Intrarenal Disorders

Question 1

What type of neoplasms are found in the kidneys?

Answer 1

benign and malignant tumors or result from metastases from extrarenal sites

Question 2

What is benign renal neoplasms?

Answer 2

several benign neoplasms found in the kidneys, developing from renal cortex, medulla or capsule

Question 3

How are benign renal neoplasms detected?

Answer 3

they are typically detected incidentally during abdominal imaging for other reasons

Question 4

SI/Sx of benign renal neoplasms

Answer 4

abdominal palpation, produce flank pain, and hematuria

Question 5

Treatment for benign renal neoplasms

Answer 5

nephrectomy- removal of kidney because they are space-occupying lesions

Question 6

Renal Cell Carcinoma (RCC) Etiology

Answer 6

genetic factors, and greater risk if a first-degree relative has the disease

Question 7

Risk factors of RCC

Answer 7

Obesity, cigarette smoking, and hypertension, diabetes

Question 8

Most common subtype of RCC

Answer 8

clear cell RCC

Question 9

Clear Cell RCC

Answer 9

tumors originate in the renal cortex from cells of the proximal tubules and are usually unilateral and random in occurrence with rare cases of familial patterns

Question 10

Papillary RCC

Answer 10

Evolve from cells of the distal tubule. this type may be sporadic or hereditary

Question 11

Chromophobe RCC

Answer 11

originates from the renal parenchyma: slow growth and infrequent metastasis

Question 12

Medullary and Collect Duct Carcinomas

Answer 12

occur in younger patients and associated with sickle anemia trait

Question 13

Treatment of RCC

Answer 13

Nephrectomy and is unresponsive to cytotoxic chemotherapy

Question 14

Who is affected most by Nephroblastoma (Wilms Tumor)

Answer 14

pediatric malignancy and most common childhood kidney cancer

Question 15

Nephroblastoma etiology

Answer 15

develop from embryonic pluripotent kidney precursor cells

Question 16

Nephroblastoma pathogenesis

Answer 16

typically large, well-encapsulated tumors that grow rapidly. they undergo hemorrhage and cystic changes, necrosis, renal pelvis compresses

Question 17

Clinical Manifestations of Nephroblastoma

Answer 17

abdominal pain, hypertension, hematuria, tumor thrombus in inferior vena cava, decreased venous return, lower extremity edema

Question 18

Pyelonephritis

Answer 18

infection of the kidney or upper urinary tract infection

Question 19

What is affected pyelonephritis?

Answer 19

renal parenchyma, pelvis and calices

Question 20

How are infectious organisms responsible for upper urinary tract?

Answer 20

delivered to the kidney via bloodstream or lymphatic system most common reached to the kidneys as an ascending infections from the lower urinary tract

Question 21

In pregnant women what type of infection is most common?

Answer 21

acute polynephritis because of the physiologic alterations that occur in the urinary tract

Question 22

In nonpregnant women, men, and children what are the most common risk factors for acute pyelonephritis?

Answer 22

diabetes mellitus, anatomic abnormalities of the urinary tract and obstructive causes

Question 23

In which kidney is acute pyelonephritis most affected?

Answer 23

right kidney and unilateral

Question 24

Si/Sx of acute pyelonephritis

Answer 24

sudden onset, fever, chills and CVA tenderness, dysuria, urgency and frequency, nausea, vomiting, and anorexia `

Question 25

Urosepsis

Answer 25

describes organisms in the bloodstream originating from a UTI

Question 26

Chronic Pyelonephritis

Answer 26

small atrophied kidneys with diffuse scarring and blunting of the calices secondary to persistent or recurrent infection of the kidneys

Question 27

What is the typical cause of chronic pyelonephritis?

Answer 27

reflux of infected urine into the renal pelvis

Question 28

Pathogenesis of chronic pyelonephritis

Answer 28

bacteriuria associated with obstructive disorders

Question 29

What is chronic pyelonephritis a potential cause of?

Answer 29

chronic kidney disease

Question 30

The presence of what is the indicative of an upper urinary tract infection as opposed to a lower UTI?

Answer 30

presence of WBC

Question 31

What is the classic symptom of Pyelonephritis?

Answer 31

CVA tenderness

Question 32

Obstructive disorders of the Urinary tract

Answer 32

interfere with the flow of urine (urine stasis), which predisposes to infection and structural damage

Question 33

What are the common causes of obstruction?

Answer 33

stones, tumors, prostatic hypertrophy and strictures of the ureters or urethra

Question 34

What is the number one cause of obstruction?

Answer 34

renal stones

Question 35

T/F the more proximal to the kidney the obstruction is located the less dilation is seen.

Answer 35

False, the more distal

Question 36

hydroureter

Answer 36

complete obstruction of a ureter

Question 37

hydronephrosis

Answer 37

enlarged kidney

Question 38

What occurs after complete obstruction?

Answer 38

hydrophonephorsis, decreased GFR, and ischemic kidney damage because of increased intraluminal pressure

Question 39

Renal calculi (Nephrolithiasis)

Answer 39

crystal aggregates composed of organic and inorganic material located within the urinary tract. these calculi are thought to form within the kidney (tubules or collecting duct) and may migrate to more distal structures

Question 40

What is the common name for renal calculi?

Answer 40

kidney stones

Question 41

Under what conditions do crystals form in the urinary tract?

Answer 41

solute supersaturation, low urine volume, and abnormal urine pH

Question 42

What is an essential requirement for stone formation?

Answer 42

urinary supersaturation

Question 43

besides crystalline formation what is the other formation of stones?

Answer 43

matrix: protein, sugar, glucosamine, bound water, and organic ash

Question 44

What is the most common component of stones?

Answer 44

Calcium-oxalate: idiopathic

Question 45

Glomerulopathies

Answer 45

glomerular disorders result from alterations in the structure and function of the glomerular capillary circulation

Question 46

Primary Glomerulopathies

Answer 46

disease states in which the kidney is the only or predominant organ involved

Question 47

Secondary Glomerulopathies

Answer 47

result from drug exposure, infection, or glomerular injury in the setting of multisytem or vascular abnormalities

Question 48

What can Glomerulopathies result in?

Answer 48

proteinuria, hematuria, abnormal urinary casts, decreased GFR, and hypertension

Question 49

Nephrotic Syndrome

Answer 49

characterized by a protein loss >3.5 in 24 hours

Question 50

Nephritic Syndrome

Answer 50

reflection of inflammation and RBC casts are present in the sediment

Question 51

Glomerulonephritis

Answer 51

due to an immune response to a variety of potential triggers and may have a primary or secondary etiology

Question 52

Acute Glomerulopathies

Answer 52

triggered by infection

Question 53

Crescentic Glomerulopathies

Answer 53

idiopathic but may be secondary to other diseases such as Goodposture Syndrome

Question 54

Chronic Glomerulopathies

Answer 54

progress to chronic kidney disease

Question 55

treatment of Glomerulopathies

Answer 55

steroids, plasmapheresis and supportive measures

Question 56

What causes Nephrotic Syndrome

Answer 56

increases glomerular permeability to proteins which results in urinary loss of 3-3.5g of protein or more

Question 57

Treatment of Nephrotic Syndrome

Answer 57

conservative, consisting of management of symptoms