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Pathophysiology > Intrarenal Disorders > Flashcards

Intrarenal Disorders Flashcards

1
Q

What type of neoplasms are found in the kidneys?

A

benign and malignant tumors or result from metastases from extrarenal sites

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2
Q

What is benign renal neoplasms?

A

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

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3
Q

How are benign renal neoplasms detected?

A

they are typically detected incidentally during abdominal imaging for other reasons

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4
Q

SI/Sx of benign renal neoplasms

A

abdominal palpation, produce flank pain, and hematuria

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5
Q

Treatment for benign renal neoplasms

A

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

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6
Q

Renal Cell Carcinoma (RCC) Etiology

A

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

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7
Q

Risk factors of RCC

A

Obesity, cigarette smoking, and hypertension, diabetes

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8
Q

Most common subtype of RCC

A

clear cell RCC

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9
Q

Clear Cell RCC

A

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

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10
Q

Papillary RCC

A

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

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11
Q

Chromophobe RCC

A

originates from the renal parenchyma: slow growth and infrequent metastasis

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12
Q

Medullary and Collect Duct Carcinomas

A

occur in younger patients and associated with sickle anemia trait

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13
Q

Treatment of RCC

A

Nephrectomy and is unresponsive to cytotoxic chemotherapy

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14
Q

Who is affected most by Nephroblastoma (Wilms Tumor)

A

pediatric malignancy and most common childhood kidney cancer

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15
Q

Nephroblastoma etiology

A

develop from embryonic pluripotent kidney precursor cells

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16
Q

Nephroblastoma pathogenesis

A

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

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17
Q

Clinical Manifestations of Nephroblastoma

A

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

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18
Q

Pyelonephritis

A

infection of the kidney or upper urinary tract infection

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19
Q

What is affected pyelonephritis?

A

renal parenchyma, pelvis and calices

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20
Q

How are infectious organisms responsible for upper urinary tract?

A

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

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21
Q

In pregnant women what type of infection is most common?

A

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

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22
Q

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

A

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

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23
Q

In which kidney is acute pyelonephritis most affected?

A

right kidney and unilateral

24
Q

Si/Sx of acute pyelonephritis

A

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

25
Q

Urosepsis

A

describes organisms in the bloodstream originating from a UTI

26
Q

Chronic Pyelonephritis

A

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

27
Q

What is the typical cause of chronic pyelonephritis?

A

reflux of infected urine into the renal pelvis

28
Q

Pathogenesis of chronic pyelonephritis

A

bacteriuria associated with obstructive disorders

29
Q

What is chronic pyelonephritis a potential cause of?

A

chronic kidney disease

30
Q

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

A

presence of WBC

31
Q

What is the classic symptom of Pyelonephritis?

A

CVA tenderness

32
Q

Obstructive disorders of the Urinary tract

A

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

33
Q

What are the common causes of obstruction?

A

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

34
Q

What is the number one cause of obstruction?

A

renal stones

35
Q

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

A

False, the more distal

36
Q

hydroureter

A

complete obstruction of a ureter

37
Q

hydronephrosis

A

enlarged kidney

38
Q

What occurs after complete obstruction?

A

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

39
Q

Renal calculi (Nephrolithiasis)

A

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

40
Q

What is the common name for renal calculi?

A

kidney stones

41
Q

Under what conditions do crystals form in the urinary tract?

A

solute supersaturation, low urine volume, and abnormal urine pH

42
Q

What is an essential requirement for stone formation?

A

urinary supersaturation

43
Q

besides crystalline formation what is the other formation of stones?

A

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

44
Q

What is the most common component of stones?

A

Calcium-oxalate: idiopathic

45
Q

Glomerulopathies

A

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

46
Q

Primary Glomerulopathies

A

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

47
Q

Secondary Glomerulopathies

A

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

48
Q

What can Glomerulopathies result in?

A

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

49
Q

Nephrotic Syndrome

A

characterized by a protein loss >3.5 in 24 hours

50
Q

Nephritic Syndrome

A

reflection of inflammation and RBC casts are present in the sediment

51
Q

Glomerulonephritis

A

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

52
Q

Acute Glomerulopathies

A

triggered by infection

53
Q

Crescentic Glomerulopathies

A

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

54
Q

Chronic Glomerulopathies

A

progress to chronic kidney disease

55
Q

treatment of Glomerulopathies

A

steroids, plasmapheresis and supportive measures

56
Q

What causes Nephrotic Syndrome

A

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

57
Q

Treatment of Nephrotic Syndrome

A

conservative, consisting of management of symptoms

Pathophysiology (19 decks)

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