chapter 8 - kidney and urinary tract disorders Flashcards
what are the 2 primary purposes of the kidney
filter the nitrogenous products of metabolism (urea and creatinine) from the blood and to maintain water and electrolyte homeostasis
what hormones does the kidney produce
erythroprotein (stimulates bone marrow to proceed red blood cells) and an active form of vitamin D that the kidney makes from the inactive form produced in the diet or formed in the skin on exposure to sunlight
what are the 2 distinct zones of the kidney
outer layer - cortex.
inner layer- the medulla.
where does kidney filtration take place
in the nephron
what are the 2 parts of the nephron
the glomerulus and the tubule
at what rate does urine form
about one cc per minute
when is ADH produced
when the concentration of sodium rises
what does aldosterone do
causes the kidneys to retain sodium
together, what do ADH and aldosterone accomplish
blood volume and sodium level to be controlled
what is angiotensin
a hormone that causes more salt to be retained and constricts small blood vessels, causing an increase in pressure
what is renin
produced by kidneys, triggers formation of angiotensin when the blood volume or BP falls
what is the most common evidence of renal disease
proteinuria
what are common benign causes of proteinuria
- exercise, fever, stress, excessive cold, vaginal contamination.
- orthostatic proteinuria
what are causes of microalbuminuria
diabetes, HTN, lipid abnormalities, some immune disorders
is microalbuminuria a risk factor for coronary artery disease
yes
what are the most common causes of hematuria
stones, nephritis, tumors, prostate disease, benign familial hematuria, menstrual contamination
what is pyuria most commonly due to
cystitis, urethritis, prostatitis
is finding of hyaline casts considered benign
yes
red blood cell casts can indicate what
glomerulonephritis
WBC casts can indicate what
inflammatory conditions, glomerulonephritis, pyelonephritis, interstitial cystitis.
epithelial casts can indicate what
nephritis syndrome, tubular injury, glomerulonephritis
granular casts can indicate what
glomerulonephritis
fatty casts can indicate what
nephrotic syndrome
waxy casts can indicate what
advanced renal failure
what is azotemia
elevation of BUN and creatinine levels
what are causes of azotemia
infrarenal diseases, pre-renal diseases, post renal causes d/t obstruction to urinary flow after it leaves the kidney (BPH)
what is uremia and what are signs and symptoms associated
a raised level in the blood of urea and other nitrogenous waste compounds that are normally eliminated by the kidneys.
condition resulting from the advanced stages of kidney failure (marked by signs and symptoms such as anemia, weight loss, weakness, N/V, excessive bleeding, edema, convulsions, lethargy progressing to coma)
what is oliguria
decreased urine output (<500 ml in 24 hrs)
what are common causes of oliguria
dehydration, total urinary tract obstruction, severe infection leading to shock, medications
what is anuria
<100 ml urine in 24 hrs
what is renal spasm caused by
spasm of ureter as a stone is being forced from the kidney to the bladder
what is nephrotic syndrome
heavy proteinuria with edema, DLD, hyper coagulability and hypoalbuminuria.
what is BUN
waste product of protein metabolism
what is serum creatinine
waste product of muscle metabolism
what is creatinine clearance
volume of plasma cleared of creatinine per minute
what is cystatin C
sensitive early marker for CKD
what is IVP
intravenous pyelogram. iodine injection and XR as it passes thru kidneys.
what is retrograde pyelogram
like IVP, uses dye injected thru catheter then XRs. done when allergy to IV contrast for IVP or IVP can’t be done
what is renal scan
uses radioactive isotope then scan with gamma camera, good for showing blood flow and organ function
is MRI good for detecting calcifications or stones
no
what can renal angiography show
tumors, blood clots, stenosis or aneurysms of the renal artery
do males or females get bladder cancer more often
males
do males or females have worse survival rate
females have slightly worse 5 yr survival rate
what is the most important risk factor for development of bladder cancer
cigarette smoking
risk of bladder cancer increases how much with smoking
2-3 times that of a nonsmoker
what are other risk factors for bladder cancer (other than smoking)
age (over 40 with 90% of cases over age 55), race (caucasian), gender (male), family hx, personal hx (80% recur rate), chemo for other types of cancer, occupation (exposure to carcinogens)
90% of bladder cancers are which type
transitional cell carcinoma (TCC).
what are the rarer types of bladder cancer that are considered more aggressive than TCC
squamous cell, adenocarcinoma, small cell and others (lymphoma, sarcoma)
urinary retention can be caused by all of the following EXCEPT:
- prostate enlargement
- mucous colitis
- diabetes mellitus
- neurological disease
mucous colitis
all of the following statements regarding PCKD are correct EXCEPT:
- multiple cysts are present in both kidneys
- it rarely progresses to end-stage renal disease
- HTN if often present
- cysts can occur in the liver
2- it rarely progresses to end stage renal disease (is not true)
what other measurement closely estimates the GFR rate
creatinine clearance
