LO3/4 Pathophysiology of GU disorders

Question 1

Kidney Stones (Renal Calculi or Renal Colic)

Answer 1

• Originate in the renal pelvis
  o Result when an excess of insoluble salts or uric acid crystallizes in the urine
  o Insufficient water intake

Question 2

kidney stones Patient presentation

Answer 2

• Some will be agitated and restless (walk and move to relieve pain).
• Others will attempt to remain motionless and guard the abdomen.
• Palpation of the abdomen difficult

Question 3

kidney stones Prehospital management

Answer 3

• Centers on pain relief
• Consider Intercept
• Breathing techniques
• Establish an IV line and administer fluids
• Transport

Question 4

Acute Renal Failure

Answer 4

• Sudden decrease in filtration through the glomeruli
  o Accompanied by an increase of toxins in the blood
  o Accounts for 30% of all ICU patients (5% of all hospitalizations)
  o Overall mortality rate of 50%
  o Reversible if diagnosed and treated early oliguria: urine output less than 500ml per day
  o Anuria: urine production stops

Question 5

o Prerenal

Answer 5

anything that will cause decreased kidney disfunction but is not directly related to kidney ex: drug OD, trauma,

Question 6

o Intrarenal

Answer 6

ex: kidney stone, infection, scarring from diabetes

Question 7

Signs and symptoms

- Prerenal acute renal failure:

Answer 7

o	Caused by hypo perfusion of the kidneys
o	Hypotension
o	Tachycardia
o	Dizziness
o	Thirst

Question 8

Signs and symptoms

- Intrarenal acute renal failure

Answer 8

o	Damage to one of the areas in the kidney which hinders blood flow
o	Flank pain
o	Joint pain
o	Oliguria- thirst
o	Hypertension
o	Headache
o	Confusion
o	Seizure

Question 9

Signs and symptoms

- Postrenal acute renal failure

Answer 9

o Caused by obstruction of urine flow from the kidneys blocked by an enlarged prostate, kidney stone, blood clots or structures
o Pain in lower flank abdomen, groin and genitailia
o Oliguria
o Distended bladder
o Hematuria
o Peripheral edema

Question 10

Chronic Kidney Disease

Answer 10

• Progressive and irreversible inadequate kidney function due to permanent loss of nephrons
  o Develops over months or years
  o More than half caused by systemic diseases
   Can also be caused by congenital disorders or prolonged pyelonephritis

Question 11

• Nephrons

Answer 11

o Damaged and cease to function
o Scarring in the kidneys, tissue begins to shrink and waste away.
o Kidney function diminishes, fluid builds up in the blood.
o Uremia, Azotemia

Question 12

Chronic Renal Failure

Signs and symptoms

Answer 12

• Altered level of consciousness
• Late stages: seizures and coma are possible.
• Lethargy, nausea, headaches, cramps, and signs of anemia
• Skin: pale, cool, and moist
• Jaundice
• Uremic frost
• Edema
• Hypotensive and tachycardia

Question 13

Urinary Tract Infection

Answer 13

• Usually develop in the lower urinary tract (urethra and bladder)
• Normal flora bacteria enter the urethra and grow
• More common in women
• In the upper urinary tracts (ureters and kidneys) occur most often when lower UTIs go untreated
• May present with vague symptoms often including confusion

Question 14

• Pyelonephritis

Answer 14

inflammation of the kidney linings

Question 15

• Abscesses

Answer 15

reduce kidney function

Question 16

Urinary Tract Infection

Symptoms

Answer 16

• Painful urination
• Frequent urges to urinate
• Difficulty urinating
• Bladder pain in women
• Prostate pain in men
• Urine may have a foul odor or appear cloudy