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pathophysio week 9 > Chapter 41: Disorders of Renal Function > Flashcards

Chapter 41: Disorders of Renal Function Flashcards

1
Q

disorders of kidney

A 
-subject to many of the same types of disorders that affect other body structures
  \+developmental defects
  \+infections
  \+altered immune responses
  \+neoplasms
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2
Q

fetal anomalies

A

+most common: anomalies in shape and position

+less common: a decrease in renal mass (i.e agenesis, hypogensis) & a change in renal structure (i.e renal cysts)

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3
Q

organ development

A

+dysgenesis: failure of an organ to develop normally

+agenesis: the complete failure of an organ to develop

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4
Q

potter syndrome

A

+characteristic facial features of newborns with renal agenesis

  • the eyes are widely separated and have epicanthic
  • ears are low set
  • the nose is broad and flat
  • the chin is receding
  • lim defects often are present
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5
Q

Causes of neonatal renal failure with potter phenotype

A

+cystic renal dysplasa
+obstructive uropathy
+autosomal recessive polycystic disease
+unilateral agenesis (uncommon)

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6
Q

cystic disease of the kidney

A

+definition: fluid filled sacs or segments of dialated nephron
+causes:
-tubular obstruction that increase intratubular pressure
- changes in the basement membrane of the renal tubules that predispose to cystic dilatation

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7
Q

types of cystic disease of the kidney

A

-simple and acquired renal cysts
-medullary cystic disease
-polycystic kidney disease
+autosomal recessive polycystic kidney disease
+autosomal dominant polycystic kidney disease

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8
Q

causes of urinary tract obstruction

A
  • developmental defects
  • calculi (stones)
  • pregnancy
  • benign prostatic hyperplasia
  • scar tissue resulting from infection and inflammation
  • tumors
  • neurologic disorders such as spinal cord injury
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9
Q

Damaging effects of urinary obstruction

A

+stasis of urine
- predisposes to infection and stone formation
+ development of back pressure
- interferes with renal blood flow and destroys kidney tissue

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10
Q

Kidney stones

A

+def: crystalline structure that form from components of the urine
+requirements for formation
-a nidus to form
-a urinary environment that supports continued crystallization of stone components

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11
Q

Factors influencing the formation of kidney stones

A

+ the concentratin of stone compenents in the urine
+the ability of stone components to complex and form stones
+the presence of substances that inhibit stone formation

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12
Q

types of kidney stones

A 
\+calcium stones
  -oxalate or phosphate
\+magnesium ammonium phosphate stones
\+uric acid stones
\+cystine stones
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13
Q

Kidney stone treatment

A

+preventative (dietary restrictionm calcium salt supplementation, thiazide diuretics, cellulose phosphate)
+treatment for pain
+antibiotic for infection
+removing stones: Ureteoscopic removal, percutaneous removal, extracorporeal lithotripsy
+diagnosis
-urialysis, radiography, intravenous pyelography, ultrasonography

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14
Q

Types of Urinary tract infections (A.S.L.U)

A
  • asymptomatic bacteriuria
  • symptomatic infections
  • lower UTIs: cystitis
  • upper UTIs: pyelonephritis
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15
Q

causes of UTIs

A
  • most uncomplicated UTIs is cause by Escherichia coli
  • other uropathis pathogens include: Staphylocococcus sapophyticus in uncomplicated UTIs, Both non-E.coli from-negative rods, Gram-positive cocci in complicated UTIs
  • most cause by bacteria that enter through the urethra
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16
Q

Causes of UTIs associated with stasis of urine flow

A 
\+anatomic obstructions
  -urinary tract stones
  - prostatic hyperplasia
  - pregnancy
  -malformations of the ureterovesical juncton
\+ increase pressure resulting in reflux
\+functional obstructions
  -neurogenic bladder
  -infrequent voiding
  - detrusor (bladder) muscle instability
  -constipation
17
Q

protective mechanisms

A
  • washout phenomenon
  • mucin layer
  • local immune responses
  • normal flora of the periurethral area in women
  • prostate secretions in men
18
Q

Characteristics of acute episode of cystitis

A
  • frequency of urination (as often as every 20 minutes)
  • lower abdominal or back discomfort
  • burning and pain on urination (dysuria)
  • cloudy and foul smelling urine on occasion
19
Q

Special considerations of UTI patients

A
  • sexually active women
  • pregnant women
  • age related effects
20
Q

diagnosis and treatment of UTIs

A
  • diagnosis based on symptoms and on examination of the urine for the presence of microorganisms
  • X-ray films, ultrasonography, and CT and renal scans are used to identify contributing factors
  • urine dipstick
  • treatment of UTI is based on the pathogen causing the infection
21
Q

Characteristics of Glomerylonephritis

A

+immune mechanisms
-glomerular antibodies
- circulating antigen-antibody complexes
+characteristics
-hematuria with red blood cell casts
-a diminished glomerular filtration rate (GFR)
-azotemia presence of nitrogenous wastes in the blood
-oliguria
-hypertension

22
Q

Causes of glomerulonephritis

A

+disease that provoke a proliferative inflammatory response of the endothelial, mesangial, or epithelial cells of the glomeruli
+the inflammatory process:
- damages the capillary wall
-permits red blood cells to escape into the urine
-produces hemodynamic changes that decrease the GFR

23
Q

Cellular changes in Glomerular Disease

A 
\+proliferative: endothelial, mesangial, leukocyte, crescent formation 
\+ basement membrane thickening
\+sclerosis
\+fibrosis 
\+diffuse glomerular changes
\+focal glomerular changes
\+segmental glomerular changes
\+mesangial changes
24
Q

urinary changes in glomerulonephritis

A 
\+proteinuria
\+hematuria
\+pyuria
\+oliguria
\+edema
\+hypertension
\+azotemia
25
Q

Types of Glomerular disease

A 
\+acute proliferative glomerulonephritis
\+rapidly progressive "  " 
\+Nephrotic syndrome
\+ membranous glomerulonephritis
\+minial change disease (lipoid nephrosis_
\+focal segmental glomerulosclerosis
\+IgA nephropathy
\+chronis glomerulonephritis
26
Q

Tubulointerstitial disorders

A

+damage to the proximal, loop, or distal portion of the nephron

  • acute tubular necrosis
  • renal tubular acidosis
  • pyelonephritis
  • the effects of drugs and toxins
27
Q

Proximal and distal tubular acidosis

A
  • renal tubular acidosis
    • proximal tubular disorders that affect bicarbonate re absorption
    • distal tubular defects that affect the secretion o fixed metabolic acids
28
Q

Major groups of renal neoplasms

A 
\+embryonic kidney tumors occurring during childhood
  -wilms tumor
  -onset 3-5 years
  -in one or both kidney 
  -WT1 mutation on chromosome 11
\+ adult kidney cancers
  -renal cell carcinoma

pathophysio week 9 (3 decks)

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