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Medical Phys II > Patho Kidney > Flashcards

Patho Kidney Flashcards

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USMLE® Step 1 flashcards
1
Q

What is a term that describes renal pain?

A

Nephralgia

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2
Q

Do kidneys have pain receptors?

A

Not in kidney- but in capsule

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3
Q

What will urine look like with decreased renal function?

A

Dark, strong smelling

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4
Q

What are 2 types of congenital renal disorders?

A

Renal Agenesis

Polycystic kidney disease

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5
Q

What is the absence of one or both kidneys?

A

Renal agenesis

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6
Q

What type of agenesis is usually fatal?

A

Bilateral

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7
Q

What is potter syndrome associated with?

A

Bilateral renal agenesis

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8
Q

Bescides kidney problems, what else is associated with Potter syndrome?

A

Facial and respiratory abnormalities

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9
Q

What is the result of multiple dilations of collecting ducts?

A

Polycystic kidney disease

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10
Q

When is ARPKD diagnosed?

A

In infants and young children (recessive versision)

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11
Q

When is ADPKD diagnosed?

A

Adulthood (dominant)

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12
Q

Where is the genetic defect in ARPKD?

A

Chromosome 6

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13
Q

What also accompanies ARPKD?

A

hepatic fibrosis

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14
Q

Why can ARPKD affect chlidren differently?

A

Depends on the number of collecting ducts affected (more affected- worse survivability)

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15
Q

What chromosomes are defected in ADPKD?

A

Chromosome 16 (95%)

Chromosome 4 (5%)

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16
Q

What is the primary pathological cause of ADPKD?

A

Tubular epithelial cell hyperplasia

Can involve the entire nephron

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17
Q

What part of the kidney can ADPKD affect?

A

Entire neprhon

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18
Q

What ages does ADPKD normally appear?

A

30-50 years

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19
Q

What symptoms appear with ADPKD?

A

UTIs

back or flank pain

heamturia

hypertension

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20
Q

What is a big protector of the urinary tract?

A

The acidic nature of urine

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21
Q

What is the most common infectious agent of the urinary tract?

A

E. Coli

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22
Q

What is pyelonephritis?

A

Infection of the upper urinary tract (renal pelvis) and interstitium

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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

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24
Q

Where is a hematogenous infection in the kidney found?

A

Thoughout the kidney

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25
Q

If an infection is caused by reflux, where is it normally found

A

More concentrated locaitons in the kidney (focal regions)

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26
Q

What are 3 pathways of pyelonephritis?

A

Hematogenous

Lymphatic

Urinary

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27
Q

Where is acute pyelonephritis found?

A

Pelvic

Calyces

Medulla

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28
Q

What cells are damaged by inflammatory mediators in actue pyelonephritis?

A

Tubule cells

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29
Q

What is chronic pyelonephritis?

A

Presistent or recurring episodes of acute pyelonephritis that leads to shrunken, fibortic kidney

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30
Q

With obstructive disorders, what do changes in the tract depend on?

A

Degree of osbstruction

Duration

Timing

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31
Q

What happens proximal to the obstruction in an obstructive renal disorder?

A

Hydrostatic pressure increase proximal

dilation of proximal tract

urine stasis

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32
Q

What is hydroureter?

A

An accumulation of fluid behind the ureter

Creates pressure in renal pelvis and tubules

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33
Q

What is postobstructive diuresis

A

Production and excretion of more urine than normal after obstruction has been cleared

Gets rid of waste materials due to obstruction

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34
Q

What is the proper name for a kidney stone?

A

Renal calculus

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35
Q

What is nephrolithiasis?

A

Presence of stone (calculus) anywhere in the tract

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36
Q

What type of cells are found in the urteters?

A

Transitional squamous

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37
Q

What 3 factors influence renal calculus formation?

A

Supersturation (calcium)

Anormal urine pH

Low urine volume

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38
Q

What is Ureteral colic ?

A

Pain when there is a renal calculus in ureter

Ureter distends behind stone

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39
Q

What are the three types of renal tumors?

A

Benign

Primary Neoplasm

Secondary Neoplasm

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40
Q

What is a genetic, slow growing, benign tumor?

A

Oncocytoma

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41
Q

What is a benign conential tumor of infancy in the kidney?

A

Mesoblastic nephroma

42
Q

What is a benign renal tumor that is caused by an excess of somethign that doesn’t belong on the kidney?

A

renal angiomyolipomas (hemartoma)

43
Q

What is a renal neoplasm of low malignant potential that may be a pre-malignant version of renal adenocarcinoma?

A

Renal adenoma

44
Q

What is a renal tumor found mostly in older adult males, with occupation exposure, high protein diet, mostly in developed countries

A

Renal Cell Carcinoma (renal adenocarcinoma)

45
Q

What is the triad of symptoms of renal adenocarcinoma ?

A

Heamturia

flank pain

mass

46
Q

Where do renal cell carcinomas normally start?

A

epithelium of PCT

47
Q

Where are urothelial tumors found?

A

Lining of renal pelvis, calyces, ureter, bladder (in transitional cell epithelium)

48
Q

What type tumor is mostly found in children and is due to a defect on chromosome 11?

A

Nephroblastoma (Wilms tumor)

49
Q

What is glomerulonephritis?

A

Inflammation of glomerulus

Most common cause of chronic renal disease and end-stage renal failure

50
Q

What causes acute glomerulonephritis?

A

Inflammation due to group A post-streptococccal infection

51
Q

Where is cellular proliferation found in rapidly-progressing glomerulonephritis?

A

Bowman’s Capsule

52
Q

What type lesions are found in rapidly progressing glomerulonephritis

A

Crescent

53
Q

What is an anti-glomerular basement membrane disease?

A

Goodpasture syndrome

54
Q

WHat do the antibodies form against in goodpasture syndrome?

A

Capillaries

55
Q

What is the name for several glomerular diseases that lead to chronic renal failure?

A

Chronic glomerulonephritis

56
Q

What are the 3 pathological changes associated with chronic glomerulonephritis?

A

Tubular dilation and atrophy

Tubulointerstitial injury

Proliferation of mesangial cells

57
Q

What are the two changes to the urine in chronic glomerulonephritis?

A

Proteinuria

Hematuria

58
Q

What is the excretion of 3.5 gram or more of protein in urine per day?

A

Nephrotic syndrome

59
Q

In nehprotic syndrome, what is edema caused by?

A

Hypoalbuminemia

60
Q

What other symptoms are seen in nephrotic syndrome?

A

Lipiduria

Hypocalcemia

Hypercoagulability

61
Q

What is a decline in renal function to 25% of normal?

A

Renal insufficiency

62
Q

What is end-stage renal failure?

A

Less than 10% of normal kidney function left

63
Q

What term describes the whole syndrome of renal failure?

A

Uremia

64
Q

What is an increase serum urea levels (nitroenous wastes, usually increased creatinine levels)

A

Azotemia

65
Q

What is an abrupt reduction in renal function with elevated BUN and creatinine levels?

A

Actue Renal Failure

66
Q

What are the three classification of ARF?

A

Prerenal (blood supply before it gets to kidney)

Intrarenal

Posternal (urinary tract)

67
Q

What do all prerenal ARF share?

A

Decreased blood flow and decreased cardiac output

68
Q

What is required for postrenal ARF?

A

Bilateral outflow obstruction

69
Q

If blood volume of BP is not restored in prerenal ARF what cna happen?

A

Acute tubular necrosis

Acute cortical necrosis

70
Q

What is the most common cause of intrarenal ARF?

A

Acute tubular necrosis

71
Q

WHat are the two caues of ATN (actue tubular necrosis) ?

A

Postichemic or nephrotoxic

*ischemic form most often after surgery

72
Q

Where does necorsis occur with ischemia ?

A

Any part of the neprhon

Patchy necrosis

73
Q

What is nephrotoxic ATN caused by?

A

Numerous antibiotics

Drugs accumulate in cortex

74
Q

In nephrotoxic ATN where does necrosis occur?

A

Only in proximal tubules- necrosis is uniform

75
Q

What are 3 reasons GFR is reduced in ARF?

A

Tubular obstruction

Tubular back-leak

Alternations in renal blood flow

76
Q

In postrenal ARF, what leads to a decrease in GRF?

A

Increase in intraluminal pressure proximal to obstruction

77
Q

WHat are the three phases of ARF?

A

Initiation phase

Maintenance phase

Recovery phase

78
Q

In which stage of ARF is urine output lowest?

A

Maintenance phase

79
Q

In which stage of ARF do serum creatinine and BUN increase ?

A

Maintenance phase

80
Q

What is an irreversible loss of renal function?

A

Chronic renal failure

81
Q

What does chornic renal failure affect?

A

All organ systems

82
Q

WHat are the most common causes of chronic renal failure?

A

Diabetes mellitus

Hypertension

83
Q

What is when GFR is reduced to 50% and BUn is elevated (no clinical symtpoms)

A

Reduced renal reserve

84
Q

What is a near complete absence of GFR?

A

End stage renal disease

85
Q

What is azotemia, acidosis, impaired urien dilution, severe anemia, electrolyte imbalances associated with?

A

Renal failure

86
Q

As GFR falls, plasma creatine levels _____

A

increase

87
Q

What are urea levels highly tied to?

A

A peron’s diet (specifically protein), this is why it is not as acurate of an indicator as creatinine

88
Q

It becomes difficult to conserve sodium after GFR is…

A

<25%

89
Q

What does PTH do?

A

Increases levels of Ca in system, needs Vitamin D to work

90
Q

What is potassium normally mediated by?

A

Aldosterone

91
Q

When does metabolic acidosis occur?

A

When GFR is <30-40%

92
Q

Where is there hypocalcemia and bone disease in renal failure?

A

Lack of Vitamin-D

93
Q

With renal failure, what cardiovascular system organ effect will there be?

A

Hypertension due to increased Na

94
Q

What is dyslipidemia caused by in individuals in renal failiure?

A

Increase in fluid volume

95
Q

What are some neural function alterations due to renal failure?

A

sleep disorders, memory loss

hiccups, muscle scramps

asterixis, seizures, coma

96
Q

In renal failure, what happends in the endocrine/ reproductive systems?

A

Drop in circulating sex steroids

Hyperinsulinemia (diabetes get better as kidneys fail)

97
Q

What are hematologic alternations associated with renal failure?

A

Anemia due to lack of EPO

normochromic, normocytic

98
Q

What immunologic dysregulation is associated with renal failure?

A

Suppression of chemotaxi, phagocytosis, antibody production, cellular immunity

99
Q

What are 2 GI problems in people with renal failure (only 25% of patients)?

A

Gastroenteritis

Uremic fetor (bad breath from nitrogenous waste, urea being excreted)

100
Q

What causes a person in renal failure to have a negative nitrogen balance?

A

Proteinuria and catabolic state

101
Q

Why is there glucose interolerance in someone with renal failure?

A

Increased amount of glucose in blood stream due to decreased filtration

Medical Phys II (16 decks)

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