Chapter 39 Flashcards
urinary tract obstruction
- compensatory hypertrophy and hyperfunction
- partially counteracts the negative consequences of ________ obstruction
- _____________
- __________
unilateral
obligatory growth
compensatory
unilateral obstruction
when the right kidney is obstructed, the _______ and _______ in the left kidney compensate by _______ in size
glomeruli, tubules
increase
kidney stones
composition of mineral salts
-most common type of renal stone is __________ and calcium phosphate
genetic disorders of amino acid metabolism
-excess urine can cause cystinuric, or xanthine, stone formation in the presence of a ______ pH
________: are large and fill the minor and major calyces
calcium oxalate
low urine
staghorn calculi
______ stones
they are more common in women then in men
-they grow ____ and branch into a ______ configuration in renal _____ and ______
-these stones are closely associated with ____ caused by ________ producing bacteria such as _________
struvite large staghorn pelvis calyces UTIs urease psuedomonas
kidney stones
the function of __________, _________, and ________: they inhibit _____ growth, _______ stone formation
potassium citrate pyrophosphate magnesium crystal prevent
clinical manifestation
_______ pain
-is described as ______ to _____ pain
-pain originates in the _____ area
-this type of pain indicates the presence of _____ stones
-pain radiated to the _______
-indicates obstruction of the renal ____ or __________
renacolic moderate, severe flank renal groin pelvis, proximal ureter
lower UTI obstruction
__________: overactive or hyperreflexive bladder function
dyssynergia
lower UTI obstruction
_________: uninhibited or reflex bladder
develops from ______ disorders that originate above the _______ _______ ______ results in this
detrusor hyperreflexia
neurologic
pontine micturition center
is a medical term used to identify a function urinary tract obstructed caused by an interruption of the ____ supply to the _____!!!!!!
neurogenic bladder
nerve
bladder
bladder _______ and urinary ________
related to the bladder would result from the effects of _______ of the sacral segments below __
distension
retention
lesions
S1
lower urinary tract obstruction treatment
the ______ muscles of the bladder ___, to treat bladder ___ obstruction are _____________ blocking (________) medications
-because the bladder neck consists of circular smooth muscle with _______ innervation, ______ ______ _____ may be managed by a-adrenergic blocking medications
circular neck neck adrenergic blocking anti muscarinic detrusor sphincter dysserngia
risk factors for developing bladder and kidney cancers
1
2
3
cig smoking
hypertension
exposure to aniline dyes
renal tumors
_____________ is rare
renal transitional cell carcinoma
renal cell carcinoma
classified as ________ tumors according to cell __ and extent of _______, arises from the ______ _______ _______
clear cell
type, metastasis
proximal tubular epithelium
bladder tumors
-bladder cancer is associated with the gene mutation _______ mutations
tp53
urinary tract infection
most common pathogens
-the most cause of uncomplicated UTI infections _______
-_______________
Escherichia coli
Staphylococcus saprophyticus
UTI
Considering host defense mechanisms, the element in the urine is _____ is _____!!
______ urine washes out bacteria, and urine with higher _____ concentrations (high osmolarity) is more _________
Mechanisms that protect the urinary tract from infection include: _____ urine.
The low pH is a mechanism that reduces the likelihood of ________
clincial manifestations of a UTI may be demonstrated in a __ year old inviduals
Older adults with _____ may demonstrate _____ or vague _______ discomfort or otherwise be asymptomatic.
bacteriostatic, urea dilute urea bacteriostatic acidic infection 85 cystitis confusion abdominal
pylenonephritis
acute:
Acute infection of the ureter, renal pelvis, and/or renal parenchyma
Evaluation- differentiating sign is required to make the diagnosis of pyelonephritis from that of ____
_____casts, indicating pyelonephritis
cystitis
WBC
Pyelonephritis is usually caused by the bacteria.
1
2
3
E coli
protus
psuedomonas
________
The abnormal laboratory value is found in _______ disorders is elevated _______ concentration
This is primarily excreted by glomerular filtration after being constantly released from _____ tissue
creatinine
glomerular
creatinine
muscular
glomerulonephritis
In glomerulonephritis activated ______ and altered membrane _______ damages the epithelial cells that results in ________
Activated complement, inflammatory _______, ______, _________ , and ________attack epithelial cells, alter membrane permeability, and cause proteinuria.
complement
permeability
proteinuria
cytokines, oxidants, proteases, growth factors
acute glomerulonephritis
____________ : Most common cause _________ -mediated glomerular injury with increased glomerular ______ and __________
-thickening of the ________ _______ wall with immune deposition of immunoglobulin ___ and __
membraneous nephropathy complement pearmability glomerulosclerosis glomerular capillary G, IgG C3
goodpasture syndrome
__________ basement membrane disease is associated with __ antibody formation against pulmonary capillary and glomerular basement membranes.
antiglomerular
IgG
clinical manifestations of nephrotic syndrome
Excretion of 3.0 g or more of protein in urine
Protein excretion as a result of glomerular inj
1
2
3
4
hypothyroidism
edema
hyperlipidemia
lipiduria
acute kidney injury
prerenal
most common cause is _____________
renal hypoperfusion
acute kidney injury
intrarenal
most common cause
________ caused by ________
acute tubular necrosis (ATN)
ischemia
prerenal injury from poor perfusion can result from these conditions 1 2 3 4
renal vasoconstriction
renal artery thrombosis
hemorrhage
hypotension
intrarenal failure \_\_\_\_\_ disorders are considered causes of intrarenal renal failure 1 2 3 4
acute glomerulus
allograft rejection
tumors
acute tubular necrosis
acute tubular necrosis
________ are considered “major culprits” in causing ______acute tubular necrosis (ATN) -the _________ (________, _______) are the major culprits.
antibiotics nephrotoxic aminoglycosides gentamicin tobramycin
acute kidney injury
_________
Restrict dietary sources of _____
Use non–potassium-sparing _____ agents, or use cation-ion exchange resins.
Administer _____ and ______ or _________e to drive potassium into the cells.
Administer _____
May need ______
potassium dieuretic glucose, insulin sodium bicarb calcium dialysis
How is glucose and insulin used to treat hyperkalemia associated with acute renal failure?
Glucose and insulin used to treat hyperkalemia associated with acute renal failure by ; When insulin transports glucose into the cell, it also carries _____ with it.
_____ infusions can be effective in shifting potassium from the extracellular to intracellular space, along with the transport of _____
potassium
insulin
glucose
chronic kidney disease
treatment
_______ is needed
erythropoeitin
Chronic Kidney Disease
Anemia of chronic renal failure can be successfully treated with ________.
Reduced erythropoietin secretion and reduced _____ production are evident in _____ resulting from chronic renal failure.
erythropoeitin
red cell
anemia
