Patho 2 - Exam 1 - Renal Flashcards
Function of the Renal System
Regulating ECV volume
regulating pH
eliminating wastes through excretion
Endocrine functions
production of erythropoietin
production of renin
activation of vitamin D
Urinary structures
ureters
bladder
urethra
Basic mechanisms of the kidney
filtration
reabsorption
secretion
excretion
Glomerular Filtration Rate
Unit of measure to determine kidney function
creatine clearance after uses as an indicator of GFR
Blood Urea Nitrogen(BUN)
can be used as an indicator for GFR
Males 97-137 ml/min Females 88-128 ml/min
Renal Calculi
higher in males
nausea and vomiting
agonizing flank pain may radiate to groin, testicles, abdominal area
Renal Calculi
sharp sudden sever pain
hematuria
dysuria
urinary frequency
Renal Calculi Diagnosis
ultrasound renal stone analysis KUB (xray) Severe -calcium oxalate -uric acid
Renal Calculi Risk Factors
infection urinary stasis and retention immobility dehydration increase uric acid increased uric oxalate
UTI
Infection of the bladder, urethra or prostate
UTI patho
breakdown in local defense
bacteria invade and multiply
bacteria can not be readily by micturition (urination)
UTI clinical manifestations
urgency and frequency
burning pain on urination (dysuria)
voiding in small amounts, incomplete emptying
low back or suprapubic pain
Pyelonephritis
Inflammation caused by bacteria of the renal pelvis
Pyelonephritis patho
causative organism in the kidney
inflammatory response triggered
inflammation leads to edema
fibrosis and scar tissue form at infection
Pyelonephritis clinical manifestations
frequency dysuria CVA tenderness flank or groin pain fever/chills malaise
Glomerulonephritis patho
auto immune related to strep throat, inflammation, increased permeability
Glomerulonephritis - three types
acute
rapidly progressive
chronic
Acute Glomerulonephritis
circulating antigen - antibody complexes trapped in glomerular membrane
Glomerulonephritis Rapidly Progessive
glomerular cells proliferate forming crescent-shaped lesions that obstruct the Bowman’s space
Chronic Glomerulonephritis
slow, progressive destruction of glomeruli
kidneys decrease in size and become granular
Glomerulonephritis clinical manifestations
headache, increased BP, facial, periorbital edema, lethargic, low grade fever, weight gain, edema,
Glomerulonephritis clinical manifestations
proteinuria, hematuria, oliguria, dysuria
Glomerulonephritis Risk Factors
Strep Infection, Lupus
Nephrotic Syndrome
manifestation of protein wasting that occurs with glomerular damage
Nephrotic Syndrome - patho
glomerular damage, protein lost to urine, hypovolemia, hypotension, and edema
Nephrotic Syndrome clinical manifestations
proteinuria, hypoalbuminemia, edema
Nephrotic Syndrome risk factors
medications, diabetes
Acute Renal Failure
Sudden inability of the kidneys to maintain normal
Acute Renal Failure three types
Prerenal - above the kidneys
Intrarenal - in the kidneys
Post renal - below the kidney
Acute Renal Failure patho
Ischemia, decreased GFR, tubular obstruction by cellular debris
Acute Renal Failure causes
Prerenal - severe blood loss, AAA, shock, MI
Intrarenal - infection - pyelonephritis, trauma, street drugs
Post renal - traumas, kidney stones, destruction
Acute Renal Failure phases
Initiation
Maintenance
Recovery
Acute Renal Failure phase clinical manifestations
Initiation - few manifestations
Maintenance - oliguria, salt and water retention
Recovery - progressive increase in urine volume
Chronic Renal Failure
slow, progressive and irreversible loss of kidney function
Chronic Renal Failure stages
early (renal insufficiency)
second (renal insufficiency)
third (end stage renal disease)
Chronic Renal Failure patho
function capacity of nephron is lost
renal mass enlarged
unable to excrete metabolic waste and regulate fluid and electrolyte balance
Chronic Renal Failure clinical manifestations (early)
decreased urinary concentration - nocturia, GFR 90ml/min
Chronic Renal Failure (renal insufficiency)
headaches, decreased ability to concentrate urine, polyuria, oliguria, edema, increased BP
Chronic Renal Failure (end stage)
GFR decreased 15 ml/min, neurological weakness, fatigue, confusion, increased BP, pitting edema, sob, depressed cough, ammonia odor to breath, anemia, withdrawn, dry flaky skin
Bladder Cancer
cancer of the cells that line the bladder
Bladder Cancer who’s at risk
men over 55, smoking, occupation
Bladder Cancer clinical manifestations
painless hematuria, constant or intermittent UTI, pelvic pain with advanced cancer
