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Pathophysiology > Genitourinary System > Flashcards

Genitourinary System Flashcards

1
Q

___ ___ ___ is the percentage of body weight that is made of up water

A

Total body water

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2
Q

Newborns have ___% total body water

A

75

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3
Q

Elderly people have a total body water of ___%

A

50

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4
Q

Adults have a total body water of ___%

A

55-60

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5
Q

____ fluid makes up 40% of our body weight which is 70% of total body water

A

Intracellular

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6
Q

____ fluid is a good indication of what is in the intracellular fluid

A

Extracellular

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7
Q

____ fluid is the fluid surrounding cells and makes up only 20% of total body weight

A

Interstitial

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8
Q

____ is the fluid in blood/vascular space

A

Plasma

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9
Q

___ ___ is the volume of all electrolytes and everything else in the blood, while plasma volume is just the fluid

A

Blood volume

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10
Q

We gain about 2500 cc per day from what three things?

A

-Ingested fluids
-Water in food
-Water from the oxidation of food

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11
Q

The GI tract absorbs up to ___ liters of fluid each day from salivary, gastric, biliary, pancreatic, and intestinal secretions

A

10

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12
Q

We usually ___ just as much water as we ___

A

Lose, gain

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13
Q

How do we lose water?

A

-Kidneys (lose 1400 cc per day)
-Skin and lungs (900-1000 cc per day)
-GI tract (200 cc/day)

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14
Q

___ ___ explains how the net effect for overall intracellular cations is greater than overall net effect for extracellular cations and anions

A

Electrolyte balance

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15
Q

There is a ____ concentration of potassium and magnesium in the cell (intracellular) than outside of the cell

A

Higher

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16
Q

There is a ____ concentration of sodium on the outside of the cell (extracellular)

A

Higher

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17
Q

___ is one regulator of fluid and electrolyte balance

A

Thirst

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18
Q

You have increased thirst in response to…

A

-Increased osmolality
-Decreased blood volume

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19
Q

What may impact an individual’s ability to respond to thirst?

A

-Decreased thirst as we age
-Medications may decrease thirst
-Neurologic impairment
-Childred

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20
Q

Antidiuretic hormone is also known as ____

A

Vasopressin

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21
Q

Antidiuretic hormone is released in response to…

A

-Increased osmolality
-Decreased blood volume

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22
Q

The ____ stimulates the anterior pituitary gland to release antidiuretic hormone

A

Hypothalamus

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23
Q

Antidiuretic hormone causes us to retain more ____

A

Water

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24
Q

When there is low blood flow or low oxygen, the kidneys release ____, which cuts a piece of angiotensin to make angiotensin I

A

Renin

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25
Q

Angiotensin I is not biologically active until ____ comes to activate it

A

ACE

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26
Q

When ACE (Angiotensin Converting Enzyme) comes across angiotensin I, it with cleave a piece to make ____ ____

A

Angiotensin II

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27
Q

___ ___ can inhibit the conversion from angiotensin I to angiotensin II

A

ACE inhibitors

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28
Q

Angiotensin II is biologically active and a potent ____

A

Vasoconstrictor

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29
Q

Angiotensin II stimulates the pituitary to release ___ ___ to increase water retention

A

Antidiuretic hormone

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30
Q

Angiotensin II also stimulates the adrenal gland to release _____ which also causes increased water and sodium retention in the body

A

Aldosterone

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31
Q

____ converts angiotensin II to angiotensin III

A

Angiotensinase

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32
Q

Angiotensin III is a biologically active molecule, but only has about ___% of the constriction power of angiotensin II (it still causes water and sodium retention by aldosterone production)

A

40

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33
Q

When the heart is stretched, it releases ___ ___ ___, which is a direct vasodilator, to decrease blood pressure and increase excretion of water and sodium

A

Atrial naturetic peptide

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34
Q

___ ___ ___ has the same vasodilator properties of atrial naturetic peptide but comes from the brain and not the heart

A

Brain naturetic peptide

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35
Q

Kidneys are located in the back, under the __ __

A

Rib cage

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36
Q

What are the three major functions of the kidneys?

A

-Filtration
-Reabsorption
-Secretion

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37
Q

The kidneys filter things from the blood into the ___ ___; this fluid will move through the tubules of the nephron where we will see reabsorption

A

Bowman’s capsule

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38
Q

Reabsorption refers to substances that are filtered but sent back to the body instead of the ____

A

Urine

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39
Q

___ refers to the movement of substances from the blood into the tubules

A

Secretion

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40
Q

The ___ is where the filtration occurs in the kidneys

A

Glomerulus

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41
Q

The ___ ___ brings oxygenated blood to the kidney to be filtered (juxtaglomerular cells that line the arteriole release renin)

A

Afferent arteriole

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42
Q

The ___ ___ is where filtered blood is returned to the circulation

A

Efferent arteriole

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43
Q

___ ___ ___ is determined by the balance between hydrostatic pressure and colloidal oncotic pressure

A

Glomerular filtration rate

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44
Q

What forces are involved in filtration?

A

-Glomerular capillary hydraulic pressure
-Oncotic pressure of fluid in Bowman’s capsule
-Hydraulic pressure in Bowman’s capsule
-Oncotic pressure of glomerular capillary plasma
-Filtration pressure

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45
Q

The tubules are responsible for ___ and ___

A

Resorption and secretion

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46
Q

The collecting duct collects, fluid that becomes ____

A

Urine

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47
Q

The majority of reabsorption of sodium occurs in the ___ ___ ___ (some also is reabsorbed in the loop of henle and the distal convoluted tubule)

A

Proximal convoluted tubule

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48
Q

___ ___ work to decrease water reabsorption in the loop of Henle

A

Loop diuretics

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49
Q

What helps regulate the pH of the blood?

A

HCO3

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50
Q

What are three blood tests of renal function?

A

-Creatinine
-Blood urea nitrogen (BUN)
-Urinalysis

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51
Q

Creatinine is a substance that is freely filtered from the blood into the glomerulus; it is an end product of ___ ___ (it is a very good indicator of glomerular function

A

Muscle metabolism

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52
Q

Normal creatinine level is ___-___ mg/dL

A

0.7-1.2

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53
Q

What is included in urinalysis?

A

-Sodium levels
-Specific gravity
-Potassium
-pH
-Osmolality
-RBC and WBC
-Casts

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54
Q

Normal BUN is from __-__ mg/dL

A

8-25

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55
Q

___ ____ measures the osmolality of urine

A

Specific gravity

56
Q

There should not be many ___ or ___ in the urine

A

RBC or WBC (WBC may indicate UTI)

57
Q

____ are mucoproteins that have come off the nephron and will stick to things and create a mold (we don’t want to see RBC casts, WBC casts, or bacteria casts because this would indicate that these were in the kidneys

A

Casts

58
Q

We don’t want to see ___ in the urine

A

Glucose

59
Q

____ in the urine would indicate pregnancy

A

HCG

60
Q

Alterations in fluid volume may be…

A

-Isotonic
-Hypertonic imbalance
-Hypotonic imbalance

61
Q

Hypertonic imbalance may be due to ____

A

Hypernatremia

62
Q

Hypotonic imbalance may be due to ____

A

Hyponatremia

63
Q

Hyponatremia is caused by serum sodium less than ____ mEq/L and causes blood to be less concentrated

A

136

64
Q

Hyponatremia can be caused by…

A

-Excess sweating
-GI losses (long-term diarrhea)
-Diuretics
-Excess water retention (syndrome of inappropriate antidiuretic hormone)
-Decreased delivery of blood volume to the kidney

65
Q

Hyponatremia may cause cells to be hypotonic and ____

A

Burst

66
Q

Hyponatremia may cause what symptoms?

A

-High intracranial pressure (neurological issues)
-Muscle spasms and cramps
-Loss of appetite
-Weakness
-Fatigue
-Severe may cause coma and death

67
Q

Hypernatremia may be caused by…

A

-Loss of body fluid
-Excess urinary output
-Diabetes insipidus
-Watery diarrhea
-Dehydration
-Excessive sodium intake
-Cardiac arrest treatment
-Hypertonic saline

68
Q

Manifestations of hypernatremia:

A

-Decreased urine output
-Excessive thirst
-Dry mucous membranes
-Water pulled out of the cells of the CNS, causes lethargy, agitation, headache, restlessness
-Edema
-Severe could cause edema and death

69
Q

____ is the abnormal development of fluid in the interstitial space

A

Edema

70
Q

Possible etiologies of edema

A

-Increased hydrostatic pressure
-Decreased colloid osmotic pressure/oncotic pressure
-Increased capillary membrane permeability
-Lymph obstruction

71
Q

What may cause increased hydrostatic pressure?

A

-Increased vascular volume (heart failure)
-Venous obstruction (thrombophlebitis, ascites)
-Gravity (swollen feet)

72
Q

What may cause decreased colloidal osmotic pressure?

A

-Decreased production of plasma proteins
-Nephrotic syndrome

73
Q

What may cause increased capillary permeability?

A

-Inflammation
-Sepsis
-Burns

74
Q

What may cause lymph obstruction?

A

-Surgical removal of lymph nodes

75
Q

Manifestations of edema:

A

-Pitting or non-pitting edema
-High risk for ischemia
-Edematous tissue is more likely to have injury
-Changes in blood pressure

76
Q

___ disorders are caused by a blockage of urine flow at the renal pelvis, bladder, or urethra

A

Obstructive

77
Q

Obstructive disorders may be caused by either an ___ or ____ blockage

A

Internal; external

78
Q

With an internal blockage, urine can’t ____, so it builds up and causes increased pressure

A

Drain

79
Q

Internal blockages increase the risk of ___ and can possibly damage kidneys

A

UTI

80
Q

Most internal blockages are caused by ____, or kidney stones

A

Calculi

81
Q

Other internal blockages can be caused by…

A

-Pregnancy
-Benign Prostate Hyperplasia
-Tumors

82
Q

Manifestations of internal blockages:

A

-Back pressure/pain
-Urine output - unchanged or none

83
Q

Renal calculi are caused by kidney stones that can be made of…

A

-Calcium
-Magnesium ammonium
-Uric acid

84
Q

What factors are needed for stone formation?

A

-Saturated urine
-Organic material
-Deficiency of substances that hinder formation

85
Q

Manifestations of renal calculi:

A

-Infections
-Hydronephrosis (too much water in the kidney)

86
Q

Signs and symptoms of renal calculi:

A

-Pain
-Clammy skin due to pain
-Nausea and vomiting due to pain

87
Q

____ is inflammation of the bladder

A

Cystitis

88
Q

Cystitis is caused by a ___ ___, commonly E. coli

A

Bacterial infection

89
Q

Risk factors for developing cystitis:

A

-Gender (women are more likely)
-Prostate hypertrophy
-Diabetes Mellitus
-Immunosuppression
-Pregnancy
-Foley catheter
-Post colonoscopy

90
Q

Manifestations of cystitis:

A

-WBC in the urine
-Pus int he urine

91
Q

Symptoms of cystitis:

A

-Possibly asymptomatic
-Young women typically have frequent urination, urgency of urination, dysuria (pain with urination), possible superpublic pain
-Severe cases may cause blood in the urine or cloudy urine

92
Q

____ is infection of the kidneys and renal pelvis (a UTI/cystitis that has traveled up to the kidneys)

A

Pyelonephritis

93
Q

____ pyelonephritis is more common and may lead to chronic

A

Acute

94
Q

Pyelonephritis is caused by ___ of bacteria up the urethra to the kidney

A

Retrograde

95
Q

Manifestations of pyelonephritis:

A

-Inflammation of the kidney, affecting the drainage system

96
Q

Symptoms of pyelonephritis:

A

-Chills
-Fever
-Headache
-Back pain
-Purulent/thick urine
-Weird odor in the urine
-Casts in the urine

97
Q

____ pyelonephritis is recurrent infections of acute pyelonephritis

A

Chronic

98
Q

With chronic pyelonephritis, ____ causes shape changes and can even lead to kidney disease

A

Scarring

99
Q

Manifestations of chronic pyelonephritis are similar to ____ pyelonephritis, but may lead to chronic kidney disease

A

Acute

100
Q

_____ is inflammation of the glomerulus and causes it to lose its ability to properly filter blood

A

Glomerulonephritis

101
Q

Glomerulonephritis is also known as __ __ __

A

Acute Nephritic Syndrome

102
Q

Nephritic Syndrome is caused by leaky basement membranes that allow ____ to get into the urine

A

Protein

103
Q

Possible causes of nephritic syndrome:

A

-Immune system overactivation (Lupus)
-Post streptococcal (10-14 days post-infection)
-Drug-induced
-Vascular disorders
-Hep B

104
Q

Manifestations of nephritic syndrome:

A

-Hematuria with red blood cell casts
-Proteinuria up to 3.5 grams per day
-Oliguria
-Azotemia
-Hypertension
-Mild edema

105
Q

About ___% of people with nephritic syndrome go on to develop nephrotic syndrome

A

10

106
Q

Nephrotic syndrome causes more severe ____ than nephritic syndrome

A

Inflammation

107
Q

What are possible manifestations of nephrotic syndrome?

A

-Edema
-Hypocalcemia
-Proteinuria > 3.5 grams per day (more than nephritic syndrome)
-High serum and urine LDL
-Hypoalbuminemia (albumin gets dumped in the urine)
-High lipidemia

108
Q

___ ___ ___ is an acute reduction of renal function; seen in up to 5% of hospitalized patients

A

Acute Kidney Injury

109
Q

____ acute kidney injury is caused a problem before the kidney

A

Prerenal

110
Q

Causes of prerenal acute kidney injury:

A

-Dehydration
-Volume depletion
-Diuretics
-Shock
-Edema
-Heart failure
-Hypovolemia
-ACE inhibitors
-NSAIDs

111
Q

Mechanism of prerenal acute kidney injury:

A

-Vasoconstriction of glomerular arterioles to decrease perfusion of the kidney
-Renal function remains normal (just slightly slower)

112
Q

Manifestations of prerenal acute kidney injury:

A

-BUN and creatinine levels will decrease
-Slight decrease in urine output

113
Q

____ acute kidney injury is caused by a problem with the actual tissue of the nephron

A

Intrarenal

114
Q

Intrarenal, or ____ kidney failure, is due to primary damage of the nephrons or destruction of the tubular epithelial cells

A

Intrinsic

115
Q

Possible causes of intrarenal acute kidney injury:

A

-Prolonged renal ischemia
-Toxicity (chemo, drugs, NSAIDs)
-Tubular obstruction (by hemoglobin, myoglobin, etc)
-Postrenal acute kidney injury

116
Q

What are the three phases of intrarenal acute kidney injury:

A

-Onset/initiating phase
-Oliguric/anuric phase
-Diuretic phase

117
Q

In the oliguric phase, someone has little to no ___ ___, as well as increased serum potassium and decreased serum sodium

A

Urine output

118
Q

In the oliguric phase, the body has increased water retention, causing _____ that can look like heart failure

A

Hypertension

119
Q

In the diuretic phase, nephrons recover enough to where they are functional; serum potassium ____ and serum sodium ____

A

Decreases; increases

120
Q

Mechanism of intrarenal acute kidney injury:

A

Ischemia and toxins lead to damage to the renal tubular cells

121
Q

What are some possible manifestations of intrarenal acute kidney injury?

A

-Edema
-Acute tubular necrosis
-Neuropathy
-Muscle pain
-Confusion
-Rash

122
Q

____ acute kidney injury causes a backup of fluid so the capsule has higher pressure which means less blood can move across

A

Postrenal

123
Q

Postrenal acute kidney injury causes damage to the ____

A

Tubules

124
Q

Possible causes of postrenal acute kidnye injury:

A

-Obstruction (prostatic disease, tumor, calculi, congenital abnormality)
-If there is a stone in the urethra, there would be increased pressure in both kidneys but sometimes there might only be damage to one kidney

125
Q

Manifestations of postrenal acute kidney injury:

A

-Increased BUN and creatinine
-Elevated serum potassium
-Low serum sodium

126
Q

___ ___ ____ is progressive and irreversible destruction of kidney structures

A

Chronic kidney disease

127
Q

Stages of CKD:

A

-Stage 1: GFR >90%
-Stage 2: GFR 60-90%
-Stage 3: GFR 30-59%
-Stage 4: GFR 15-29%
-Stage 5: GFR <15% (end-stage renal disease)

128
Q

Causes of CKD:

A

-Diabetic nephropathy
-Chronic glomerular disease
-Hypertension: leads to bumpy surface of the kidney that damages it
-Polycystic disease

129
Q

What are fluid, electrolyte, and acid-base balance manifestations of CKD?

A

-Hyperkalemia
-Metabolic acidosis
-Edema

130
Q

What are some calcium, phosphate, and bone metabolism manifestations of CKD?

A

-Too much parathyroid hormone is released and is toxic
-Hyperphosphatemia
-Hypocalcemia

131
Q

What are some hematologic and immune manifestations of CKD?

A

-Anemia
-Poor coagulation and GI bleeding
-Bruising
-Impaired immune system function

132
Q

What are some cardiovascular manifestations of CKD?

A

-Hypertension (90%)
-Congestive heart failure
-Pericarditis

133
Q

What are some GI manifestations of CKD?

A

-Anorexia
-Nausea
-Vomiting

134
Q

What are some neurological manifestations of CKD?

A

-Peripheral neuropathies
-Uremic encephalopathies (excess toxins in the blood cause brain problems)

135
Q

What are some skin manifestations of CKD?

A

-Yellow-brown tinge
-Diminished activity of the oil glands
-Pruritis
-Uremic frost

136
Q

CKD may also cause ___ dysfunction in men and women

A

Sexual

Pathophysiology (18 decks)

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