Renal 1 Flashcards

1
Q
  • Relatively common (1 in 800)
  • Pt usually unaware
  • Usually only one kidney
  • Both kidneys is rare/incompatible w/ life
A

Unilateral agenesis (one kidney does not form)

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2
Q

What are the 4 diseases of the kidney we learned about?

A
  • Unilateral agenesis
  • Renal Hypoplasia
  • Horseshoe Kidney
  • Renal Cystic Dysplasia
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3
Q
  • Kidneys do not develop to normal size
  • More often affects 1 kidney
  • When both kidneys involved, results in renal failure (will need dialysis)
A

Renal Hypoplasia

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4
Q

What are the 2 most common causes of Renal Hypoplasia?

A
  • HTN
  • DM
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5
Q
  • Fusion of kidney at midline
  • Occurs in 1 in 600
  • No issues, unless defect favors obstruction to renal flow
A

Horseshoe Kidney

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6
Q

What vessel blocks a horseshoe kidney?

A

Inferior Mesenteric Artery (IMA)

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7
Q
  • Most common renal development disorder
  • Results from abnormal differentiation of the renal structures during embryonic period along w/ cyst formation
  • Usually unilateral
A

Renal Cystic Dysplasia

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8
Q
  • Histologically, tube like structures enclosed by mesenchyme, foci of cartilage, and immature glomeruli and tubules
  • ***NO association w/ malignancy***
A

Renal Cystic Dysplasia

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9
Q
  • Multiple, expanding serous or purulent filled cysts of both kidneys that destroys intervening parenchyma
  • Autosomal Dominant disorder
  • Cysts derivedm from obstructed tubules, but reason for obstruction is unknown
A

Adult Polycystic Kidney Disease

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10
Q
  • # 1 disorder that needs dialysis
  • Develops by age 30 or 40
  • BUN and Creatnine are increased
  • Kidneys are size of liver!
A

Adult Polycystic Kidney Disease

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11
Q
  • Early sign is dull/aching pain in abdomen or back
  • Tubules, vessels, glomeruli are all impinged upon
  • Signs of renal failure in 3rd or 4th decades of life
A

Adult Polycystic Kidney Disease

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12
Q
  • Results in hematuria w/ “red frank blood”
  • May lead to ischemic atrophy of intervening parenchyma leading to: hemorrhage, infection, and HTN
A

Adult Polycystic Kidney Disease

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13
Q
  • The most common congenital kidney disease that people go on dialysis for
A

Adult Polycystic Kidney Disease

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14
Q

3 things common in people w/ Adult Polycystic Kidney Disease

A
  • HTN w/ varying severity occurs in 75%
  • Saccular berry aneurysms present in 10-30% of patients
  • End stage renal failure occurs about age 50
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15
Q
  • As soon as umbilical cord is cut, baby goes into kidney failure
  • Autosomal recessive disorder
  • Enlarged bilateral kidneys which are non-functional at birth
  • Resemble sponges
A

Childhood Polycystic Kidney Disease

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16
Q
  • Which disease is “obstructed tubules?
  • Which disease is “cyst appear to originate from epithelium of collecting ducts?
A
  • Tubules: Adult Polycystic Kidney Disease
  • Ducts: Childhood Polycystic Kidney Disease
17
Q

Infection of kidney

A

Pyelonephritis

18
Q

Infection of urinary bladder

A

Cystitis

19
Q
  • Are pyelonephritis and cystitis acute or chronic infections?
A

Either

20
Q

Most common cause of UTIs?

(Bacterial, viral, or fungal)

A

Bacterial (E. coli) : Gram negative rod in GI tract

21
Q

What are 2 ways that bacteria reach the urinary tract and which is most common?

A
  • From blood (hematogenous infection)
  • Ascending infection (most common)
22
Q

What causes a woman’s urethra to be more open; making them more prone to contracting UTIs?

A

Estrogen

23
Q

Besides E. coli, what are 3 other less common bacterias causing UTIs?

A
  • Candida
  • Staph aureus
  • Staph epidermidis
24
Q

What is the 2nd most common bacteria of the stool?

A

Ameroides Nigelis

25
Q

Pathologic finding on kidney with acute pyelonephritis

A

Petechia on surface of kidney

26
Q

Primary infection which leads to hematogenous infection is typically located in which 3 areas?

A
  • Endocardium
  • Lungs
  • GI tract
27
Q

Ascensing infection of UTIs are usually from which 3 things?

A
  • Sexual intercourse (honeymoon cystitis)
  • After urinary catheterization
  • Following surgical procedures (removal of bladder tumor)
28
Q

Why are UTIs more common in women? (3)

A
  • Estrogen/Progesterone have relaxing effect on urthera (opening it up to bacteria)
  • Shorter urethra (easier to colonize bladder)
  • Pregnancy (enlarged uterus has mechanical/ compressing effects on urinary bladder and ureters)
29
Q

What are other 5 conditions which can lead to UTIs?

A
  • Urinary stones
  • Tumors
  • BPH
  • DM
  • Immunosuppression
30
Q

***What is the most common cause of UTIs in men?***

A

BPH

31
Q

Which bacteria is most common cause of Acute Pyelonephritis?

A

E. coli (gram negative rod)

32
Q

What are the 2 uncommon bacterial causes of Acute Pyelonephritis?

A

Staph and Strept (faecalis)

33
Q
  • Suppurative infection of kidneys
  • Grossly contains foci of pus and focal abscesses
  • Severe cases: pus may permeate entire kidney and fill renal pelvis
A

Acute Pyelonephritis

34
Q
  • Round, yellow, raised abscesses are present on renal surface surrounded by areas of congestion
A

Acute Pyelonephritis

35
Q
  • Onset of sudden, sharp pain in the _____ ____, along w/ fever, chills, & malaise.
  • UA: pyuria, bacteriuria, & leukocytosis
A
  • Costovertebral angle
  • Acute Pyelonephritis
36
Q

Tx for acute pyelonephritis

A

Abx may be used, but if patient is immunocompetent the infection subsides on its own (usually)

37
Q

Older women, especially with DM, fever, sxs of dehydration, and disorientation probably have what??

A

UTI –> acute pyelonephritis

38
Q

Connective tissues between blood vessels, tubules, and glomeruli

A

Interstitium

39
Q

Will acute pyelonephritis have PMNs/neutrophils?

A

Yes