ tests

55
Q

these 4 signs can indicate acute nephritic syndrome in the blood tests: __, __, __, and __

A

elevated serum urea & creatinine; decreased compliment; increased strep antibodies (aso); metabolic acidosis: decreased serum bicarbonate

56
Q

1) antibiotics 2) sodium restriction 3) fluid and protein restriction (severe cases) 4) prophylactic antibiotics and 5) corticosteroids and meds are treatments for __

A

acute nephritic syndrome

57
Q

antibiotics help to __ strep infection

58
Q

prophylactic antibiotics __ recurring infection and inflammation

59
Q

corticosteroids and meds __ immune system

60
Q

__ can result into chronic renal failure

A

chronic glomerulonephritis (fibrosis)

61
Q

lupus, diabetes, and infection can cause __

A

nephrotic syndrome

62
Q

in __ (acute nephritic syndrome/nephrotic syndrome), you can see hypoalbuminemia, imunoglobulins and complement, decreased binding proteins, and loss of clotting and anticlotting factors

A

nephrotic syndrome

63
Q

hypoalbuminemia leads to __

A

generalized edema, hyperlipidemia, salt and water retention, increased active drug

64
Q

immunoglobulins and complement lost in urine results in __

A

decreased immune function

65
Q

decreased binding proteins result in __

A

low ions and hormones

66
Q

loss of clotting and anticlotting factors can result in __

A

thrombosis

67
Q

__ are when bacteria enter through the urethra

A

urinary tract infections

68
Q

__ (keep urinating out, hydrate), __ (prevents pathogens from attaching to bladder wall), __, __, and __ and prostate secretions are host defenses of uti’s

A

washout phenomenon; protective mucin layer; local immune responses and IgA; normal bacterial flora and prostate secretions

69
Q

lower uti’s are called __

A

cystitis and urethritis

70
Q

upper uti’s are called __

A

pyelonephritis

71
Q

__ and __ are more susceptible to a uti

A

females; males with prostate hypertrophy

72
Q

__: incomplete emptying of the bladder, __ of urine, __ to urine flow, __ are not flushed out of the bladder and consequently begin to __

A

incontinence; bladder retention; obstruction; bacteria; divide

73
Q

these 5 factors all contribute to infection because urine and its contaminants DO NOT flow through and out of the system

A

pregnancy
scar tissue
congenital defects
renal calculi
vesicoureteral reflex

74
Q

__ can be determined by:
an inflamed urethra and bladder wall
reduced bladder capacity
lower abdominal pain
dysuria (frequency and urgency are common as inflamed bladder is irritated by urine)
systemic signs of infection (fever, malaise, nausea, leukocytosis)

75
Q

cystitis is diagnosed by a __

A

urinalysis (bacteria, pyuria, hematuria; cloudy and smelly urine)

76
Q

structural or functional urinary tract abnormalities is called __

A

(complicated) pyelonephritis

77
Q

pyelonephritis is considered an __

78
Q

true or false. anything that results in the retention of urine can lead to cystitis and then pyelonephritis

79
Q

outflow obstruction, pregnancy, neurogenic bladder, and vesicourethral reflux required are factors of __

A

complicated pyelonephritis

80
Q

pyelonephritis involves __ (one/both/one or both) kidney(s)

A

one or both

81
Q

pyelonephritis involves the __, __, and the __ in ascending infection

A

renal pelvis; ureters; medullary tissue

82
Q

pyelonephritis is usually caused by __

83
Q

__ exudate fill the kidney __ and the __ are inflamed with necrosis

A

purulent; pelvis; medullary tubules

84
Q

if pyelonephritis is severe, it can __ the renal artery and vein and obstruct __

A

compress; urine flow

85
Q

urinary casts of leukocytes or renal epithelial cells
dull, aching flank pain (stretching of renal capsule)
chills w/moderate-high fever

are all __ of pyelonephritis

A

signs and symptoms

86
Q

the 2 treatments for pyelonephritis include:

A

antibiotics and increase water intake

87
Q

an __ disorder can be considered unilateral or bilateral, partial or complete, sudden or insidious, or urethra to renal pelvis

A

obstructive

88
Q

congenital abnormalities, stones, pregnancy, scar tissue, bph, and spinal cord injury are __ of obstructive disorders

89
Q

obstructive disorders are classified based on __, __, and __

A

site; degree; duration (SDD)

90
Q

in order for something to be a lower urinary tract obstruction, it must be __ and __

A

below the uretero-vesical junction; bilateral

91
Q

in order for something to be an upper urinary tract obstruction, it must be __ and __

A

above the uretero-vesical junction; unilateral

92
Q

an obstruction that lasts only a few days is considered __ and leads to the formation of __

A

acute; renal calculi (kidney stones)

93
Q

an obstruction that develops slowly for a long time is considered __ and can result in __

A

chronic; congenital ureterovesical abnormalities

94
Q

bilateral acute obstruction is considered __ (acute/chronic/acute renal failure) and can lead to __ (acute renal failure/chronic renal failure)

A

acute renal failure; chronic renal failure

95
Q

__ and __ can result due to dilation of the renal tubules/tract

A

hydronephrosis; stasis of urine

96
Q

__ occurs when the renal pelvis and calyces (usually unilateral) are dilated by the filling of urine

A

hydronephrosis

97
Q

hydronephrosis can result in: __, __, and __

A

increased pressure inside renal capsule (damage due to back pressure); compartment syndrome compresses blood vessels inside kidney; renal ischemia

98
Q

risk for infection is found as a result of __ due to the dilation of the renal tubules/tract

A

stasis of urine

99
Q

the four types of renal calculi are: __, __, __, and __

A

calcium stones (oxalate and phosphate); magnesium ammonium phosphate stones; uric acid stones; cystine stones (CMUC)

100
Q

hypercalcemia, hypercalciuria, and immobilization are contributing factors of __

A

calcium stones

101
Q

treatment of underlying conditions, increased fluid intake, and thiazide diuretics are treatments for __ (calcium/magnesium/uric acid/cystine)

A

calcium stones

102
Q

treatment of uti’s, acidification of urine, and increased fluid intake are treatments for __

A

magnesium stones

103
Q

urea-splitting uti’s are contributing factors of __ (calcium/magnesium/uric acid/cystine)

A

magnesium ammonium phosphate stones

104
Q

gout and high-purine diet are contributing factors of __ (calcium/magnesium/uric acid/cystine)

A

uric acid stones

105
Q

increased fluid intake, allopurinol for hyperuricosuria, and alkalinization of urineare treatments for

A

uric acid stones

106
Q

cystinuria is a contributing factor of __ (calcium/magnesium/uric acid/cystine)

A

cystine stones

107
Q

increased fluid intake and alkalinization of urine are treatments for __

A

cystine stones

108
Q

the most common neoplasm in young children is __

A

wilms tumor (nephroblastoma): embryonic kidney tumor

109
Q

__ is so dangerous because it doesn’t show any s/s until after tumor has metastasized

A

renal cell carcinoma

110
Q

__ is found during adulthood, is a silent diorder, and has more advances (hematuria, flank pain, palpable flank mass)

A

renal cell carcinoma

pathophysiology (11 decks)

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