Exam 6: GU Disorders Flashcards
Acute Kidney Injury
pre- (hypovolemia), intra- (infection or meds) or post-renal (blockage) etiologies
Quick onset decreased GFR of the blood leads to azotemia, high serum creatinine, and fluid retention (oliguria)
4 phases: onset, oliguria, diuresis, recovery
Diagnosis: dec. UOP, inc. creatinine, sudden drop in GFR, inc. BUN, hyperkalemia, metabolic acidosis
Can be reversible
Acute Tubular Necrosis
destruction of the tubular epithelial cells (which sloughs off and blocks tubules) with acute suppression of renal function
Chronic Kidney Disease
Leading causes = DM and HTN
Gradual onset - function deteriorates until unable to excrete waste (failure)
Diagnosis: dec. UOP, inc. creatinine, inc. BUN, elevated electolytes (concentrated), proteinuria
Irreversible, progressive disease (dialysis or transplant to live)
Urinary tract infection
Etiology: intercourse, anatomical (hypospadias), obstruction (BPH), DM, catheter, stones, neurogenic bladder
E. coli
Voiding washes out, but bacteria able to ascend up the urethra and inflame urinary epithelium
CM: Symptomatic or asymptomatic, Dysuria (pain/burning), Frequency, Urgency, Nocturia, Low back pain, Cloudy urine, Foul smelling urine, Pyuria (WBCs in urine), Hematuria
UA diagnosis, can progress to pyelo
Pyelonephritis
Progression of UTI to full kidney infection
Starts with UTI CM but then presents w/ flank pain (CVA), fever, hematuria
Can cause renal failure
Interstitial cystitis
Patho/etiology unclear - erythema, tears, and ulcerations of the bladder wall
May present like UTI (frequency & urgency)
No infectious process present
Acute glomerulonephritis
inflammation and damage of the glomerular structure of the kidney - causes can be immunologic, non-immunologic, and hereditary
2nd leading cause of kidney failure
sudden hematuria (damage to capillary wall), oliguria, HTN, edema
proteinuria in UA, inc. BUN and creatinine
Renal Calculi
kidney stones
calcium most common, links to diet/genetics (caucasian and males more common)
hematuria, extreme flank/abd pain, renal colic, crystalluria
abd non-contrast CT (unless pregnant)
Benign prostatic hyperplasia/hypertrophy (BPH)
Androgens (testosterone and dihydrotestosterone) and estrogen contribute to the development. Enlarges -> pressure on the urethra -> decreases urinary flow and the bladder is unable to empty
frequency, weak stream, hesitancy, residual volume, nocturia, incontinence
biopsy only if concern from DRE (asymmetric or nodular)
Polycystic kidney disease
genetic (autosomal dominant)
leading cause of CRF
develop renal cysts throughout cortex
cysts swell and press against the renal capsule=extreme pain, gross hematuria, flank pain
require transplant
4 phases of AKI
oliguric - (50% won’t experience): not voiding, hyperkalemic
diuresis - not concentrating urine, voiding a lot (hyponatremic and maybe hypo/hyperkalemic)
recovery - kidney function starting to improve
nephrotic syndrome
proteinuria
nephritic syndrome
hematuria and RBC casts
