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Patho > disorders of the renal system > Flashcards

disorders of the renal system Flashcards

1
Q

urinary tract obstruction is a ___ of __ ___ within the urinary tract

A

blockage

urine flow

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2
Q

severity of urinary tract obstruction is based on

A 
Location
Completeness
Involvement of one or both upper urinary tracts
Duration
Cause
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3
Q

calculi or urinary stones/ urolithiasis

A

Masses of crystals, protein, or other substances that form within and may obstruct the urinary tract

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4
Q

risk factors of calculi or urinary stones

A 
gender
race
 geographic location
seasonal factors 
fluid intake
diet
occupation
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5
Q

calculi/ urinary stone pathophysiology

A
  • Supersaturation of one or more salts/substances
  • Precipitation of a salt from liquid to solid state
  • Growth through crystallization or aggregation
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6
Q

types of renal stones

A
  • calcium oxalate or calcium phosphate
  • struvite stones (magnesium- ammonium-phosphate)
  • uric acid stones
  • cystinuric stones (genetic disorder)
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7
Q

CM of renal calculi

A

flank pain
hydration makes pain worse
N/V

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8
Q

Evaluation of renal calculi

A 
urinalysis
kidney, ureter, bladder (KUB) xray
iv pyelogram (IVP)
abdominal CT
stone analysis
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9
Q

treatment goals of renal calculi

A

remove stones

prevent formation of new stones

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10
Q

risks of renal calculi

A

hydronephrosis
pyelonephritis
acute renal failure

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11
Q

UTI is an ___ of the urinary ___ following invasion and colonization by some pathogen within the urinary tract

A

inflammation

epithelium

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12
Q

most common pathogens in a UTI

A

e. coli
staphylococuus saprophyticus
enterobacter

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13
Q

UTI causes ___, an inflammation of the bladder

A

cystitis

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14
Q

cystitis can be caused by

A

trauma
autoimmune disease
certain medications

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15
Q

manifestations of UTI

A

frequency
dysuria
urgency
lower abdominal and suprapubic pain

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16
Q

elderly and UTI

A

usually none of the normal sx, but with delirium

17
Q

treatment of UTI

A

antimicrobial therapy
increased fluid intake
avoid bladder irritants
cranberry capsules have been shown to reduce risk in those with chronic infection

18
Q

acute pyelonephritis is an acute infection of the ____, ___ ____ and/ or ___ ___

A

ureter
renal pelvis
renal parenchyma

19
Q

manifestations of pyelonephritis

A

rapid onset of fever
chills
malaise
flank pain

20
Q

treatment of acute pyelonephritis

A

antibiotics

generally resolves in 10-14 days

21
Q

chronic pyelonephritis

A

persistant or recurring episodes of acute pyelonephritis

22
Q

people with ___ ____ and some type of ____ pathological condition are at risk for chronic pyelonephritis

A

renal infections

obstruction

23
Q

chronic pyelonephritis can lead to

A

loss of tubular function
ability to concentrate urine
this leads to polyuria, nocturia, proteniuria and maybe eventual end stage renal failure

24
Q

Glomerulonephritis

A
  • presence of anti- steptococcal antibodies:
    1. formation of antigen- antibody complex
    2. activates complement system
    3. inflammatory response in glomeruli causing leakage of some protein and RBC
  • severe inflammatory response
    1. congestion and cell proliferation; decreased GFR leading to retention of fluids and wastes
25
Q

CM of Glomerulonephritis

A 
urine is dark and cloudy 
facial and per-orbital edema 
elevated BP
flank back pain
general signs of inflammation 
decreased urine output
26
Q

dx of Glomerulonephritis

A

blood tests
metabolic acidosis
urinalysis

27
Q

blood tests for Glomerulonephritis

A
  • elevated serum urea and creatinine
  • elevated anti-DNase B, streptococcal antibodies, anti- spteptolysin, anti- streptokinase
  • decreased complement levels (used in renal inflammation)
28
Q

urinalysis of Glomerulonephritis

A

proteniuria
hematuria
erythrocyte casts
no evidence of infection

29
Q

tx of Glomerulonephritis

A

sodium restriction
protien and fluide intake decreased
drug treatment like glucorticoids and anti-hypertensives

30
Q

polysystic kidney disease

A

growth of fluid filled cysts BILATERALLY in kidneys , resulting in replacement of functional tissue, reduced profusion, tubule obstruction

31
Q

PKD categories

A

Genetic, autosomal dominant
Genetic, autosomal recessive
Acquired

32
Q

CM of PKD

A 
Enlarged kidneys
Hypertension
Flank pain
Altered fluid, electrolyte balance
Renal calculi- Diverticular disease
Urinary tract infection
Liver, pancreatic cysts
Cardiac valvular disease
Cerebral aneurysms
33
Q

PKD dx

A 
Family history
Genetic testing
Physical exam
Hypertension
Imaging studies	
Presence of > 3 kidney cysts on ultrasound
Extrarenal cysts
Laboratory confirmation of renal failure
34
Q

PKD treatment

A

Symptomatic care

  • Pain control
  • Treatment of infection
  • Blood pressure control

Promotion of renal function

  • Dialysis
  • Renal transplant
  • Supportive care during end-stage renal disease

Patho (17 decks)

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