Renal

Question 1

How is the urine flow obstructed? What are the anatomical and functional factors?

Answer 1

Anatomical = Can occur at any point along the urinary tract, including the kidneys, ureters, bladder, prostate, or urethra via blockage or compression
Functional = Can occur when the nerves or muscles that control urine flow are not working properly. Eg: decreased muscle action.

Question 2

What does urinary obstruction result in?

Answer 2

It results in the back up and accumulation of urine in the tract buildup of pressure in urinary system.
The pressure can cause urine to flow backwards from the bladder and back into the kidneys.
As a result of this backup, there may be dysfunction or damage to the nephrons and glomeruli in the kidneys.

Question 3

What are the S+S of urinary obstruction?

Answer 3

D P
Decreased urine flow AND output
Pain during urination AND Back pain

Question 4

What is the solution for the urinary obstruction?

Answer 4

Depends on the causative factor such as surgery for taking out the kidney stone.

Question 5

Most common cause for urinary obstruction?

Answer 5

Kidney stones = can be passed or if severe, surgery is needed.

Question 6

What is AKI? What does it result in?

Answer 6

Acute kidney injury = Significant decline in renal function resulting in a decrease in fluid, electrolyte and ph balance.

Question 7

What are the 3 renal category of causes?

Answer 7

1 = Pre renal
2 = Intra renal
3 = Post renal

Question 8

Describe pre renal, the causes and the results.

Answer 8

PRE RENAL IS THE DECREASED BLOOD FLOW TO KIDNEYS CAUSED BY HYPOVOLEMIA OR RENAL ARTERY CLAMPING. RESULTS IN AKI

Question 9

Describe Intra renal and the causes

Answer 9

Intra renal is due to the complications within the kidney such as tubular necrosis (most common), CKD or glomerulonephritis.

Question 10

Describe post renal and the cause

Answer 10

Complications within renal tract that affect kidney function. The cause could be urinary tract obstruction.

Question 11

What is AKI associated with also?

Answer 11

A decreased GFR (25% or more), Oliguria, Azotemia

Question 12

S+S of AKI?

Answer 12

EDM
DIC

EDEMA, DECREASED URINE OUTPUT, METABOLIC ACIDOSIS
DROWSY, IRRITABILITY, CONFUSION
NAUSEA/VOMIT

Question 13

Treatment for AKI?

Answer 13

Depends on causative factors BUT can be for example fluid management via IVF.

Question 14

How do you manage AKI?

Answer 14

Management is specific to the cause but it also includes fluid, electrolyte and ph maintenance (maybe via dialysis). Maybe nutritional maintenance.

Question 15

What does AKI increase the risk of?

Answer 15

CKD

Question 16

What is the 2 major intrinsic cause of AKI?

Answer 16

glomerulonephritis and acute tubular necrosis

Question 17

What is glomerulonephritis?

Answer 17

Its the leading cause of AKI and CKD. It’s basically the inflammation of the glomerulus resulting in GFR decreasing and glomerular permeability increasing.

Question 18

S+S of glomerulonephritis?

Answer 18

Proteinuria = protein in urine = protein is too fucking big to be in our urine hence why it shouldn’t be.
Hematuria = RBC in urine = AGAIN to fucking big to be present in urine.
HAP HOE
HEMATURIA,AZOTEMIA,PROTEINURIA, HYPERTENSION, OLIGURIA, EDEMA
ALSO = We filter shit that shouldn’t be filtered but we also don’t filter shit enough.

Question 19

What is the acute and chronic cause of glomerulonephritis?

Answer 19

Acute = streptococcal infection
Chronic = due to other systemic complications like diabetes.

Question 20

What is chronic kidney disease? CKD

Answer 20

Progressive/irreversible loss of nephrons.

Question 21

What is the pathophysiology of CKD?

Answer 21

Decrease in GFR results in the decrease in reabsorption and secretion of WASTE impairing the kidneys ability to maintain homeostasis including BP and the production of EPO (erythropoietin). This results in glomerular hypertension, hyper-filtration and hypertrophy. This will then result in glomerulosclerosis (SCARRING), tubular inflammation and fibrosis = THIS ALL LEADS TO FURTHER NEPHRON LOSS.

Optional:
(The scarring and loss of nephrons exacerbate the decrease in GFR leading to a vicious cycle of worsening kidney function.)

Question 22

What are the causes of CKD?

Answer 22

G DAHP!!!!
GLOMERULONEPHRITIS
DIABETES
AKI
HYPERTENSION
POLY CYSTIC KIDNEY

Question 23

What is the solution for CKD?

Answer 23

Depends on how many nephrons we lost. Fluid and dietary control, EPO supplements, use of ACE inhibitors. If these don’t work = dialysis or renal transplant.