Disorders of Renal Function

Question 1

list four common causes of urinary tract obstruction

CUPB

Answer 1

congenital anomalies, urinary calculi (stones), pregnancy, benign prostatic hyperplasia,

C
U
P
B

Question 2

define hydronephrosis and differentiate unilateral from bilateral.

Answer 2

hydronephrosis refers to urine -filled dilation of the renal pelvis and calices associated with progressive atrophy of the kidney because of obstruction of urine outflow.

unilateral: usually unilateral

if bilateral, the only cause is that there is an obstruction below the level of the ureterovesical junction.

Question 3

what components are required for kidney stone formation?

Answer 3

supersaturated urine (high concentration of ions like calcium salts, uric acid, magnesium ammonium phosphate) so they can calcinate.

also an environment that allows the stone to grow–a nidus or nucleus that facilitates crystal aggregation (to keep ion clusters together to form a stone)

also an acidic pH will promote their growth.

Question 4

identify diagnosis and treatment for kidney stones

Answer 4

diagnosis is based on symptomatology and diagnostic tests, which include urinalysis, plain film radiography, intravenous pyelography, and abdominal ultrasonography.

treatment is usually supportive. pain relief may be needed during acute phases of obstruction. Antibiotics for UTIs.
most stones that are less than 5 mm pass okay spontaneously. All urine should be strained in the hope of retrieving the stone for chemical analysis–along with other info–gives long term care preventative measures

Question 5

describe two immune causative mechanisms for glomerular injury

Answer 5

1. injury resulting from antibodies reacting with fixed glomerular antigens or antigens planted within the glomerulus.
2. injury resulting from circulating antigen-antibody complexes that become trapped in the glomerular membrane.

Question 6

explain the mechanism of acute postinfectious glomerulonephritis and clinical manifestations.

Answer 6

mechanism: infiltration of leukocytes and messangial cells. also swelling of endothelial cells. the combination of proliferation, swelling, and leukocyte infiltration obliterates the glomerular capillary lumens

clinical manifestations: oliguria, proteinuria, hematuria, cola colored urine, edema, HTN,

Question 7

describe the pathophysiology of the nephrotic syndrome

Answer 7

nephrotic syndrome is where the podocytes or the basement membrane (which are usually good at filtering things out), do not work for whatever reason (response to a disease, etc). They cannot keep the protein in, in essence. Then, there is a substantial loss of protein (3.5 grams/day).

Signs and symptoms include:
frothy urine
edema (cannot keep fluid in the space where it should be)
LOW albumin causes HIGH lipids (WHY? liver compensation)
LOW AT (antithrombin) III (3) can cause HYPERcoagulable states, putting the patient at RISK for DVTs and PEs.

Question 8

explain risk factors for renal cell carcinoma

Answer 8

smoking, obesity (particularly in women), acquired cystic kidney disease associated with chronic renal insufficiency.