Quiz 4 Study Guide: Renal Flashcards
What are the symptoms of Urinary Obstruction?
Anuria
Polyuria
Bladder Distention
(Sometimes Asymptomatic)
Symptoms of Renal/Ureter stones
Renal Colic
Hematuria
Pyelonephritis
(Sometimes Asymptomatic)
What is Pyelonephritis?
Inflammation of Kidney tissue often caused by bacterial infection in or from the urinary tract.
- Retrograde spread from Cystitis
- Common with Urinary Obstruction, Stenosis
- Diabetes
What are consequences of Pyelonephritis?
Flank Pain
Fever
Kidney Scarring
Chronic Renal Failure in 10-20%
What are properties of Renal Cell Carcinomas?
80-90% of renal malignancies
More common in males > 40 Yrs, and Smokers
Analgesic Users (NSAIDS)
Obesity
What are symptoms of Renal Cell Carcinomas?
Often Asymptomatic Hematuria Dull Flank Pain Fever Fatigue
Where do Renal Cell Carcinomas likely metastasize?
The Lungs or Bones
What is Wilms Tumor?
Most common childhood (Congenital) renal tumor
- Most common in first 3 years.
The two infections of the Bladder…
Bacterial Cystitis
Urothelial Carcinomas
What are contributing factors to Bacterial Cystitis?
Stones
Catheters
Short Female Urethras
Obstructions
What are the features of Urothelial Carcinomas?
Most often in males > 50 years old
Associated with Smoking (Carcinogens)
MOST COMMON urothelial malignancy
Three diseases of the Prostate
Prostatitis
Benign Prostatic Hyperplasia
Serum PSA and Prostatic Adenocarcinoma
What are the features or Prostatitis?
Often caused by bacteria (Cystitis)
Causes enlarged and tender prostate (Obstruction)
Most common in older men
What are the features of Benign Prostatic Hyperplasia?
Very common in older men (95% > 75 Years old)
Serious Sequelae less common
Cause not well known (maybe androgens or estrogens)
Urinary obstruction is common
What are the features of Prostatic Adenocarcinoma
The most common Malignancy in older men (other than skin cancers. (60% of men > 80 Years old)
Most often detected by rectal exams
Many are small and clinically irrelevant
*** can be deadly to some
What role does PSA (Prostate Specific Antigen) play?
Rapidly increasing PSA = High risk for cancer
>4-6 mg/ml is abnormal (usually with increased age)
The more PSA bound to alpha-1-antichymotrypsin, the greater the risk for cancer.
What are the main causes of Chronic Renal Disease?
Diabetes, Hypertension, and chronic glomerulonephritis.
***26 million American adults have this. 500,000 on dialysis.
The most common primary Glomerulonephritis is…
IgA nephropathy - triggered by a viral infection
Chronic Renal Disease patients have…
Platelet dysfunctions (bleeding)
gingival hyperplasia
bone abnormalities (slow healing after surgery)
Premature bone loss (osteoporosis)
Infections complications (immunosuppression)
What are common symptoms of Chronic Renal Disease
Heavy Proteinuria (Indicates renal cell death)
Hematuria
Inflammatory injury to kidneys
Glomeruli scarring and damaged function. (Sclerotic types)
Treatments for Small Kidney Stones (
Drink lots of water
Dietary changes
OTC analgesics (ibuprofen and Naprosyn)
Tamulosin (Flomax) - Relaxes ureter muscle
Treatments for Larger Kidney Stones
Lithotripsy (Shock-wave treatment)
Surgical removal
Opioid Analgesics for pain
What are the 4 types of Kidney Stones?
Calcium/oxylate (80% of stones)
Struvite (10% of stones)
Uric Acid (gout)
Cysteine
What is the only type of kidney stone that you treat by acidifying the urine?
Struvite stones
-Usually caused by urinary infections associated with magnesium ammonium phosphate crystals
What are the 3 medications for Kidney stones?
- Hydrochlorothiazide (Thiazide diuretic that reduces calcium in the urine.
- Sodium Bicarbonate (Alkalinizes the urine)
- Allopurinol (Reduces uric acid excretion)
What causes Urinary Tract Infections?
Often E. Coli
Usually in Females
What is the Treatment for UTI’s?
Trimethoprim-Sulfamethoxazole
Amoxicillin + Clavulanic Acid (Resistant bacteria)
Ciprofloxacin (expensive)
What drugs are used for those receiving hemodialysis?
Atenolol and/or captopril for hypertension
Heparin (Prevents clotting during dialysis)
Furosemide
Prophylactic antibiotics (these pts. have high rate of infections)
What is Furosemide?
Potent diuretic that reduces fled retention and the amount of fluid that needs to be removed by the dialysis.
Dental Concerns of patients on Hemodialysis?
Higher incidence of Periodontal disease
More likely to have oral infections
Need for prophylactic antibiotics before treatment.
