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Patho > Disorders Of Renal & LUT Function > Flashcards

Disorders Of Renal & LUT Function Flashcards

1
Q

Renal agenesis

A

without a kidney

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2
Q

Renal hypoplasia

A

small kidney or fewer nephrons

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3
Q

renal dysplasia

A

structures in the kidney are not well differentiated

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4
Q

When are kidneys formed?

A
  • 1st month of pregnancy

- less amniotic fluid means the fetus’ kidney aren’t working well

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5
Q

Autosomal dominant polycystic kidney disease

A

development of cysts on the nephrons and collecting tubules

-causes pain, HTN, infection from sitting urine, hematuria

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6
Q

autosomal recessive polycystic kidney disease

A

almost always progresses to renal failure

-causes pain, HTN, infection from sitting urine, hematuria

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7
Q

Medullary cystic kidney disease

A

occurs in adults only

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8
Q

Nephronophthisis

A

occurs in kids; progresses to renal failure

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9
Q

Acquired form of renal cystic disease

A

results from dialysis

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10
Q

Acute nephritic syndrome

A
  • caused by strep

- 7 to 12 days later you have oliguria

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11
Q

Most common type of kidney cancer

A

Wilms tumor/ nephroblastoma (same thing)

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12
Q

Who gets Wilms tumors?

A

Children 3-5 years old

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13
Q

Distinctive feature of Wilms tumors

A

hypertension

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14
Q

Renal cell carcinoma: who gets it; symptoms

A
  • Adults: usually over 55
  • silent in early stages so it is usually caught in advanced stages
  • late stages: hematuria and flank pain, can metastasize to the lung
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15
Q

What happens when kidneys fail?

A
  • Less waste is removed and more remains in the blood
  • unable to regulate fluid, electrolyte, and pH balance
  • nitrogenous compounds build up in the blood
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16
Q

Acute renal failure

A

abrupt onset and usually reversible but can develop into chronic

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17
Q

Chronic renal failure

A

develops slowly over time and ends up in renal failure

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18
Q

How do we test nitrogenous build up in the blood

A

BUN and creatinine

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19
Q

Prerenal injury

A
  • marked decreased in renal blood flow
  • caused by shock, dehydration, vasoconstricion, clot, atherosclerosis
  • causes decreased CO, and makes them susceptible to ischemia
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20
Q

Intrinsic renal injury

A
  • damage to structures within the kidney (something is wrong with the glomerulus, bowmans capsule or basement membrane
  • caused by ischemia, toxins, intratubular obstruction
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21
Q

Postrenal injury

A
  • obstruction of urine outflow from the kidney

- caused by stones, tumors, enlarged prostate

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22
Q

Acute tubular necrosis

A
  • outcome of prerenal issues in oxygen and blood supply to the kidney
  • if we can’t fix ischemia, we get necrosis or infarct
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23
Q

Which type of kidney injury (AKI) would be most likely to accompany BPH?

A

Postrenal

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24
Q

chronic kidney disease

A
  • decreased GFR greater than 3 months
  • fewer nephrons are functioning
  • remaining nephrons must filter more which leads to hypertrophy
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25
Q

manifestations of chronic kidney diesase (Uremia, fluid, CV, and GI)

A
  • Uremia/azotemia: CNS, GI, and immune disturbances
  • Fluid: Salt wasting, acidosis, hyperkalemia
  • CV: HTN, heart disease
  • GI: Anorexia, N/V, ulcerations
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26
Q

mineral metabolism disorders from chronic kidney disease lead to…

A

metastatic calcifications and bone disease

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27
Q

hyperphosphatemia in chronic kidney disease

A

hyperphosphatemia → hypocalcemia → increased PTH → calcium resorption from bone → bone loss → metastatic calcifications

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28
Q

decreased vitamin D in chronic kidney disease

A

decreased vitamin D → increased PTH and impaired osteoblasts

29
Q

Manifestations of chronic kidney disease (systemic, CNS and PNS, sexual function, skin)

A

-systemic: decreased inflammation and immunity
CNS/PNS: peripheral neuropathy, RLS, uremic encephalopathy
sexual: impotence, hyppfertility, dysmenorrhea
skin: dryness, bruising, Terry nails

30
Q

How can the kidney dysfunction affect the CV system

A
  • causes anemia: decreased blood viscosity → increased HR and peripheral vasodilation
  • angina
  • decreased platelets → bleeding
31
Q

lower urinary tract disorders: obstruction

A
  • occurs below the bladder

- retention or stasis of urine will cause stone to form

32
Q

s/s of lower urinary tract obstruction

A

frequency, hesitancy, straining, weak stream (esp in men, post-void residual greater than 200 ml

33
Q

bladder wall hypertrophy

A

huge prostate has narrowed urethra

34
Q

neurogenic bladder disorders

A

problems coming from neurological mis-signaling

  • bladder overactivity
  • areflexic bladder dysfunction
35
Q

Bladder overactivity

A

failure to relax and store urine

  • hyperactivity
  • common in spinal cord injury and MS
36
Q

Areflexic bladder dysfunction

A

failure to contract and empty (ANS controls bladder, so when it is stimulated, you get lots of bad reactions)

  • HTN, bradycardia, sweating
  • lethal if not fixed
  • common is sacral cord injuries, trauma, spina bifida
37
Q

Autonomic hyperreflexia/ dysreflexia

A
  • failure to store urine
  • spinal cord injury
  • from outside or bodily
  • causes sudden hypertensive crisis
38
Q

uninhibited bladder

A
  • problem with brain signaling
  • failure to store urine
  • stroke, MS, lesions
39
Q

Detrsor-sphincter dyssynergia

A
  • failure to store urine

- detrusor muscles and bladder sphincter can’t work together because of trauma or lesions

40
Q

stress incontinence

A

weakness of detrusor muscles

  • common in women who’ve given birth, elderly, obese
  • do kegel exercises
41
Q

urge incontinence

A

have to go right away

42
Q

mized incontinence

A

stress+urge

-common in elderly and menopausal women, women who’ve given birth, and obesity

43
Q

overflow incontinence

A
  • obstruction or large prostate, tumor

- causes dribbling, leaking, or weak stream

44
Q

nocturnal enuresis

A
  • urinate at night

- normal in children up to 6 years old, lots of drugs or night sedation

45
Q

postmicturition dribble

A

you think its empty but you get dribble a few mins later

46
Q

continuous urinary leakage

A
  • problems with storing urine or neurological damage that does’t allow sphincter to close
  • tumor
47
Q

UTI

A

(usually) a bacterial infection that entered from the urethra

48
Q

host defenses for UTIs

A
  • washout phenomenon: body will make a lot of urine to remove bacteria
  • protective mucin layer: keeps bacteria from colonizing in the bladder
  • Local immune responses and IgA
  • Phagocytic blood cells
  • normal flora and prostate secretions
49
Q

UTI during pregnacy

A

want to avoid at all costs because it could irritate the uterus and cause premature labor

50
Q

Normal flora and prostate secretions that protect from UTIs

A
  • vagina has lactobascillus which inhibits baterial growth in the same place
  • prostate has a fluid that comes out with seminal fluid that is antimicrobial
51
Q

urothelial neoplasias: invasive urothelial cell carcinomas

A
  • high grade: infiltrate the structure around the bladder

- malignant and spread

52
Q

1 sign of invasive urothelial cell carcinomas

A

painless hematuria (infection causes flank pain, so painless hematuria is much worse)

53
Q

urothelial neoplasias: Malignant tumors

A

-usually occur in the inside of the bladder lining

54
Q

IgA nephropathy

A

Buerger’s disease

55
Q

Azotemia

A

Presence of nitrogenous waste in the blood

56
Q

Nephrotic Syndrome: Proteins in Urine

A
  • Albumin–> edema & increased free drug
  • Immunoglobulins & complement–> immune suppression
  • Binding proteins–> low ions & hormones
  • Clotting & anticlotting factors–>thrombosis
57
Q

Nephritic Syndrome

A

Inflammatory process damages the capillary wall

58
Q

Good pasture syndrome

A
  • nephritic syndrome

- antibodies to your basement membrane

59
Q

Acute tubular necrosis

A

lack of blood supply to the kidney (think of as renal MI)

60
Q

Tubulointerstitial nephritis

A

inability to concentrate urine

61
Q

Acute pyelonephritis

A
  • abrupt onset
  • painful urination
  • usually caused by E. coli
62
Q

Chronic pyelonephritis

A
  • scarring & atrophy
  • reflux: urine backs up
  • ends with renal failure
63
Q

Uncomplicated pyelonephritis

A

no other comorbidities

64
Q

Complicated pyelonephritis

A

Pyelonephritis r/t obstruction, catheterization, renal surgery, spinal cord injury, pregnancy, reflux

65
Q

Hydronephrosis

A

Obstruction resulting from urine filled calculi

Ex: stones, scarring, or tumors can cause this

66
Q

Calcium stones treatment

A
  • Treat underlying conditions
  • Increased fluid intake
  • Thiazide diuretics
67
Q

Magnesium ammonium phosphate stones treatment

A
  • Treat UTI
  • Acidification of urine
  • Increase fluid intake
68
Q

Cystine Stones

A
  • Kids usually get these

- not infectious for kids

69
Q

Uric acid stones

A

Gout

Patho (10 decks)

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