Exam 3 - Renal and urologic systems Flashcards
What is the function of the renal and urologic systems?
- -filter waste products and remove excess fluid from the blood
- control mineral and water balance
- acid-base regulation
- secretion of endocrine hormones
- control arterial pressure
- store and excrete urine
3 locations that can be messed up with urine formation
1- blood flowing into the kidneys
2- blood within the kidney
3- changes in capillary pressures
What is GFR?
- glomerular filtration rate
- (125 ml/min)
- depends on a few things and is a good marker of kidney pathology going on
Acute kidney injury
- aka acute renal failure
- characterized by: rapid dec in GFR, dysregulation of fluid and electrolyte balance, and retention of metabolic waste products with dec urine flow
*temporary injury
Chronic kidney disease
- aka chronic renal failure
- altered kidney function and diminished GFR for MORE than 3 months
- MCC = diabetes
- final stage is ESRD (end stage renal disease)
ESRD
- end stage renal disease
- final stage of chronic kidney disease. loss of kidney function leading to significant systemic effects (need dialysis or transplant)
How do you diagnosis someone with CKD? (chronic kidney disease)
- history of DM, HTN, family history
- decreased GFR
- inc BUN and Creatinine
- protein in urine
How do you treat CKD?
- treat the underlying disease and help prevent further kidney damage (HTN, DM)
- manage cardiovascular risk factors (#1 cause of death)
- meds
- renal replacement therapy
What is glomerular disease?
- disease damaging the kidney’s filtering untis (glomeruli)
- MCC of ESRD worldwide. (DM,HTN in US)
-have primary and secondary
What is primary Glomerulonephritis?
linked to what?, 3 ways it can happen?, blah
- type of glomerular disease
- linked to immune mechanisms (antibody-antigen complexes clump together and get trapped)
- inflammation of glomerulus (autoimmune, filtering toxins, or complexes get trapped)
- Damages cells and basement membrane
- get proliferation of mesangial cells and ECM deposition
- fibrosis and sclerosis
Glomerulonephritis is associated with what 2 syndromes?
Nephritic syndrome = associated with blood (blood in urine, dec GFR, protein in urine, HTN)
Nephrotic syndrome = associated with protein (heavy proteinuria, dec protein in blood, severe edema, lipids in urine)
Why does Nephrotic syndrome cause edema?
-causes more proteins in the urine. this means less proteins in the blood. this changes osmotic pressure and fluids go into the tissues = EDEMA!
how do you diagnosis and treat glomerulonephritis?
Dx: test urine, serum antibody analysis, biopsy kidney
Treat: treat underlying disorder, immune suppressants, plamapheresis/dialysis or transplant (plasma… is like dialysis but filter antibodies?)
What is a UTI? (and symptoms)
- urinary tract infection
- very common
- Can have cyctitis (bladder) or urethritis
- symptoms: frequency, urgency, nocturia, pain, stuff in pee, mental status change in older adults
UTI diagnosis and treatment
diagnosis: history, urinalysis, scans for contributing factors
Treatment: antibiotics, inc fluid intake, treat contributing factors
What is pyelonephritis and what are the 2 classifications?
- an inflammation/infection involving the kidney parenchyma and renal pelvis
- can have acute and chronic
What is the difference btwn acute and chronic pyelonephritis?
Acute: usually associated with ascending UTIs
Chronic: tubulointerstitial disorder characterized by inflammation and scarring of the calyces and pelvis (can be caused by reflux, obstructino, abnormalities, or toxins and can lead to ESRD)
What is nephrolithiasis?
- one of the most common urinary tract disorders (more so in men)
- renal calculi or urinary stones made of various materials.
- due to inc blood levels and urinary excretion of the mineral
What are symptoms of nephrolithiasis?
- severe pain
- flank pain
- blood in urine
- similar to UTI
How do you diagnosis and treat nephrolithiasis?
diag: CT, US, X-ray, urinalysis
treat: lots of fluids, pain meds, blast it to break it up or surgery to remove in needed.
What is renal cystic disease?
- lots of cysts (filled with fluid or renal tubular elements) in the kidney that cause a dec in function by causing degeneration of obstruction
- fairly common
- 6 categories: polycystic kidney disease (PKD) = most common
- most cysts form from tubular epithelium
- *more cysts = more interruption of function!
- often asymptomatic
What is polycystic kidney disease? (PKD)
- most common category of renal cystic disease
- genetic disorder
- leading cause of ESRD
What is renal cell carcinoma? (RCC)
- kidney cancer
- risk factors: genetic, smoking, obesity, HTN., job, acquired cystic disease
Bladder cancer (where does it form, risk factors, major symptoms)
- 4th leading cause of cancer in men
- majority form in epithelial cells lining bladder
- Risk: SMOKING, job, male……..
- Symptom: HEMATURIA
- need surgery
Functional urinary incontinence
-cannot make it to toilet due to joint or muscle dysfunction increasing the time to get to the bathroom
Stress urinary incontinence
something increases intraabdominal pressure and you pee a little (cough, laugh, lifting)
Urge urinary incontinence
- sudden urge with uncontrolled loss of urine
- stronge contraction of bladder
overflow urinary incontinence
- bladder is over stretched
- constant leaking from a full bladder that is unable to fully empty
Mixed urinary incontinence
combination of more than one
-functional, stress, urge, overflow
