Chapter 39

Question 1

urinary tract obstruction

• compensatory hypertrophy and hyperfunction
• partially counteracts the negative consequences of ________ obstruction
• _____________
• __________

Answer 1

unilateral
obligatory growth
compensatory

Question 2

unilateral obstruction

when the right kidney is obstructed, the _______ and _______ in the left kidney compensate by _______ in size

Answer 2

glomeruli, tubules

increase

Question 3

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

Answer 3

calcium oxalate
low urine
staghorn calculi

Question 4

______ 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 _________

Answer 4

struvite
large
staghorn
pelvis
calyces
UTIs
urease
psuedomonas

Question 5

kidney stones

the function of __________, _________, and ________: they inhibit _____ growth, _______ stone formation

Answer 5

potassium citrate
pyrophosphate
magnesium
crystal
prevent

Question 6

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 __________

Answer 6

renacolic
moderate, severe
flank
renal 
groin
pelvis, proximal ureter

Question 7

lower UTI obstruction

__________: overactive or hyperreflexive bladder function

Answer 7

dyssynergia

Question 8

lower UTI obstruction
_________: uninhibited or reflex bladder

develops from ______ disorders that originate above the _______ _______ ______ results in this

Answer 8

detrusor hyperreflexia
neurologic
pontine micturition center

Question 9

is a medical term used to identify a function urinary tract obstructed caused by an interruption of the ____ supply to the _____!!!!!!

Answer 9

neurogenic bladder
nerve
bladder

Question 10

bladder _______ and urinary ________

related to the bladder would result from the effects of _______ of the sacral segments below __

Answer 10

distension
retention
lesions
S1

Question 11

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

Answer 11

circular 
neck
neck
adrenergic blocking anti muscarinic
detrusor sphincter dysserngia

Question 12

risk factors for developing bladder and kidney cancers
1
2
3

Answer 12

cig smoking
hypertension
exposure to aniline dyes

Question 13

renal tumors

_____________ is rare

Answer 13

renal transitional cell carcinoma

Question 14

renal cell carcinoma

classified as ________ tumors according to cell __ and extent of _______, arises from the ______ _______ _______

Answer 14

clear cell
type, metastasis
proximal tubular epithelium

Question 15

bladder tumors

-bladder cancer is associated with the gene mutation _______ mutations

Answer 15

tp53

Question 16

urinary tract infection
most common pathogens
-the most cause of uncomplicated UTI infections _______
-_______________

Answer 16

Escherichia coli

Staphylococcus saprophyticus

Question 17

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.

Answer 17

bacteriostatic, urea
dilute
urea
bacteriostatic
acidic
infection
85
cystitis
confusion
abdominal

Question 18

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

Answer 18

cystitis

WBC

Question 19

Pyelonephritis is usually caused by the bacteria.
1
2
3

Answer 19

E coli
protus
psuedomonas

Question 20

________
The abnormal laboratory value is found in _______ disorders is elevated _______ concentration
This is primarily excreted by glomerular filtration after being constantly released from _____ tissue

Answer 20

creatinine
glomerular
creatinine
muscular

Question 21

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.

Answer 21

complement
permeability
proteinuria
cytokines, oxidants, proteases, growth factors

Question 22

acute glomerulonephritis

____________ : Most common cause _________ -mediated glomerular injury with increased glomerular ______ and __________

-thickening of the ________ _______ wall with immune deposition of immunoglobulin ___ and __

Answer 22

membraneous nephropathy
complement
pearmability
glomerulosclerosis
glomerular capillary
G, IgG
C3

Question 23

goodpasture syndrome
__________ basement membrane disease is associated with __ antibody formation against pulmonary capillary and glomerular basement membranes.

Answer 23

antiglomerular

IgG

Question 24

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

Answer 24

hypothyroidism
edema
hyperlipidemia
lipiduria

Question 25

acute kidney injury
prerenal
most common cause is _____________

Answer 25

renal hypoperfusion

Question 26

acute kidney injury
intrarenal
most common cause
________ caused by ________

Answer 26

acute tubular necrosis (ATN)

ischemia

Question 27

prerenal injury from poor perfusion can result from these conditions
1
2
3
4

Answer 27

renal vasoconstriction
renal artery thrombosis
hemorrhage
hypotension

Question 28

intrarenal failure
\_\_\_\_\_ disorders are considered causes of intrarenal renal failure
1
2
3
4

Answer 28

acute glomerulus
allograft rejection
tumors
acute tubular necrosis

Question 29

acute tubular necrosis
________ are considered “major culprits” in causing ______acute tubular necrosis (ATN) -the _________ (________, _______) are the major culprits.

Answer 29

antibiotics
nephrotoxic
aminoglycosides
gentamicin
tobramycin

Question 30

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 ______

Answer 30

potassium
dieuretic
glucose, insulin
sodium bicarb
calcium
dialysis

Question 31

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 _____

Answer 31

potassium
insulin
glucose

Question 32

chronic kidney disease
treatment
_______ is needed

Answer 32

erythropoeitin

Question 33

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.

Answer 33

erythropoeitin
red cell
anemia