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Nursing school pt 3 > Patho Exam 3 > Flashcards

Patho Exam 3 Flashcards

1
Q
  1. Function of the Kidney
  2. What is the general renal rule?
  3. What is the function of the glomerulus
A
  1. filter plasma, reabsorb/secrete, forms filtrate of protein free fluid, regulate filtrate to maintaine body fluid volume, excrete waste
  2. Decrease protein.
  3. Filtration
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2
Q
  1. How is it driven?
  2. What does the proximal tubule do?
  3. What does the proximal tubule secrete?
A
  1. hydrostatic pressure
  2. reabsorption of sodium/glucose, reabsorps 180L/day
  3. H+ and foreign substances
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3
Q
  1. What is the loop of henle?
  2. Descending loop
  3. Ascending loop
A
  1. concentration
  2. water reabsorption, Na+ diffuses in
  3. Na reabsorps, (active transport), water stays in
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4
Q
  1. Distal tubule
  2. Collecting tubule requires what?
  3. What does it do
A
  1. Selective reabsorption, potassium and hydrogen ions
  2. ADH
  3. H2O
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5
Q
  1. Normal pH in urinalysis
  2. What do most bacteria favor?
  3. Protein in the urine represents?
A
  1. 5-8
  2. alkaline
  3. kidney disease, increasus BUN
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6
Q
  1. Specific gravity
  2. What end is more concentrated
  3. Glucose in the urine represents
A
  1. 1.010-1.025
  2. higher the number
  3. diabetes, stress
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7
Q
  1. What are ketones
  2. What does it represent if in urine
  3. Nitires in the urine represent
A
  1. fats
  2. acute metabolic demand, stress, DKA (atkin’s diets)
  3. bacterial infection (convert nitrates-nitrties)
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8
Q
  1. WBC in the urine
  2. Should RBC’s be present in urine?
  3. Creatnine clearance (24hr urine collection)..
A
  1. UTI
  2. no
  3. glomerular filtration rate, renal disease
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9
Q
  1. How do you measure kidney function?
  2. Normal creatnine level
  3. What is BUN
A
  1. Creatnine and BUN
  2. 0.6 - 1.2
  3. end product of protein metabolism, index
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10
Q
  1. Normal BUN
  2. Types of Upper UT obstruction
A
  1. 7 - 18 mg/dL
  2. Stricture, stone, tumor fibrosis, hydroureter, hydronephrosis, urinary stasis above the level of obstruction
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11
Q
  1. What is hydroureter
  2. what is hydronephrosis
  3. What can happen if urinary stasis?
A
  1. (thick/fat), allows back flow. Dilation of ureter.
  2. Dilation of renal pelvis
  3. infection, staph, stones, dilation of ducts, atrophy of kidney
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12
Q
  1. Within 7 days of obstruction
  2. Within 28 days of obstruction
  3. If kidney does not retain bicarb or excrete hydrogen, what acid-base imbalance?
A
  1. enlargement and fibrosis
  2. glomeruli damaged
  3. metabolic acidosis
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13
Q
  1. If the kidney does not conserve Na but retains potassium?
  2. What does kidney stone obstruction have to do with?
  3. 3 types of kidney stones
A
  1. hyponatremia, hyperkalemia
  2. Diet, genetics, food intake
  3. Calcium, Struvite (mg,large), Uric Acid (gout)
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14
Q
  1. Manifestation of kidney stones
  2. Diagnostics
  3. Prevention
A
  1. pain, renal colic, N/V, hematuria (gross or microscopic), flank uoq
  2. xray, ultrasound, IV pilogram (dye will outline stone)
  3. fluid intake, caclium (decrease oxelate (cut back on spinach chard, choco)
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15
Q
  1. TX Renal
  2. Lower Ut obstruction types
  3. What is a neuorogenic comprised of
A
  1. lithotripsey (shock waves) not invasive, Stent- cath opens tube to pass urine, stone removal
  2. neurogenic, anatomic
  3. dysnergia, hypotonic bladder, detrusor hyperreflexia (empties automatically, overflow)
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16
Q
  1. What is anatomic obstruction
  2. Manifestation of lower obstruction
  3. What is an adenoma
A
  1. rectocele (prolapse of rectum), cystocele (bladder drops ontio itself and causes blockage)
  2. nocturia, polyuria, urgency/hestiation, incomplete
  3. common tumor, benign tendency to become malignant
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17
Q
  1. Renal Cell carcinoma
  2. Renal Tranistional cell carcinoma?
  3. Demographics
A
  1. most common renal cancer
  2. rare
  3. males, diabetes, obesity, uncontrolled htn
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18
Q
  1. S/Sx of renal tumor
  2. Bladder tumors common or not?
  3. Where are bladder tumors located?
A
  1. Frank blood, bloody urine (slight or microscopic)
  2. most common
  3. epithelium of the bladder
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19
Q
  1. Risk factors for bladder tumor
  2. What ia a UTI
  3. What is acute cystitis
A
  1. Male >60, smoking, Aniine dyes (leather couch), secondary of cervix/prostate
  2. inflamed epithelium caused by bacteria
  3. Inflammation of the bladder
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20
Q
  1. Common bacteria in acute cystitis?
  2. Manifestation of acute cystitis
A
  1. E. Coli
  2. sphincter inflamed, urgency, hematuria, cloudy urine, flank pain, confusion
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21
Q
  1. Tx of Acute Cystitis
  2. What is pyelonephritis
A
  1. C/S test, analgesic (pyridium), fluid intake, avoid sugary drinks, Cranberry juice (antimicrobe)
  2. infection of 1 or both upper urinary tracts
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22
Q
  1. Where does puelonephritis occur
  2. Is it unilateral or bilateral
A
  1. Upper Tract
  2. could be both
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23
Q
  1. Causes of pyelonephritis?
  2. Patho behind it?
  3. Manifestations
A
  1. stones, vesicoureteral reflux, pregnancy, neurogenic, instrumentation, female sex trauma.
  2. inflamed kidneys, shrinks when it is chronic
  3. fever, chills, groin pain
24
Q
  1. What are risk with chronic pyelonephritis
  2. What is glomerulonephritis
  3. What are primary causes
A
  1. kidney failure, risk of scarring/fibrosis
  2. inflammation of glomerulus
  3. primary injury (ischemia, free radicals, drugs, vascular disorder, infection)
25
Q
  1. Secondary causes of glomerulonephritis
  2. Most common cuase
  3. What happens in glomerlAR nephritis?
A
  1. systemic diseases, diabetes, lupus, CHF, HIV
  2. immunologic , STREP!
  3. Antigen-antibody deposit in glomeruil, infiltrate with WBC
26
Q
  1. Manifestations of Glomerular nephritis
  2. What color is the urine in glomerular nephritis?
  3. What will you see in the urine
A
  1. edema, HTN, accumulates water and retention of sodium,
  2. Coke colored (hematuria)
  3. RBC, protein, casts, elevated BUN/creatnine
27
Q
  1. Manifestation of NephrOtic syndrome
  2. what else do they lose with this syndrome?
  3. What system does this stimulate?
A
  1. lose a lot of protein, MASSIVE edema, FOAMY Urine
  2. Ig, anticoagulants, hyperlipidemia, vitamin D, reduced vascular fluid volume.
  3. Renine, makes it worse b/c no protein to hold it.
28
Q
  1. Causes of nephrOtic syndrome
  2. What membrane can this change
A
  1. hole in kidneys, idiopathic, secondary to lupus, diabetes, infection, glomurlonenephritis!
  2. Basement membrane (filtration)
29
Q
  1. What is Azotemia
  2. What does nephrItic syndrome cause
  3. Acute Kidney injury is renal insufficiency declined by
A
  1. abnormally high levels of nitrogen-containing compounds (urea, creatnint)
  2. azotemia, hypertension, oliguria, hematuria
  3. 25% of normal
30
Q
  1. End stage renal failiure is what percent of functioning nephrons
  2. How often is dialysis required
  3. What is the mortality rate
A
  1. less than 10% function
  2. 3x/ wk or transplant
  3. 20-80%, depending onhow soon intervene
31
Q
  1. Prerenal AKI:
  2. Intrarenal AKI
  3. Postrenal AKI
A
  1. hypovolemia, filtration drops, BP drops, REVERSIBLE
  2. nephritis in kidney, septic shock, blood transfusion, nephrotoxic drugs
  3. liver failure, kidney stones, BPH, neurogenic bladder disease
32
Q
  1. AKI Initiation Phase: Oliguric
  2. AKI Maintenance phase: Diuretic
  3. AKI recovery phase:
A
  1. time of injury, perfusion/filtration drop, decreased specific gravity. Hypervolemia, hyperkalemia, hypocalcemia
  2. severe hypovolemia, low urine outpus, BUN/Creat high
  3. clear creatnine, massive diaresis, may take 2 years to heal
33
Q
  1. Causes of chronic kidney failure
  2. Stage I
  3. Stage 2
A
  1. hypertension, diabetes, chornic glomerulonephritis
  2. Normal kidney function > 90mL/min (hypertensionn
  3. Mild reduction in GFR (60-80 mL/min
34
Q
  1. end Stage Kidney diease
  2. What happens to creatnine?
  3. What happens to potassium with AKI
A
  1. GFR <15ml/min
  2. in urine is low, in your body is high
  3. gets excreted in bowels
35
Q
  1. What happens to acid/base in Kidney Failure
  2. What happens with proteinuria
  3. What happens with Calcium/Phosphate?
A
  1. Acidotic, uable to excrete H+ in distal tubule
  2. loss of protein, leads ot increase LDL and insulin resistance
  3. Hypercalcemia, leaves bone to compensate
36
Q
  1. Cardiovascular changes with Kidney failure
  2. Pulmonary changes
  3. Hematologic
A
  1. electrolyte imbalance
  2. fluid overload
  3. dont have ecogin (anemic)
37
Q
  1. Platelets in Kidney Failure
  2. Neurologic changes in KF
  3. GI changes in KF
A
  1. increased bleeding factor
  2. increased risk for CVA, uremic coma
  3. uremic breath
38
Q
  1. Endocrine changes in KF?
  2. Integumentary changes in KF
  3. Most common cause of acute renal failure?
A
  1. decreased sex hormones
  2. uremic frost (like salt), end stage.
  3. Pre renal
39
Q
  1. CKD manifestation / lab resuts
  2. What is horseshoe kidney
  3. What is chordee
A
  1. elevated BUN/Creatnine, Elevated Na & K, Fluid volume excess, dec pH
  2. fusion into 1 kidney (ped anomaly)
  3. shortening of subQ of penis to bend downward
40
Q
  1. What can cordee cause?
  2. What is hypospadias
  3. What is epispadias
A
  1. bladder extrophy, herniation through ab wall
  2. underneath is an urethral opening
  3. on the front is an opening
41
Q
  1. Wha is hypoplastic kidney
  2. what is dysplastic kidney
  3. what is polycystic kidney
A
  1. small kidney, need transplant, decreased nephrons
  2. no renal tissue
  3. autosomal inherited (cysts on kidneys)
42
Q
  1. What is renal agenesis
  2. What can children with strep cause?
  3. What causes hemolytic Uremic Syndrome?
A
  1. one or both kidneys fail to develop
  2. Acute glomelular nephritis
  3. E.Coli
43
Q
  1. What does HUS produce?
  2. what do you need if you have this?
  3. What is the triad anemia?
A
  1. toxins caused by inflammation
  2. dialysis
  3. hemolytic, thrombocytopenia, acute renal failure
44
Q
  1. Manifestations of HUS
  2. S/Sx
  3. Hemorrhagic manifestations
A
  1. Proteinuria, hematuria and presence of urinary casts
  2. vomiting, irritability, lethargy, pallor
  3. bruising, petechiae, jaundice, bloody diarrhea, oliguria, anuria, CNS (seizure)
45
Q
  1. What is vesicoureteral Reflux
  2. What is nephroblastoma/Wilms Tumor
  3. Malignant/benign
A
  1. Gradual dilation of the ureter, infected urine reaches the kidneys
  2. embryonal tumor of the kidney- unilateral
  3. malignant
46
Q
  1. When does wilms present
  2. how does it start
  3. what should you not do?
A
  1. before age 5
  2. abdominal swelling
  3. palpate, can spread to other organs
47
Q
  1. What is enuresis?
  2. How much blood do kidneys receive
  3. When PT has hypotension, which enzyme gets released
A
  1. involunatry urination, especially children at night.
  2. 100 -1200 mL per min, 20-25% Cardiac Output
  3. Renin (starts a cascade of events)- juxta cells
48
Q
  1. What is relased in response to elevated blood volume
  2. 3 Types of Nephrons
  3. PT has uncontrolled premature contraction of detrusor muscle
A
  1. Atrial Natriuretic Peptide (increase water/Na excretion)
  2. superficial, midcortical, juxtamedullary
  3. Spinal Cord Injury
49
Q
  1. Conditions that can cause obstructed urine flow
  2. wide-set eyes, “parrot beak” nose, low-set ears, and receding chin, what is renal manifestation?
  3. A child whose kidneys are enlarged presents with chills, fever, and abdominal pain.
A
  1. prostate enlargment, pevlic organ prolapse, low bladder wall compliance, detrusor hyperflexia
  2. Potter Syndrome
  3. pyelonephritis
50
Q
  1. Complications of horseshoe kidneys
A
  • hydronephrosis
  • infection
  • stone formation
51
Q
  1. A patient with deficient ADH & dehydrated will have what in urine
  2. what is the fucntional unit of the kidney
  3. Normal Creatnine Clearance
A
  1. low specific gravity
  2. nephrons
  3. 125 mL/min
52
Q
  1. Best estimate of glomerular filtration
  2. AKI causes
  3. Kidney disease risk for
A
  1. Creatnine Clearance
  2. retention of nitorgenous waste, fluid retention, inability to regulate F&E’s
  3. hyperkalemia, dysrhythmias
53
Q
  1. Best way to determine fluid balance
  2. Sign of UTI in older adults
  3. When is circumcision contraindicated
A
  1. daily weight
  2. altered mentation
  3. Epispadias/Hypospadias
54
Q
  1. What do principal cells do
  2. How much volume to kidneys receive
  3. What hormone is release in response to elevated blood volume
A
  1. Reabsorb Na & Water, secrete Potassium
  2. 1000-1200 L /min
  3. ANP
55
Q
  1. Stone formation is composed of
  2. What could cause an obstruction
  3. Kussmal respiration can cause
A
  1. Salt, aggregate, liquid-solid, Tamm Horsefall
  2. prostate enlargement, pelvic organ prolase, low bladder wall compliance, detrusor hyperflexia
  3. pulomnary edema, metabolic acidosis
56
Q
  1. A syndrome related to renal agenesis causes heart defect and parrot beak
  2. Complications of horseshoe kidney
  3. 3 Types of nephrons
A
  1. potter’s syndrome
  2. hydronephrosis, infection, stone formation
  3. superficial, midcortical, justamedullary

Nursing school pt 3 (13 decks)

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