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Med Conditions > GU/ Renal Disorders > Flashcards

GU/ Renal Disorders Flashcards

1
Q

What are the components of a nephron?

A
  1. Bowmans capsule/Glomerulus = Renal corpuscle
    renal tubule:
    3.Proximal Convoluted Tubule
    4.Lope of Henle / nephron loop
  2. Distal Convoluted Tubule
  3. Collecting duct
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2
Q

What are the functions of the Renal System

A

Filters wast products
Regulates ion levels in plasma
Regulates blood pH
Conserves valuable nutrients
Regulates blood volume
Regulates RBC production (erytripoietin)

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3
Q

Where is the nephron

A

Between the cortex and medulla

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4
Q

Filtration in the kidney

A

Blood from the renal a. is filtered in the glomerulus. Blood comes in to the afferent artery 1/5 of blood is filtered and exits the efferent arteriole to get move to the tubule

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5
Q

Tubular reabsorption

A

solutes taken out ( Glucose; Na +; K+; Cl-and H2O) and returned to circulation via capillaries surrounding Proximal tubule, loop of henle, and distal tubule

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6
Q

Tubular secretion

A

Capillaries surrounding the distal convoluted tubule move waste products into the DCT and then eventually transfered to bladder for storage and illemination

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7
Q

Urinary excretion

A

filtrate /urine is transported from the collecting duct to the bladder for elimination

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8
Q

Dark yellow urine, pale yellow urine, cloudy urine, Hematuria, redish brown urine , foamy urine

A

Normal pale yellow I/O of 2 L per day

dark yellow: dehydration
cloudy urine: white blood cells/infection UTI-AKI
Hematuria: blood RBC in urine / pink / red color- AKI
Redish brown: myoglobin happens in Rhabdo, AKI
Foamy urine: proteins stay in blood chronic renal failure

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9
Q

Polyuria

A

Abnormal amounts of diluted urine

ex: Diabetes

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10
Q

Urinary frequency

A

Need to urinate many times of day or night

ex: UTI

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11
Q

Nocturia

A

excessive urination at night

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12
Q

Acute kidney disfunction causes Oliguria and Anuria what does that mean

A

Oliguria: reduced volume of urine (<400 mL)

Anuria: no urine production

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13
Q

Causes of Acute Renal Failure and what is the most common??

A

pre-renal most common : 55%
Conditions that decrease renal blood flow
-HF,sepsis,hypovolemia

Intra-renal: 40%
injury or inflammation in the kidney
-nephritis, tubular necrosis

Post-renal: 40%
Conditions that obstruct blood flow
-kidney stones, blood clots

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14
Q

Pyelonephritis

A

When UTI progresses to involve the upper urinary system including the kidneys and ureters

Special test: Mental status change

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15
Q

How are kidney stones managed

A

Pain management
pain
Cystoscope: snare and sucking out (removal) of stone
Lithotripsy:ultrasound to breakdown stone

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16
Q

Rhabdomyolysis

A

Breakdown of skeletal muscle fibers resulting in release of myoglobin -can cause AKI /renal failure

Cause: traumatic /compression
Non-traumatic : exertion

Triad: muscle pain, weakness, dark urine

Creatine kinase 5x the ULN

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17
Q

Top 3 causes of Chronic Renal Failure

A
  1. Diabetic
  2. Hypertension
  3. Glomerulonephritis
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18
Q

Signs and symptoms of CKD

A

Wight loss , poor appetite , edema, SOB, DOE,Fatigue, Nocturia, Hematuria, Protenuria , insomnia , Pruritis, Muscle cramps, Headaches, Erectile dysfunction

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19
Q

Lab Values of Renal Function

A
  1. GFR Glomerular Fultration Rate
    Great measure kidney function , but difficult to measure
    As GFR goes down, kidney damage goes up -inverse relationship
  2. Creatinine
    Most common measure
    as C goes up , kidney damage also goes up -direct relationship
  3. Albumin
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20
Q

What is the role of Dialysis ?

A

Try’s to filter and clean blood and do the role of the kidney

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21
Q

Differences between Peritoneal Dialysis … Hemodialysis … CRRT?

A

Hemodialysis: placed in arm passes blood across a semi-permeable membrane (dialyzer) allowing the metabolic waste to diffuse into correction fluid (dialysate)
via AV fistula /AV graft or temporary access via catheter in IJV

Continuous Renal Replacement Therapy (RRT): continuous removal of solutes and fluid : used for patients that are critically ill

Peritoneal Dialysis: uses the peritoneum as semipermeable membrane, several hours of infusion prior to drainage

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22
Q

Lab values of CRD

A

High Creatinine
high potassium hyperkalemia
high calcium hypercalcemia
metabolic acidosis

23
Q

Signs and symptoms of AKI:

A

Pain with urination
Nausea vomiting
Blood in urine: hematuria
Cloudy or foul smelling urine
Increasing frequency of urination
Confusion / Mental status change (in older adults esp.)
Fever /chills
Feeling sick

24
Q

Functions of the GI Tract

A

Digestion: physical/ chemical breakdown, GI motility /enzymes
Absorption: movement of nutrients
Excretion: food residue
Host defense: largest lymphoid organ in body , gut microbiome

25
Q

Contributing factors of GERD

A
  1. Non functional lower esophageal sphincter
  2. Impaired gastric emptying
  3. Hiatal hernia
    4.Alcohol abuse
  4. developmental delays in kids
26
Q

Functions of the stomach

A

Reservoir
-controlled release of chyme
Mechanical digestion
Motility: peristalsis
Chemical digestion
-pepsin , lipase enzymes
Hydrochloric acid
- chemical digestion, immune defense
Intrinsic factor
-binds Vit. b12 for absorption in small intestine
-deficiency leads to pernicious Anemia

27
Q

Gastric defense

A
  1. Compact epithelial cell lining
  2. Mucus covering
  3. Bicarbonate ions
  4. Blood flow
28
Q

Gastritis

A

inflammation of the inner lining of the stomach (the mucosa)
due to
1. excessive acid production > gastric defense
(NSAIDS , ASA, ETOH)
2. Stress induced
common in critically ill patients

29
Q

Peptic Ulcer Disease (PUD)

A

increase acid secretions and digestive enzymes erode gastric mucosa

OR
helicobactor pylori infection

can lead to hemorrhage, perforation , peritonitis, scarring

defend by site of origin

30
Q

NSAIDS Non steroidal anti inflammatory drugs

A

3 types:
Acetylsaclic acid (ASA) : ex asprin
Traditional: ex : ibprofen
Cox-2 inhibiters (off marked)

31
Q

ASA and traditional NSAIDS

A

pain relief with increase in GI bleed risk

32
Q

Cox 2 inhibiters

A

pain relief with decrease risk of GI bleed but increase risk of CVA /MI risk

33
Q

50% of GI bleeding due to what?

A

NSAID use in elderly

34
Q

Continued GI bleeding and re-bleeding are high predictors of what ?

A

mortality and morbidity in older adults

35
Q

Syncope
Hypotension
Pallor
Diaphoresis
Tachycardia
all red flags and are suggestive of what?

A

Shock (GI bleed)

36
Q

Hematemesis and coffee ground emesis usually originated from what?

A

an upper GI bleed

37
Q

Melena is a result of what?

A

Lower OR upper GI bleed

38
Q

In a GI bleed what do you need to be concerned about

A

Decrease in hematocrit , hemoglobin

39
Q

Functions of small intestine

A

Segmentation
Peristalsis
Digests and absorbs nutrients
Secretes regulatory hormones

40
Q

What type of hormones aide in chemical digestion in the small intestine

A

Endocrine cells, exocrine enzymes -regulate gastric pancreatic and gallbladder function

Cholecystokinin (CCK): increases pancreatic enzymes and bile release

41
Q

Villi and microvelli in small intestine

A

Increase SA for absorption

42
Q

Lacteals (lymphatic capillaries)

A

for fat absorption (chyle)

43
Q

Main role of colon

A

re-absorption of water and ions , some vitamins

44
Q

Crohns Disease

A

Crohn’s : Patchy inflammation that may occur anywhere in the Digestive Tract
-entire bowel wall
-pain in lower R abdomen

Ulcerative Colitis: continuous inflammation affected through the large intestine
-mucosa
-pain in lower L abdomen

45
Q

Crohn’s Disease & Ulcerative Colitis medical management and presentation

A

presentation: joint pain , anemia
abdominal cramping, pain, diarrhea, malabsorption leading to weight loss & malnutrition

medications:
immunosuppressents
biologics
Anti-inflammatory agents

46
Q

IBS: Irritable bowel syndrome

A

disturbed bowel without structural abnormalities

spastic motility pattern
malabsorption : nutrient deficiency + loose stools

related to colonic sensitivity

47
Q

Types of hernia

A

Ventral : incision related where abdominal contents protude through the linea alba
Hiated hernia: gastroesophageal junction moves above the diaphragm with some of the stomach
Inguinal: abbdominal contents through induinal canal

48
Q

Acute Abdomen

A

Medical emergency : palpation reveals rigidity, rebound tenderness , bowel sounds absent
Also known as peritonitis
sudden severe abdominal pain

49
Q

Colorectal cancers

A

Progression starts with benign polyp
bleeding , pressure/pain with defecation

3rd most common Cancer , 3rd leading COD

50
Q

Types of abdominal surgery

A

Ileectomy: resection of Small I.
Colectomy: resection of Large I
Ostomy: surgical opening for discharge of body wastes
Stoma : end of the intestine protruding through abdominal wall

51
Q

Common post operative complications (POC) and PT role

A

pain
pulmonary issues
bleeding
infection
Ileus
Bowel leakage
Post surgical adhesions

PT role: bowel motility

52
Q

Bariatric Surgery benefits

A

weight loss
remission of type 2 DM
improve CR risk factors and CV health
improve mental health
better sleep
decrease hip and knee pain
improve fertility

53
Q

Meds for GI issues

A

Antibiotic therapy: pylori PUD
antiflammatory agents “ presone
anti-emetics : nausea and vomiting
laxatives: short term relief of constipation
antidirrheal

Med Conditions (6 decks)

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