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Patho- Exam 3 > Disorders of the Renal System > Flashcards

Disorders of the Renal System Flashcards

1
Q

Urinary Tract Obstruction

  • what is it
  • what 2 things can cause it
A
  • bloackage of urine within the urinary tract

- usually due a stone or tumor

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2
Q

where is a urinary obstruction most likely located?

A

-in the kidneys or the ureters

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3
Q

what determines how serve the urinary blockage is?

A
  • location
  • incomplete or complete obstruction of urine flow
  • duration
  • cause
  • is it in one or both of the urinary tracts
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4
Q

calculi or urolithiasis- what are they made of

A
  • stone

- crystals or proteins

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5
Q

risk factors for renal calculi

A

-gender
-race
geographic location
seasonal factors
dec fluid intake
high protein intake , high na intake, alot of sugar, corn syrup, grapefruit, apple juice
family hx
if you get your first one before 25 chances inc a lot to get another one
-people who have chrons disease are more likely to get it bc they have MG malabsorption

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6
Q

patho of renal stones

A

-supersaturation of one or more stone
basically higher amounts of salts then there is water to dissolve them
so salt percipiated into a solid mass
aggregation makes it bigger also

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7
Q

types of renal stone

A
  • calcium oxalate or calcium phosphate seen in hyperparathryiodism
  • struvite- women have this one 2x more, MG AM-phosphate
  • uric acid- people with gout have this
  • cystinuric- rare and genetic
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8
Q

manifestations of a renal stone

A
  • Really bad flank pain : indicates the stone is in the upper ureter or kidney
  • plain that extends to the scrotum or the vulva- stone is in the bladder or the ureter
  • nausea and vomiting
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9
Q

when does the pain get worse for people with a renal stone

A
  • hydration

- when the stone is moving

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10
Q

hydroureter

A

ureter dilates

happens to people with stones

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11
Q

hydronephrosis

A

fluid builds up into the kidneys

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12
Q

how do the stone move in the renal system

A

-form in the kidneys and they move to the ureter and they get lodged into a space that the ureter bends or changes shape

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13
Q

what evaluations are done for someone who we suspect to have a kidney stone

A

-urinalysis for blood or WBC
-x-ray
intravenous pyelogram IVP- use contrast to see any obstruction
abdominal CT
analysis the stone once it comes out

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14
Q

treatments goals for people with stones

A
  • prevent new ones

- remove old ones

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15
Q

kidney stones can lead a person to develop what 4 things

A

-hydroureter
hydroenphrosis
-pyelonephritis- kidney infection
actue renal failure

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16
Q

what is an UTI

A

-inflammation of the urinary epithelium due to invasion and colonization by bacteria or fungus

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17
Q

what is a women’s risk and why is it higher

A

-location of the anus is closer to the urethra and E.coli is one of the main reasons UTI occur 30% risk

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18
Q

UTI are the most common cause of what disease in hospitalized PT and it is due to what

A
  • sepsis

- due to catheters for long periods of time

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19
Q

what hapthogens cause UTI

A
  • USUALLY FROM THE GI TRACT
  • E.Coli
  • Enterobacter
  • Pseudomonas or Klebsiella which are resistent
  • staph
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20
Q

risk factors for UTI

A

-urinary stasis
-people are immobile
-urinary retention from meds like beta blockers
-benign prostate hyperplasia is obstruction the urethra
-urinary stone lead to obstruction of urine
-CATHETERS ARE THE NUMBER ONE REASON
-fistulas expose the urinary stream to skin or vagina to GI tract
-sex
-immunocompromised
-constiatpation
neurological disorders that make it hard for PT to pee

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21
Q

cystitis

2 types explain each

A
  • inflammation of the bladder
  • UTI causes this
  • could be caused by trauma, autoimmune disease or meds but usually caused by the growth of bacteria, virus or fungus which is infectious cystitis the other ones are noninfectious
22
Q

where can a UTI occur

A

in the kidneys or the bladder anywhere the urinary system

23
Q

manifestations of a UTI

A
  • LUTS- low urinary tract symptoms
  • lower abdominal or supra-pubic pain
  • urgency to pee
  • dysuria
  • frequency inc
24
Q

what are the manifestations of UTI in older people

A
  • they usually don’t have the LUTS they get delirious- confused and agitated
25
Q

treatment for a UTI

A
  • drink alot of water
  • antimicrobial meds
  • avoid bladder irritants like caffeine
  • cranberry juice is really good for preventing but so has constant hydration
26
Q

pyelonephritis

A
  • upper urinary tract infection could be acute or chronic
27
Q

actue pyelonephritis

  • what areas can it impact
  • what does it usually begin as?
A
  • infection of the ureter, renal pelvis, renal parenchyma

- usually begins as a bacterial infection that spread up the urethra or traveled through the blood tot he kidney

28
Q

manifestations of acute pyelonephritis

A
  • rapid onset of fever
  • chills
  • flank pain
  • malaise
29
Q

treatment for acute pyelonephritis

A

-antibiotics for 10-14 days

30
Q

what organisms can cause acute pyelonephritis

A
  • E.coli

- Hospital Acquired Infection - colform bacteria but could also be because of the resistent klebsiella and pseudomonas

31
Q

chronic pyelonephritis

A

-persistent or occurrent episodes of acute pyelonephritis

32
Q

in what group of people does risk for chronic pyelonephritis inc

A
  • individuals who have renal infections

- obstructive condition

33
Q

what can chronic pyelonephritis lead to?

A
  • loss of tubular function and the loss of the ability to concentrate urine
  • poluria
  • protienuria
  • nocturia
  • end stage renal failure in 10 %
34
Q

Glomeruli

A

-filtering uint of the kidneys

35
Q

glomerulonephritis GN

A
  • several diseases of the kidney that usually impact both of them
  • one of the leading causes of end stage kidney disease
36
Q

what do the many of the glomerulonephritis present as?

A
  • inflammation of the glomeruli or of the small blood vessels in the kidneys
  • but some do not have the inflammation
  • they have a collection of immune complexes in the glomeruli made up of antigens and antibodies
  • the antigens can be part of the normal kidney tissue or something dissolved in the blood or body fluid
  • viruses and bacteria are also antigens
  • exposure to bacteria, viruses, drugs or toxins can trigger the glomerular injury
37
Q

some autoimmune diseases that trigger GN

A

-lupus and diabetic nephropathy

38
Q

GN causes what

4things

A

-serve inflammatory response which leads to a dec functioning of the kidneys causes retention of wastes
-dec GFR
-cell proliferation
congestion in the kidney

39
Q

how is GN classified

A

extent of damage that was done

initial cause of the the damage- scleroderma, lupus, strepp

40
Q

In GN describe the steps leading to the disease

A
  • presence of anti-strep antibodies
  • formation of the antibody-antigen complex
  • complement is activated
  • glomeruli have an inflammatory response leading to the accumulation of antigen and antibody and compliment
  • increases the capillary permeability so there is leakage of some large protein and RBC into the urine
41
Q

Acute GN happens after what?

Who is it more common in?

A

men

after a strep oral infection

42
Q

when do symptoms appear for acute GN

A

-10 days after the infection began

43
Q

Clinical Manifestations of GN

A

-dark and cloudy urine bc blood and protein are passing through it
-high blood pressure bc inc renin secretion and dec GFR
-flank or back pain - bc of edema and stretchig of renal capsule
-facial and preorbital edema then general edema
-general signs of inflammation
dec urine output

44
Q

diagnostic tests for GN

A 
-blood tests
high serum urea and creatinine bc the kidneys aren't removing it well
strep antibodies
-will have metabolic acidosis
-urinalysis- check for blood (will have it, rusty urine), protein, in urine, 
inc BUN
dec GFR
no evidence of infection
45
Q

treatments of GN

A

-steroids LIKE GLUCOCORDITIDS to reduce inflammation
-high BP meds
dec protein, Na and water intake bc they are retaining these things already

46
Q

Polycystic Kidney Disease

A
  • life threatening genetic disorder
    -usually starts in one kidney and progresses to both
    -growth of fluid filled cysts on the kidney which causes enlargement of the kidneys
    functional tissue is replaced
    reduced perfusion of the kidneys
    tubule obstruction
47
Q

in serve cases of PKD what gets damaged?

A

-the liver, pancreas via pancreatic cysts and the heart and brain cerbral aneurysms

48
Q

two forms of PKD

A 
determined by the way they are inherited 
Autosomonal dominant 
Autosomonal recessive (less common)
49
Q

clinical manifestations of PKD

A 
enlarged kidneys usually both
HTN
Flank pain bc of the enlarged kidneys 
altered fluid and electrolyte imbalances 
renal calculi
UTI
50
Q

diagnosing PKD

A

-family history
-genetic testing
-physical exam- HTN, Ultrasound or CT to see the cyst
LABS- GFR, BUN, creatinine

51
Q

treatments for PKD

A

control the symptoms like pain, treat infections, control BP

promotion of renal function- dialysis 3-4 hours a week, renal transplant

Patho- Exam 3 (3 decks)

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