Patho Kidney Flashcards
1
Q
What is a term that describes renal pain?
A
Nephralgia
2
Q
Do kidneys have pain receptors?
A
Not in kidney- but in capsule
3
Q
What will urine look like with decreased renal function?
A
Dark, strong smelling
4
Q
What are 2 types of congenital renal disorders?
A
Renal Agenesis
Polycystic kidney disease
5
Q
What is the absence of one or both kidneys?
A
Renal agenesis
6
Q
What type of agenesis is usually fatal?
A
Bilateral
7
Q
What is potter syndrome associated with?
A
Bilateral renal agenesis
8
Q
Bescides kidney problems, what else is associated with Potter syndrome?
A
Facial and respiratory abnormalities
9
Q
What is the result of multiple dilations of collecting ducts?
A
Polycystic kidney disease
10
Q
When is ARPKD diagnosed?
A
In infants and young children (recessive versision)
11
Q
When is ADPKD diagnosed?
A
Adulthood (dominant)
12
Q
Where is the genetic defect in ARPKD?
A
Chromosome 6
13
Q
What also accompanies ARPKD?
A
hepatic fibrosis
14
Q
Why can ARPKD affect chlidren differently?
A
Depends on the number of collecting ducts affected (more affected- worse survivability)
15
Q
What chromosomes are defected in ADPKD?
A
Chromosome 16 (95%)
Chromosome 4 (5%)
16
Q
What is the primary pathological cause of ADPKD?
A
Tubular epithelial cell hyperplasia
Can involve the entire nephron
17
Q
What part of the kidney can ADPKD affect?
A
Entire neprhon
18
Q
What ages does ADPKD normally appear?
A
30-50 years
19
Q
What symptoms appear with ADPKD?
A
UTIs
back or flank pain
heamturia
hypertension
20
Q
What is a big protector of the urinary tract?
A
The acidic nature of urine
21
Q
What is the most common infectious agent of the urinary tract?
A
E. Coli
22
Q
What is pyelonephritis?
A
Infection of the upper urinary tract (renal pelvis) and interstitium
23
Q
How do infections get from the bladder to the kidney?
A
Reflux from the bladder
There are no spinchter so urine can go from bladder back into kidney
24
Q
Where is a hematogenous infection in the kidney found?
A
Thoughout the kidney
25
If an infection is caused by reflux, where is it normally found
More concentrated locaitons in the kidney (focal regions)
26
What are 3 pathways of pyelonephritis?
Hematogenous
Lymphatic
Urinary
27
Where is acute pyelonephritis found?
Pelvic
Calyces
Medulla
28
What cells are damaged by inflammatory mediators in actue pyelonephritis?
Tubule cells
29
What is chronic pyelonephritis?
Presistent or recurring episodes of acute pyelonephritis that leads to shrunken, fibortic kidney
30
With obstructive disorders, what do changes in the tract depend on?
Degree of osbstruction
Duration
Timing
31
What happens proximal to the obstruction in an obstructive renal disorder?
Hydrostatic pressure increase proximal
dilation of proximal tract
urine stasis
32
What is hydroureter?
An accumulation of fluid behind the ureter
Creates pressure in renal pelvis and tubules
33
What is postobstructive diuresis
Production and excretion of more urine than normal after obstruction has been cleared
Gets rid of waste materials due to obstruction
34
What is the proper name for a kidney stone?
Renal calculus
35
What is nephrolithiasis?
Presence of stone (calculus) anywhere in the tract
36
What type of cells are found in the urteters?
Transitional squamous
37
What 3 factors influence renal calculus formation?
Supersturation (calcium)
Anormal urine pH
Low urine volume
38
What is Ureteral colic ?
Pain when there is a renal calculus in ureter
Ureter distends behind stone
39
What are the three types of renal tumors?
Benign
Primary Neoplasm
Secondary Neoplasm
40
What is a genetic, slow growing, benign tumor?
Oncocytoma
41
What is a benign conential tumor of infancy in the kidney?
Mesoblastic nephroma
42
What is a benign renal tumor that is caused by an excess of somethign that doesn't belong on the kidney?
renal angiomyolipomas (hemartoma)
43
What is a renal neoplasm of low malignant potential that may be a pre-malignant version of renal adenocarcinoma?
Renal adenoma
44
What is a renal tumor found mostly in older adult males, with occupation exposure, high protein diet, mostly in developed countries
Renal Cell Carcinoma (renal adenocarcinoma)
45
What is the triad of symptoms of renal adenocarcinoma ?
Heamturia
flank pain
mass
46
Where do renal cell carcinomas normally start?
epithelium of PCT
47
Where are urothelial tumors found?
Lining of renal pelvis, calyces, ureter, bladder (in transitional cell epithelium)
48
What type tumor is mostly found in children and is due to a defect on chromosome 11?
Nephroblastoma (Wilms tumor)
49
What is glomerulonephritis?
Inflammation of glomerulus
Most common cause of chronic renal disease and end-stage renal failure
50
What causes acute glomerulonephritis?
Inflammation due to group A post-streptococccal infection
51
Where is cellular proliferation found in rapidly-progressing glomerulonephritis?
Bowman's Capsule
52
What type lesions are found in rapidly progressing glomerulonephritis
Crescent
53
What is an anti-glomerular basement membrane disease?
Goodpasture syndrome
54
WHat do the antibodies form against in goodpasture syndrome?
Capillaries
55
What is the name for several glomerular diseases that lead to chronic renal failure?
Chronic glomerulonephritis
56
What are the 3 pathological changes associated with chronic glomerulonephritis?
Tubular dilation and atrophy
Tubulointerstitial injury
Proliferation of mesangial cells
57
What are the two changes to the urine in chronic glomerulonephritis?
Proteinuria
Hematuria
58
What is the excretion of 3.5 gram or more of protein in urine per day?
Nephrotic syndrome
59
In nehprotic syndrome, what is edema caused by?
Hypoalbuminemia
60
What other symptoms are seen in nephrotic syndrome?
Lipiduria
Hypocalcemia
Hypercoagulability
61
What is a decline in renal function to 25% of normal?
Renal insufficiency
62
What is end-stage renal failure?
Less than 10% of normal kidney function left
63
What term describes the whole syndrome of renal failure?
Uremia
64
What is an increase serum urea levels (nitroenous wastes, usually increased creatinine levels)
Azotemia
65
What is an abrupt reduction in renal function with elevated BUN and creatinine levels?
Actue Renal Failure
66
What are the three classification of ARF?
Prerenal (blood supply before it gets to kidney)
Intrarenal
Posternal (urinary tract)
67
What do all prerenal ARF share?
Decreased blood flow and decreased cardiac output
68
What is required for postrenal ARF?
Bilateral outflow obstruction
69
If blood volume of BP is not restored in prerenal ARF what cna happen?
Acute tubular necrosis
Acute cortical necrosis
70
What is the most common cause of intrarenal ARF?
Acute tubular necrosis
71
WHat are the two caues of ATN (actue tubular necrosis) ?
Postichemic or nephrotoxic
\*ischemic form most often after surgery
72
Where does necorsis occur with ischemia ?
Any part of the neprhon
Patchy necrosis
73
What is nephrotoxic ATN caused by?
Numerous antibiotics
Drugs accumulate in cortex
74
In nephrotoxic ATN where does necrosis occur?
Only in proximal tubules- necrosis is uniform
75
What are 3 reasons GFR is reduced in ARF?
Tubular obstruction
Tubular back-leak
Alternations in renal blood flow
76
In postrenal ARF, what leads to a decrease in GRF?
Increase in intraluminal pressure proximal to obstruction
77
WHat are the three phases of ARF?
Initiation phase
Maintenance phase
Recovery phase
78
In which stage of ARF is urine output lowest?
Maintenance phase
79
In which stage of ARF do serum creatinine and BUN increase ?
Maintenance phase
80
What is an irreversible loss of renal function?
Chronic renal failure
81
What does chornic renal failure affect?
All organ systems
82
WHat are the most common causes of chronic renal failure?
Diabetes mellitus
Hypertension
83
What is when GFR is reduced to 50% and BUn is elevated (no clinical symtpoms)
Reduced renal reserve
84
What is a near complete absence of GFR?
End stage renal disease
85
What is azotemia, acidosis, impaired urien dilution, severe anemia, electrolyte imbalances associated with?
Renal failure
86
As GFR falls, plasma creatine levels \_\_\_\_\_
increase
87
What are urea levels highly tied to?
A peron's diet (specifically protein), this is why it is not as acurate of an indicator as creatinine
88
It becomes difficult to conserve sodium after GFR is...
\<25%
89
What does PTH do?
Increases levels of Ca in system, needs Vitamin D to work
90
What is potassium normally mediated by?
Aldosterone
91
When does metabolic acidosis occur?
When GFR is \<30-40%
92
Where is there hypocalcemia and bone disease in renal failure?
Lack of Vitamin-D
93
With renal failure, what cardiovascular system organ effect will there be?
Hypertension due to increased Na
94
What is dyslipidemia caused by in individuals in renal failiure?
Increase in fluid volume
95
What are some neural function alterations due to renal failure?
sleep disorders, memory loss
hiccups, muscle scramps
asterixis, seizures, coma
96
In renal failure, what happends in the endocrine/ reproductive systems?
Drop in circulating sex steroids
Hyperinsulinemia (diabetes get better as kidneys fail)
97
What are hematologic alternations associated with renal failure?
Anemia due to lack of EPO
normochromic, normocytic
98
What immunologic dysregulation is associated with renal failure?
Suppression of chemotaxi, phagocytosis, antibody production, cellular immunity
99
What are 2 GI problems in people with renal failure (only 25% of patients)?
Gastroenteritis
Uremic fetor (bad breath from nitrogenous waste, urea being excreted)
100
What causes a person in renal failure to have a negative nitrogen balance?
Proteinuria and catabolic state
101
Why is there glucose interolerance in someone with renal failure?
Increased amount of glucose in blood stream due to decreased filtration
