CHAPTER 39 Flashcards
Alterations of Renal and Urinary Tract
Urinary tract obstruction
Upper urinary tract obstruction
-Compensatory hypertrophy and hyperfunction:
Partially counteracts the negative consequences of _____
- _____ growth
- _____ growth
unilateral obstruction
Obligatory
compensatory
unilateral obstruction
When the _____ kidney is obstructed, the _____ and _____ in the _____ kidney compensate by _____ in size.
right glomeruli tubules left increase
kidney stones
- Composition of mineral salts
- -Most common type of renal stone _____ and calcium phosphate: 70% to 80%
- Genetic disorders of amino acid metabolism
- -Excess urine can cause cystinuric, or xanthine, stone formation in the presence of a _____.
- _____
- -Are _____ and fill the _____ and _____ calyces.
calcium oxalate low urine pH staghorn calculi large minor major
struvite stones
-They are more common in _____ than in _____.
- They grow large and branch into a _____ configuration in _____ and _____.
- Struvite stones are closely associated with _____ caused by _____-producing bacteria, such as _____.
women men staghorn renal pelvis calyces urinary tract infections urease pseudomonas
kidney stones
kidney stone formation
-The function of _____, _____, and _____: They inhibit _____ growth, Prevent stone formation.
potassium citrate
pyrophosphate
crystal growth
crystal
clinical manifestation: renacolic (pain)
- is described as _____ pain
- Pain originates in the _____ area.
- Renal colic indicates the presence of _____.
- Pain radiated to the _____.
- Renal colic indicates obstruction of the _____ or _____.
moderate to severe flank renal stones groin renal pelvis proximal ureter
lower urinary tract obstruction
- neurogenic bladder
- -upper motor neurons
- –_____: Overactive or hyperreflexive bladder function
—_____: Uninhibited or reflex bladder
Dyssynergia
Detrusor hyperreflexia
Detrusor hyperreflexia
-Detrusor hyperreflexia develops from _____ disorders that originate above the _____ result in _____.
neurologic
pontine micturition center
detrusor hyperreflexia
Neurogenic bladder
-Is a medical term is used to identify a functional _____ caused by an interruption of the _____ supply to the _____!!!!
urinary tract obstruction
nerve
bladder
Lesions of the sacral segments below S1
-_____ and _____ related to the bladder would result from the effects of _____ of the _____ below _____
Bladder distension urinary retention lesions sacral segments S1
treatment
-The circular muscles of the bladder neck, to treat bladder neck obstruction are _____ (_____) medications
-Because the bladder neck consists of _____ with _____ innervation, _____ may be managed by a-adrenergic blocking (antimuscarinic) medications
a-adrenergic blocking antimuscarinic circular smooth muscle adrenergic detrusor sphincter dyssynergia
risk factors for developing bladder and kidney cancers
- _____
- _____
- _____
cigarette smoking
hypertension
exposure to aniline dyes
tumors
renal tumors
-_____: rare
renal transitional cell carcinoma
Renal cell carcinoma, classified as clear cell tumors
-Renal cell carcinoma, classified as _____ according to _____ type and extent of _____, arises from the _____
clear cell tumors
cell
metastasis
proximal tubular epithelium
bladder tumors
-Bladder cancer is associated with the gene mutation _____
TP53 mutations
UTI
- Most common pathogens
- the most common cause of uncomplicated urinary tract infections _____
- _____
Escherichia coli
Staphylococcus saprophyticus
UTI
-Considering host defense mechanisms, the element in the urine is bacteriostatic is _____!!!
- _____ washes out _____, and urine with higher urea concentrations (high osmolarity) is more _____.
- Mechanisms that protect the urinary tract from infection include: _____.
- The _____ (acidic urine) is a mechanism that reduces the likelihood of infection.
urea Dilute urine bacteria bacteriostatic Acidic urine low pH
Clinical manifestations of a urinary tract infection may be demonstrated in an 85-year-old individual
-Older adults with cystitis may demonstrate _____ or _____ or otherwise be _____.
confusion
vague abdominal discomfort
asymptomatic
pyelonephritis
acute pyelonephritis
-Evaluation- _____ is required to make the diagnosis of pyelonephritis from that of _____
–_____, indicating _____
differentiating sign
cystitis
White blood cell casts
pyelonephritis
pyelonephritis
-Pyelonephritis is usually caused by the _____.
- _____
- _____
- _____
bacteria
Escherichia coli
Proteus
Pseudomonas
creatinine
-The abnormal laboratory value is found in _____ is elevated _____ concentration
-Creatinine is primarily excreted by _____ after being constantly _____ from _____
glomerular disorders creatinine glomerular filtration released muscle tissue
Glomerulonephritis
-In glomerulonephritis _____ and _____ damages the epithelial cells that results in _____.
-Activated _____, _____, _____, _____, and _____ attack _____, alter _____, and cause _____.
activated complement altered membrane permeability proteinuria complement inflammatory cytokines oxidants proteases growth factors epithelial cells membrane permeability proteinuria
Acute Glomerulonephritis
- types
- _____: Most common cause
- –_____-mediated glomerular injury with increased glomerular _____ and _____
Membraneous nephropathy
Complement
permeability
glomerulosclerosis
Acute Glomerulonephritis Membraneous Nephropathy
-_____ of the glomerular _____ with immune deposition of _____ (_____) and _____.
Thickening
capillary wall
immunoglobulin G (IgG)
C3
