Renal Flashcards
What is gluconeogenesis?
Making noncarbs into carbs
What 4 things do the kidneys regulate?
- Water and electrolyte balance
- Arterial pressure
- Acid-base balance
- Vit D production
Important hormone that the kidney produces - responsible for making RBCs
Erythropoietin
Kidneys function to excrete __________
Metabolic waste
The kidney can control arterial _______
BP
Aging = _______ blood flow to kidneys
Decrease
Units that extract wastes from the blood and concentrate them in the urine
Nephrons
What happens to the # of nephrons as you age?
Decrease
Most common electrolyte imbalance
Mild hyponatremia
Due to aging, when does urine production occur?
Night production
4 common signs of UTI
- Frequency
- Urgency
- Incontinence
- Nocturia
_____ is an abnormal number of times to urinate at night
3+
Inflamed urethra causes
Bladder infection
Among the most common bacterial infections
UTI
Upper/lower tract UTI locations
Upper: kidneys and ureters
Lower: bladder and urethra
2 ways to classify uti
Complicated/uncomplicated
Relapsed/recurrent
Can account for 40% of UTIs in health care facilities
Urinary catheter placement
3 clinical manifestations of UTI in older adults
- Malaise
- Anorexia
- Confusion
Term for inflammation of kidney tissue, calyces and renal pelvis caused by bacterial infection
Pyelonephritis
20-30% of diabetics experience…
Diabetic nephropathy
What level do you want hgb A1C at?
<6.5
a progressive kidney disease caused by damage to the capillaries in the kidneys’ glomeruli
Diabetic nephropathy
Term for narrowing of renal artery
Renal artery stenosis
Renal artery stenosis causes _____________
Decreased renal perfusion
Most common adult renal neoplasm
Renal cell carcinoma (RCC)
New/abnormal growth of tissue in some part of the body
Neoplasm
Accounts for 90% of renal tumors
RCC
Classic triad of symptoms for RCC
Flank pain, hematuria, palpable abdominal mass
How is RCC discovered?
CT scan
4 places RCC mets are often found
- Lungs
- Regional lymph nodes
- Bones
- Liver
What is the single most common finding in RCC?
Hematuria
Symptoms that occur at sites distant from a tumor or its metastasis
Paraneoplastic symptoms
_____ are produced by RCC tumor
Hormones
RCC is associated with _________ symptoms
Paraneoplastic
Most common malignant kidney neoplasm in children
Wilms tumor
Wilms tumor is also called…
Nephroblastoma
When does wilms tumor most often occur?
Within first 6 years of life
Most common ethnicity for Wilms tumor
African american girls
__________ play a role in wilms tumor development
Molecular genetics
When do symptoms start for wilms tumor?
Late - grows very large before symptoms start
Most common sign of wilms tumor
Abdominal mass
5year survival rate of wilms tumor is
90%
Wilms tumor prognosis is _________ in adults
Poorer
Clinical term for kidney stone
Renal caliculi
Term for formation of urinary tract stones
Nephrolithiasis
Where is your “flank”?
Muffin top
Type of pain caused by kidney stones
Renal colic
Where is renal colic felt?
Flank and upper outer abdominal quadrant pain
Where do renal caliculi occur?
Ureteropelvic junction
What causes renal caliculi to form?
When urine contains excess solids (Ca, oxalate, uric acid etc) and urine is unable to dilute/dissolve them
Term for gradual kidney function loss
Chronic renal failure
Name 4 stages of chronic renal failure
- Diminished renal reserve
- Renal insufficiency
- Renal failure
- End stage renal disease (ESRD)
Important treatment of chronic renal failure
Restrict dietary protein
Common cause of chronic renal failure
HTN
ESRD patients HR range for exercise
40-70% THR or 20 beats above resting
2 things to watch for in ESRD patients who you exercise
- Hypotension
2. Muscle cramping
Can you give your ESRD pt water while exercising?
Nope
two types of dialysis
peritoneal
hemodialysis
uses the peritoneal cavity as a semipermeable membrane to exchange substances and water between dialysate fluid and blood vessels of abdominal cavity
peritoneal dialysis
how often is peritoneal dialysis performed?
4x daily or overnight
arterial blood is circulated thru semipermeable tubing that is surrounded by a dialysate solution in an artificial kidney
hemodialysis
how often is hemodialysis performed?
3x per week for 4 hours
can a patient on dialysis perform exercise?
yes, during first two hours
always test BP in _____ arm for dialysis pts
opposite
4 signs of bladder cancer
- hematuria
- voiding dysfunction
- lymphedema
- hepatomegaly
enlargement of liver
hepatomegaly
4 stages of bladder ca
- limited to mucosal lining
- invasion of smooth muscle wall
- extends beyond bladder wall
- tumor involving prostate with distant mets
bladder dysfunction (flaccid or spastic) caused by neurologic damage
neurogenic bladder
3 types of incontinence
- stress
- urge
- overflow
when are men likely to have incontinence issues?
after prostate issues
a high BUN signals…
decrease in kidney function
normal blood urea nitrogen
10-20 mg/dl
can be the first sign that something is wrong with the kidneys
elevated BUN
high uric acid concentration in blood can present as…
bad joint pain - gout
high uric acid concentration in urine can cause…
stones
5 renal diagnostic tests
- renal arteriogram
- abdominal - pelvic CT
- kidney MRI
- cystography
- ultrasound
inflammation of prostate gland
prostatitis
BPH
benign prostate hypertrophy
age-related nonmalignant enlargement of prostate gland
BPH
inflammation of testis often associated with bacteria and chlamydia
orchitis
inflammation of the epididymis caused by bacteria
epididymitis
abnormal twisting of spermatic cord
testicular torsion
majority of tumors in testicular cancer are __________
germ cell tumors
metastatic testicular cancer may present as _____
LBP
