Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

CV487 > Class 7: Renal > Flashcards

Class 7: Renal Flashcards

1
Q

Concentration & dilution of urine

A

-Water, sodium, chloride, urea & catecholamines
-Renal hormones

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Renal hormones

A

ADH, aldosterone, natriuretic peptides, vitamin D, erythropoietin & renin-angiotensin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Renal assessment (males)

A

-Frequency, urgency, nocturia, dysuria, hesitancy & straining
-Urine color, GU history
-Penis: Pain, lesion, discharge
-Scrotum: Self-care behaviors, lumps
-Sexual activity and contraceptive use & STI contact

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Renal assessment (female)

A

-Menstrual & obstetrical hx
-Menopause, self-care behaviors, urinary symptoms, discharge
-Sexual activity, contraceptive use & STI contact and risk reduction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Renal objective assessment

A

-Fluid balance
-Lab values: Electrolytes, creatinine and BUN

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Renal obstruction

A

-May be anatomical or functional
-Flow is impeded; dilation of the urinary system; increased risk for infection; compromises the renal system

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Etiology of upper urinary tract obstructions

A

-Stricture, kidney stones, malignancy
-Congenital compression of a calyx, ureteropelvic or ureterovesical junction
-Compression from an aberrant vessel, tumor or abdominal inflammation and scarring

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Pathophysiology of upper urinary tract obstructions

A

-Obstruction causes dilation of the ureter, renal pelvis, calyces and renal parenchyma proximal to the site of the blockage
-Dilation is an early response to the obstruction
-Increased pressure decreases filtration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Response to relief of upper urinary tract obstructions

A

-Post-obstructive diuresis
-Restoration of fluid and electrolyte imbalance
-May be further complicated by severe post obstructive diuresis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Kidney stones

A

-Calculi or urinary stones are masses of crystals, protein or other substances
-Most common stone type is calcium oxalate or phosphate, struvite and uric acid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Pathophysiology of kidney stones

A

-Super-saturation of one or more salts in urine
-Precipitation of salts from liquid to a solid state
-Crystallization or agglomeration
-Presence or absence of stone inhibitors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Kidney stone influencing factors

A

-Age, gender, race, genetic predisposition
-Seasonal factors
-Fluid intake, diet, occupation, previous UTI
-HTN, obesity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Kidney stone clinical manifestations

A

-Moderate to severe pain:
-Located in the flank and radiating to the groin
-Lateral flank or lower abdomen pain
-Urinary urgency, frequency, UI hematuria & N/V

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Evaluation & diagnosis of kidney stones

A

-Functional study of renal pelvic and urethral pressures
-Urinalysis (including pH)
-X-Rays, CT scan or ultrasound

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Lower urinary tract obstruction

A

Related to how urine is stored in the bladder or how urine is emptied from the bladder

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Etiology of lower urinary tract obstruction

A

-Neurogenic, anatomic alterations
-Both Neurogenic and Anatomic
-Primary symptom is incontinence*

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Neurogenic bladder is caused by

A

Spinal cord or brain disruption

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Neurogenic bladder: Lesion above C2 or the pontine micturition center resulting in detrusor hyperrefelxia that causes

A

Loss of coordinated neuromuscular contraction and overactive or hyper-reflexive bladder function

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Neurogenic bladder: Lesion located on the upper motor neurons between C2 & S1 resulting in detrusor hyperreflexia with vesical shincter dyssynergia

A

Loss of bladder muscle contraction and overactive bladder

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Neurogenic bladder lesions can occur…

A

-In the sacral area of the spinal cord or peripheral nerves below S1 resulting in detrusor areflexia causing an underactive, hypotonic or flaccid bladder function with loss of sensation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Lower urinary tract obstruction: Overactive bladder syndrome

A

-Syndrome of detrusor over-activity
-May be spontaneous or provoked
-Affects men, women and children

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Characterization of overactive bladder syndrome

A

Characterized by urgency with involuntary detrusor contractions during the bladder filling

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Diagnosis of overactive bladder syndrome

A

Diagnosed by symptoms and assessment confirmed by urodynamic studies

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Lower urinary tract obstruction: Obstruction to urine flow

A

-Anatomic causes of impedance to urine flow:
-Urethral stricture, prostate enlargement, pelvic organ prolapse, partial obstruction of the bladder outlet or urethra

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Diagnosis & tx of obstructed urine flow

A

Diagnostic tests to identify correct issue & hx

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

UTIs

A

-Inflammation of the urinary epithelium caused by bacteria from the gut
-Can occur anywhere along the urinary tract
-Classified by location or complicating factors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Classification of UTIs

A

-Cystitis, pyelonephritis
-Uncomplicated & complicated UTI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

UTIs: Cystitis

A

-Inflammation of the bladder
-Most common site of UTI*
-Mild inflammation leads to hyperemic mucosa

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Etiology of cystitis

A

Most common infecting microorganism is Esherichia coli (E. Coli)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Advanced cystitis

A

May show hemorrhage, pus formation, or exudate on epithelial surface of the bladder

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Manifestations of cystitis

A

Asymptomatic to frequency, urgency, dysuria and suprapubic and lower back pain
-Hematuria, cloudy and foul-smelling urine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Diagnosis of cystitis

A

Assessment, symptoms and urinalysis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Tx of cystitis

A

Antibiotics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Cystits may lead to…

A

Urosepsis and septic shock; Emergency Situation!!!

35
Q

Urinary tract infection: Acute pyelonephritis

A

Infection of one or both upper urinary tracts (ureter, renal pelvis and interstitium)

36
Q

Etiology of acute pyelonephritis

A

Kidney stones, vesicoureteral reflux, pregnancy, neurogenic bladder, instrumentation and/or female sex trauma

37
Q

Pathophysiology of acute pyelonephritis

A

Infection spreads, tubules most affected, rarely causes renal failure

38
Q

Acute pyelonephritis manifestations

A

-Onset is acute, fever, chills, flank or groin pain
-Similar to symptoms of UTI including frequency, dysuria and costovertebral tenderness
-Older adults have low grade fever and malaise

39
Q

Diagnosis and Treatment of acute pyelonephritis

A

-Blood cultures and urinary tract imaging
-Treated with antibiotic therapy
-May require surgical intervention to remove lesions

40
Q

Glomerulonephritis

A

Inflammation of the glomerulus

41
Q

Etiology of glomerulonephritis

A

Infection, immunologic abnormalities (most common cause), ischemia, free radicals, drugs, toxins, vascular disorders, systemic disease (ie: diabetes mellitus and lupus)

42
Q

Glomerulonephritis pathophysiology

A

-Glomerular capillary endothelium is disturbed d/t streptococcal infection
-aPermeability
-Basement membrane of the epithelium becomes thickened

43
Q

Glomerulonephritis presentation

A

-Nephrotic syndrome
-Nephritic syndrome
-Acute or chronic Kidney Failure

44
Q

Glomerulonephritis clinical manifestations

A

-Insidious or sudden
-Occurs 10 to 21 days post infection (Impetigo or pharyngitis)
-Hematuria, RBC casts, proteinuria, decreased GFR, elevated Cr and BUN
-Oliguria, HTN, edema around the eyes feet & ankles, ascites or pleural effusions

45
Q

Glomerulonephritis tx

A

No specific treatment and patients resolve without significant loss of function

46
Q

Pertinent labs for the renal system

A

-CBC
-Electrolytes
-Kidney function: Creatinine, BUN & GFR

47
Q

Acute kidney injury

A

-Sudden decline in kidney function with decrease in GFR
-Accumulation of nitrogenous waste products in the blood
-Elevated Creatinine and BUN

48
Q

Acute kidney injury pathophysiology

A

-Extracellular volume depletion
-Decreased renal blood flow
-Toxic/inflammatory injury to the kidney cells that results in alterations of function

49
Q

Causes of acute renal failure: Prerenal

A

Sudden and drop in BP (shock) or interruption of blood flow to the kidneys from severe injury or illness

50
Q

Causes of acute renal failure: Intrarenal

A

Direct damage to the kidneys by inflammation, toxins, drugs, infection, or reduced blood supply

51
Q

Causes of acute renal failure: Postrenal

A

Sudden obstruction of urine flow d/t enlarged prostate, kidney stones, bladder tumor or injury

52
Q

Acute kidney injury classification

A

-RIFLE
-Risk, injury, failure, loss & end-stage kidney disease

53
Q

Progression of acute kidney injury: Initiation phase

A

-Kidney injury evolving with reduced perfusion or toxicity
-Prevent injury possible

54
Q

Progression of acute kidney injury: Maintenance phase

A

-Renal injury and dysfunction resolved
-Urine output is lowest during this phase
-Elevated creatinine and BUN

55
Q

Progression of acute kidney injury: Recovery phase

A

-Injury repaired and normal renal function reestablished
-Diuresis common
-Decline in creatinine and urea
-Increase in CrCl

56
Q

Acute kidney injury clinical manifestations

A

-Oliguria
-Anuria is uncommon in acute tubular necrosis
-Increased BUN and creatinine with decreased GFR
-Monitor for hyperkalemia and hyperphosphatemia
-Fluid retention; CHF in people with CV disease
-N/V & fatigue

57
Q

Acute kidney injury clinical manifestations: Oliguria

A

-3 mechanisms to contribute to oliguria:
-Alterations in renal blood flow
-Tubular obstruction (ie: necrosis)
-Backleak

58
Q

AKI tx

A

-Prevention of AKI and maintenance of perfusion are major treatment factors
-Correct fluid and electrolyte disturbances, manage BP, treat infections, maintain nutrition
-Remember drugs or metabolites that are not excreted
-Continuous Renal Replacement Therapy (CRRT- short term dialysis)

59
Q

AKI monitoring

A

-CV arrhythmias by ECG
-Ins & outs

60
Q

Pertinent labs for a patient with an AKI

A

-CBC
-Coagulation
-Electrolytes
-Kidney function: Creatinine, BUN & GFR
-Liver function tests
-Specialty labs

61
Q

Rhabdomyolysis

A

-Life-threatening complication of muscle trauma with muscle cell loss
-Muscles breakdown and release myoglobin; myoglobinuria
-Protein molecule is too large to excrete

62
Q

Rhabdomyolysis etiology

A

-Immobility & unresponsiveness, malignant hyperthermia, infection, herbal medicines, snakebite, cowfish ingestion
-Cocaine, hypernatremia, fire ant bites, & venlafaxine

63
Q

Rhabdomyolysis clinical manifestations

A

-Urine becomes dark reddish brown color
-CK is released in massive quantities (100x normal)
-Hyperkalemia, hypophosphatemia &
hypocalcemia
-Increase in cr & BUN

64
Q

Pertinent labs to monitor in rhabdomyolysis

A

-CBC
-Coagulation
-Electrolytes
-Kidney function
-Specialty labs

65
Q

Reflex urinary incontinence etiologies, where it occurs & what it effects

A

-Stroke, MS, hydrocephalus, cerebral palsy, TBI, brain tumours, & alzheimers
-Influences the detrusor motor area, lesions above C2

66
Q

Detrusor hyperreflexia with vesicosphincter dyssynergia etiologies & where it occurs

A

-Disk problems, MS, transverse myelitis & Guillain-Barré syndrome
-Spinal cord injury/issue between C2-T12

67
Q

Detrusor areflexia, with or without urethral sphincter incompetence etiologies & where it occurs

A

-Myelodysplasia, peripheral polyneuropathies, MS, tabes dorsalis, cauda equina syndrome, herpes
-Spinal injury/issue below S1

68
Q

Mechanism of oliguria in AKI + Prerenal

A

Decreased renal blood flow (hypoperfusion); reduced GFR, increased proximal tubule reabsorption of Na+ & H2O; increased aldosterone & ADH secretion, increased distal tubule reabsorption of Na+ & H2O… Oliguria

69
Q

Mechanism of oliguria in AKI + intrarenal

A

Renal vasoconstricition; hypoxia; renal tubular injury; cast formation; increased intratubular obstruction (increases pressure); tubular backleak; reduced GFR… Oliguria

70
Q

Mechanism of oliguria in AKI + postrenal

A

Obstruction of urine flow; increased intraluminal pressure, inflammatory response & entholial cell injury; renal vasoconstriction; edema; reduced GF pressure… Oliguria

71
Q

Kidney dysfunction often leads to…

A

Left sided heart complications, HTN, & respiratory compromise if severe enough

72
Q

Obstruction in the renal pelvis or proximal ureter

A

Pain located in the flank radiating to the groin

73
Q

Obstruction in the mid ureter is characterized by

A

Pain located in the lateral flank or lower abdomen

74
Q

Calcium oxalate is made up of…

A

Crystals & struvite (struvite is smoother)

75
Q

Diet that contributes to kidney stone formation

A

Valentine’s day diet

76
Q

Upper urinary tract obstructions range from…

A

The kidney to the bladder

77
Q

Lower urinary tract obstructions range from…

A

The bladder to the urethra

78
Q

Blank is more common in pediatrics

A

Nephrotic

79
Q

Normal urine output & what happens if it decreases

A

-30mL/hr or 0.5-1mL/kg/hr
-If voiding decreases, Cr & BUN will increase

80
Q

Detrimental effects of hypocalcemia

A

Chvostek’s sign, trousseau’s sign, prolonged QT & CATS (convulsions, arrhythmia, tetany & stridor)

81
Q

Chvostek’s sign

A

Twitch of the facial muscles that occurs when gently tapping an individual’s cheek, in front of the ear

82
Q

Trousseau’s sign is…

A

Considered positive when a carpopedal spasm of the hand and wrist occurs after an individual wears a blood pressure cuff inflated over their systolic blood pressure for 2 to 3 minutes

83
Q

Chvostek & trousseau signs can…

A

Be used to determine if someone has hypocalcemia

CV487 (15 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions