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Renal phys > Diseases/Conditions of the Renal System > Flashcards

Diseases/Conditions of the Renal System Flashcards

1
Q

Diuretics

A

act to INCREASE urine volume output

typically also increase SOLUTE output

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2
Q

Edema

A

-presence of fluid in body tissues
2 types:
1) Intracellular
2) Extracellular

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3
Q

Intracellular Edema

A

Due to:

1) hyponatremia
2) metabolic depression
3) lack of adequate nutrition

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4
Q

Extracellular Edema

A

Due to:

1) fluid leakage
2) lymphatic failure

Causes:

  • increased capillary pressure
  • decreased plasma proteins
  • increased capillary permeability
  • decreased lymph return
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5
Q

Increased capillary permeability (ext. edema)

A

1) excessive kidney retention of salt and water
- kidney failure; mineralocorticoid excess

2) high venous pressure and venous constriction
- heart failure; venous obstruction; failure of venous pumps

3) decreased arteriolar resistance
- high body heat; decreased SNS; vasodilator drugs

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6
Q

Decreased plasma proteins (ext. edema)

A
  • loss of proteins in the urine (NEPHROTIC SYMDROME)
  • loss of proteins due to BURNS or WOUNDS
  • decreased production of proteins (extreme dietary restriction; liver disease)
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7
Q

Increased capillary permeability (ext. edema)

A
  • immune reactions - HISTAMINE
  • toxins
  • bacterial infection
  • vitamin deficiency (vit C)
  • prolonged ischemia
  • burns
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8
Q

Decreased lymph return (ext. edema)

A
  • cancer
  • infections
  • surgery
  • congenital abnormality of lymphatic vessels
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9
Q

Edema - Natural Safety Factors

A
  • interstitial fluid hydrostatic pressure in loose subcutaneous tissues of the body (suction)
  • increase in lymph flow
  • “washdown”
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10
Q

Washdown

A
  • INC in interstitial fluid pressure = INC lymph flow
  • DEC in interstitium protein concentration as we INC lymph flow

-DEC in protein -> DEC osmotic pressure -> fluid prevention from capillaries to interstitial fluid

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11
Q

T/F: Capillary pressure can rise double the normal amount before edema can occur.

A

TRUE

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12
Q

Hyponatremia

A
  • plasma sodium is LOW
  • Dehydration - loss of NaCl
  • Overhydration - over retention of water (ADH)
  • *MOST COMMON electrolyte disorder!!!
  • can result in edema, brain swelling or damage, death
  • rapid correction can also cause damage
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13
Q

Hypernatremia

A
  • plasma sodium is HIGH
  • Dehydration - water loss (lack ADH)
  • Overhydration - excess NaCl (HIGH AHD)

-effects = less severe - cells resist damage from shrinkage

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14
Q

Nephrotic Syndrome

A
  • caused by a variety of disorders that damage the kidneys at the glomerular membrane
  • all result in RELEASE OF EXCESS PROTEIN in the urine
  • children - minimal change disease; loss of PODOCYTE at glomerulus
  • adults - membranous glomerulonephritis (disbetes, lupus, multiple myeloma)
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15
Q

Symptoms of Nephrotic Syndrome

A

1) Protein in urine (mostly ALBUMIN; foamy)
2) Edema
3) Others:
- dec appetite
- weight gain from fluid retention
- hypertension
- hyponatremia
- hylerlipidemia

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16
Q

Treatments/prevention of Nephrotic Syndrome

A
  • decrease BP
  • ACE inhibitors
  • Corticosteroids
  • Dietary changes
  • Blood thinners
17
Q

Nephritic Syndrome

A

Similar to nephrOtic syndrome; however, cells are now able to pass through the glomerular membrane

-acute membranous glomerulonephritis (abnormal immune response, severe infection)

18
Q

Symptoms of Nephritic Syndrome

A

1) BLOOD in urine (RBC casts)
2) Protein in urine (albumin; foamy)
3) Hypertension

19
Q

Cystitis

A

*Urinary tract infection - inflammation of bladder usually caused by bacterial infection

**if left untreated, can turn into PYELONEPHRITIS

20
Q

Causes of cystitis

A

-Germs (bacteria) enter the urethra and bladder

21
Q

Factors that increase frequency of cystitis

A
  • urinary catheter
  • blockage of bladder or uretha
  • diabetes
  • pregnancy
  • narrow urethra
  • immobility
22
Q

Symptoms of cystisis

A
  • persistent urge to urinate
  • burning sensation when urinating
  • pelvic discomfort
  • lower abdominal pressure
  • cloudy or bloody urine can have a strong odor
23
Q

Pyelonephritis

A

*acute infection of the renal pelvis or parenchyma (usually due to an ascending infection - UTI)

24
Q

Symptoms of pyelonephritis

A

Chills, fever, nausea, vomiting, unilateral or bilateral loin pain that can radiate to suprapubic region

Children and elderly can present no symptoms other than mental confusion

25
Q

Nephrolithiasis

A
  • KIDNEY STONES
  • most common types=
    1) CALCIUM OXALATE
    2) CALCIUM PHOSPHATE
26
Q

Symptoms of nephrolithiasis

A
  • flank pain
  • can come in waves
  • uncomfortable
  • nausea
  • vomiting
  • blood in urine
27
Q

Causes of nephrolithiasis

A

1) imbalance of water (solutes in urine crystalize; too concentrated)
2) predisposition to having kidney stones runs in families

28
Q

Treatment/prevention of nephrolithiasis

A
  • increase fluid intake to help pass the stone
  • pain medications
  • surgery/scope
  • sound waves
29
Q

Polycystic kidney disease (PKD)

A

*a genetic disorder that causes the formation and enlargement of cysts in the kidneys

30
Q

Symptoms of PKD

A
  • blood in urine
  • abdominal pain
  • frequent kidney stones
  • high blood pressure
  • frequent UTI
  • liver and pancreatic cysts
31
Q

Causes of PKD

A
  • *genetic disorder
    1) Autosomal Dominant PKD (ADPKD)
  • Cysts develop in NEPHRONS (typically 30-40 yrs)

2) Autosomal Recessive PKD (ARPKD)
- seen in young children or the womb
- cysts develop in COLLECTING DUCTS
- can be very fatal

32
Q

Treatment/prevention of PKD

A
  • ease pain and prolong life
  • medication to decrease BP and pain
  • antibiotics to treat UTIs
  • dialysis and kidney transplant after renal failure
33
Q

Chronic Kidney Disease

A
  • continual damage/loss of function in kidneys
  • can be masked until 75% of ability to process is lost
  • Steps:
    1) injury
    2) persistence
    3) loss
    4) adaptation
    5) return to step 1
34
Q

Initial kidney disease/damage

A
  • loss of nephrons
  • damage to remaining nephrons
  • increased demand on remaining nephrons
  • cardiovascular changes
35
Q

Most common causes of CKD/end stage renal disease

A

1) diabetes mellitus 45% ***
2) hypertension 27%
3) glomerulonephritis 8%
4) PKD 2%
5) unknown 18%

36
Q

Dialysis

A
  • used both short and long term to treat loss of kidney function
  • NOT as effective as actual kidneys
  • functions via DIFFUSION only
  • does NOT replace kidney functions (i.e., hormones)
  • must sit attached to equipment for 4-6 hours (3X a week)

Renal phys (8 decks)

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