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St John/ Uni > Patho & Pathophis Renal disorders > Flashcards

Patho & Pathophis Renal disorders Flashcards

1
Q

What is the overall function of the kidney

A

They selectively reabsorb minerals like sodium and potassium back into the circulation to maintain body fluids

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2
Q

What is allowed through the glomeruls into the proximal convoluted tubule

A

Only plasma is allowed through red blood cells and other minerals arent

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3
Q

What is the function of the Nephron

A

This controls the amount of sodium that get reabsorbed back into the blood to maintain blood volume while also eliminating the waste material

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4
Q

What do diuretics do

A

These increase urine volume “water pills”
They remove excess sodium & water from the body by blocking reabsorption of these substances.

May also cause excessive potassium removal from body necessitating concurrent usage of drugs to prevent hypokalemia

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5
Q

What regulates the reabsorption of minerals

A
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6
Q

How do the Kidneys control PH

A

It plays a role in the bicarbonate buffering system

It also plays a role in excreting hydrogen atoms

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7
Q

What is Creatinine

A

This is a chemical waste molecule that is generated from muscle metabolism.

It is transported through the blood and filtered out by the kidneys so it can be disposed of in urine

It is mainly absorbed in the glomerular reabsorption but can also be in the proximal tubular excretion

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8
Q

How to the kidneys reabsorb water

A

They do this with the help of osmosis

This involves the reabsorption of sodium then water follows increasing blood volume

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9
Q

How does Glucose affect the body

A

Glucose is the fuel for ATP
Glucose also has an osmotic pull

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10
Q

How is Amonia made and how is it excreted through the body

A

Amonia is form when amino acids are broken down. Amonia is toxic to the body so the liver adds CO2 to it making it urea. This is then transported to the kidney and excreted via urination

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11
Q

How does potassium affect the body

A

This has a major affect on the sodium potassium pump (involved in sending action potentials)

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12
Q

What do Amino acids do in our body

A

These are the building blocks for proteins
It is also essential for muscle growth and synthesis (pretty much all amino acids r reabsorbed back into circulation)

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13
Q

What does Bi Carbonate do

A

This is heavily involved in the bicarbonate buffer
This binds with acid and created carbonic acid, this can then dissociate into water and CO2

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14
Q

Do respiratory disorders causing acidosis or alkalosis initiate a kidney response?

A

YES
Acidaemia: Kidneys excrete excess hydrogen ions and reabsorb bi carobonate

Alkalaemia: Kidneys secrete less hydrogen back into the kidney tubules and excrete more bicarbonate ions (usually with sodium ions)

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15
Q

How does the body balance water

A
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16
Q

What is Hyponatremia

A

This is a decrease in the sodium concentration

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17
Q

What is Acute renal failure

A

Both kidneys have to be involved.

This can be directly linked to reduced blood flow or inflammation and Necrosis of tubules causing obstruction and back flow

This can be reversible if detected early enough but can end up with patients having to go in dialysis

18
Q

What are the 3 main areas that Renal failure can occur in

A

Prerenal - this is the most susceptible area and can lead to metabolic acidosis

Intrinsic - this is damage or inflammation to the filtering parts of the kidney of the basement membrane causing renotoxins to accumulate in the renal cortex

Postrenal - this is an obstruction of the urine outflow from the kidney e.g. kidney stone causing damage to the filtering structures of the kidney

19
Q

What is Oliguria

A

This is the reduced urine outflow

20
Q

What is Acute Tubular Necrosis

A

This makes up 75% of acute renal failure cases.

This is where the tubular segment of the nephron injured via ischemic injuries damaging the cell membrane.

Patch necrosis at multiple points in tubules may occlude the lumen. If not fatal regeneration eventually completely reverses the damage

21
Q

What is the mortality rate for Acute tubular neucrosis

A

40 - 70%

22
Q

What are UTI’s

A

These are extremely common and typically caused by E. coli

Depending on virulence infection will ascent especially if
Bacteria is not flushed out during urination
Bladder lining does not provide sufficient protection
Insufficient immune response

23
Q

How does E. coli cause UTI’s

A

E. coli can adhere to the mucosa of the bladder, which means that it is not always washed out by urination this leads infection.

UTI’s are most common in woman because their urethras are much smaller than men and men’s prostatic fluids give a natural barrier

24
Q

What are the two lower UTI’s

A

Urethritis - the urethra is inflamed, red an swollen

Cystitis - bladder wall inflamed, red, swollen
- the bladder becomes hypersensitive and has reduced capacity

25
Q

What is Pyelonephritis

A

This is the flash word for Kidney infection

26
Q

What are some risk factors for developing a UTI in children

A

Constipation/dehydration
History of UTI’s
Familial history of issues
Prolonged time in unchanged nappies
Poor Toilet paper technique

27
Q

What are some risk factors for developing a UTI in Adults

A

Poor toilet paper technique
First UTI at early age
Sex
Adult nappies
Antibiotic use
History of UTI
Catheter in situ

28
Q

What is Glomerulonephritis

A

This is a bilateral inflammation of glomeruli, typically following streptococcal infections
Previous infection creates antigen antibodies that are in the glomerular capillaries another infection triggers a type 3 hypersensitivity reaction activating complement system and inflammatory response

29
Q

What happens with the inflammation response in Glomerulonephritis

A

This is when there is glomerular permeability resulting in the leakage of some proteins and erythrocytes into the filtrate making the urine dark and cloudy

It also increases congestion decreasing Glomerulus filtration rate

30
Q

Can Glomerulonephritis cause death?

A

Yes in severe cases
Blood flow can decrease to the kidney triggering renin secretion increasing the blood pressure & oedema leading to acute kidney failure and death

31
Q

What happens in Pyelonehritis

A

Sudden inflammation caused by bacterial infection
can involve both kidneys or just 1
infection extends from ureter into kidney
Pus fills the kidney pelvis and calyces leading to inflamed medulla
If infection is severe, exudate can compress renal artery & veins and obstruct urine outflow
Bi-lateral obstruction likely to cause acute renal failure

Chronic infection can result in scar tissue forming

32
Q

What are Kidney stones (Calculi)

A

These can form anywhere in the urinary tract but most commonly in the kidney

Calculi tend to form when there are excessive amount of relatively insoluble salts in the filtrate or when insufficient fluid intake results in high concentrate filtrate

Once any debris form, deposits continue to accumulate forming a large stone

33
Q

What are most calculi composed of

A

75% are composed of calcium salts which can be from a parathyroid tumor or other metabolic disorders.

The Urines PH can increase stone formation

34
Q

Chronic Renal Failure

A

This may result from hypertension & diabetes
It represents loss of functioning kidney nephrons

This is usually asymptomatic until greatly advanced

35
Q

What are the stages of chronic Renal failure

A
36
Q

Overview of chronic Kidney disease

A
37
Q

What are some treatment plans for Chronic Renal faliure

A

Kidney transplant / dialysis
These are treatment for someone who has advanced uremia

Transplant surgery and dialysis is dictated by age, donor availability & personal preference

Transplantation is the preferred method of treatment

38
Q

What is the difference between Hemodialysis & Peritoneal dialysis

A

Hemodialysis - Blood is taken out from a vein and goes through a dialyzer then pumped back into the body

Peritoneal dialysis - this is where you pump dialysis fluid into the peritoneum

39
Q

When can rejection occur with a kidney transplant

A

Acute rejection - typically occurs in the first several months after transplantation

Chronic rejection - occurs months or years after transplant

40
Q

What sort of questions to ask when treating a patient on dialysis

A
41
Q

What are some important vitals to check for a patient on dialysis

A

St John/ Uni (23 decks)

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