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Pathophysiology; McCance and Huether 8th addition > Renal > Flashcards

Renal Flashcards

1
Q

Anatomic changes in the urinary system caused by obstruction are referred to as

A

obstructive uropathy

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2
Q

Dilation of the ureter

A

hydroureter

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3
Q

Enlargement of the renal pelvis and calyces

A

hydronephrosis

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4
Q

Dilation of both the ureter and the pelvicaliceal system

A

ureterohydronephrosis

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5
Q

The deposition of excessive amounts of extracellular matrix (collagen and other proteins) by activated fibroblasts with associated areas of tubular atrophy

A

Tubulointerstitial fibrosis

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6
Q

When distal tubular damage occurs in the kidney what is the result?

A

It decreases the kidneys ability to concentrate urine and then increasing urine volume despite decrease in GFR

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7
Q

Ultimately the obstructed kidney cannot conserve sodium, bicarbonate, or water to excrete hydrogen or potassium this leads to

A

metabolic acidosis and dehydration

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8
Q

Kidney stones that are large and fill the minor and major calyces

A

Staghorn calculi

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9
Q

Kidney stones that are variable size are are located in the calyces in the renal pelvis or various sites along the ureter

A

Nonstaghorn calculi

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10
Q

The presence of a higher concentration of a salt within a fluid than the volume is able to dissolve to maintain equilibrium

A

supersaturation

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11
Q

Hydroxyapatite deposits that become exposed and serve as sites for calcium oxalate stone formation

A

Randall plaque

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12
Q

How does the size of the stone predict its ability to pass spontaneously?

A

<5 mm have a 50% chance of passing spontaneously. Stones that are 1 cm or larger have almost no chance of spontaneously passing.

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13
Q

Women are at greatest risk for which kind of kidney stone?

A

Struvite because of their increased incidence of urinary tract infection

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14
Q

Someone with gouty arthritis, has a high consumption of purines, and acidic urine is at high risk for which type of kidney stones?

A

Uric acid

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15
Q

These kidney stones are caused by genetic disorders of amino acid metabolism and are due to their excess in urine

A

Cystinuric and xanthine stone

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16
Q

Moderate to severe pain often originating in the posterior hypochondrium (flank) and radiating to the groin

A

Renal colic

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17
Q

Lesions that develop in the upper motor neurons of the brain and spinal cord result in a loss of coordinated neuromuscular contraction and overactive or hyperreflexive bladder function called…

A

dyssynergia

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18
Q

Lesions that develop in the sacral area of the spinal cord or peripheral nerves result in this type of bladder disorder

A

hypotonic, atonic (flacid) bladder function

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19
Q

Involuntary loss of urine associated with an abrupt and strong desire to void common in older adults.

A

Urge incontinence

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20
Q

Involuntary loss of urine during coughing sneezing, laughing, and is common in women younger then 60 and men who have had prostate surgery

A

stress incontinence

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21
Q

Involuntary loss of urine with over-distention of the bladder

A

Overflow incontinence

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22
Q

Involuntary loss of urine caused by dementia or imobility

A

Functional incontinence

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23
Q

An atonic bladder with retention of urine and distention. The full bladder is sensed but the detrusor will not contract causing an underactive bladder wyndrome with symptoms of stress and overflow incontinence.

A

Detrusor areflexia

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24
Q

A chronic syndrome of bladder contraction of reduced strength and/or duration, resulting in prolonged bladder emptying or a failure to achieve complete bladder emptying, or both within a normal time span and may be characterized by a weak stream, intermittency, hesitancy, and straining to void.

A

Underactive bladder syndrome

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25
Q

What are anatomic causes of resistance to urine flow for men and women?

A

Urethral stricture, prostatic enlargement in men, pelvic organ prolapse in women, and tumor compression

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26
Q

A narrowing of the urethral lumen and occurs when infection, injury, or surgical maniuplation produces a scar that reduces the caliber of the urethra.

A

Urethral stricture

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27
Q

What is the most common pelvic organ prolapse, in a woman, that causes bladder outlet obstruction?

A

Cystocele

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28
Q

What can happen to men that creates bladder outlet obstruction that is similar to pelvic organ prolapse in women?

A

Bladder herniates into the scrotum

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29
Q

If partial obstruction of the bladder outlet or urethra persists it leads to

A

urinary urgency, overactive detrusor contractions, and ultimately the bladder wall loses its ability to stretch and accommodate urine

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30
Q

The inability to stretch and accommodate urine is called

A

low bladder wall compliance

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31
Q

Low bladder wall compliance chronically (blank) which greatly increases the problems of (blank, blank, and blank).

A

elevates intravesicular pressure, hydroureter, hydronephrosis, and impaired renal function

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32
Q

A benign renal tumor that is solid, encapsulated, usually located near the cortex of the kidney and because they can become malignant are usually surgically removed.

A

Renal Adenomas

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33
Q

The most common renal neoplasm, an adenocarcinoma that arises from tubular epithelilum.

A

Renal cell carcinoma

34
Q

The most common type of RCC is

A

Clear cell tumor

35
Q

Which genetic mutation is associated with RCC?

A

von Hippel-Lindau

36
Q

A rare renal neoplasm that primarily arises in the renal parenchyma and renal pelvis.

A

Renal transitional cell carcinoma

37
Q

Hematuria, dull and aching flank pain, and palpable flank mass in thinner individuals as early signs and weight loss, fatigue, intermittent fever, anemia, hypertension, and alterations in liver function tests are late symptoms of

A

Renal Cancer

38
Q

The most common bladder malignancy; appearing on the inner lining of the bladder.

A

Urothelial (transitional cell) carcinoma

39
Q

Which mutation and inactivation are genomic subtypes of bladder cancer

A

TP53 mutation and retinoblastoma gene inactivation

40
Q

Someone who presents with painless gross microscopic hematuria with nonspecific lower urinary tract symptoms should be screened for…

A

Bladder cancer

41
Q

An inflammation of the urinary epithelium usually caused by bacteria from gut flora

A

UTI

42
Q

Why is cystitis more common in women?

A

Because of the shorter urethra and the closeness of the urethra to the anus

43
Q

What are UTI mechanisms are in place to protect men and women?

A

Periurtherial mucus secreting glands in women, length of the urethra and secretions from the prostate in men.

44
Q

Why are certain individuals with certain Lewis blood groups more prone to UTIs?

A

Because they secrete fewer antigens capable of resisting bacterial adherence by pilus formation

45
Q

An inflammation of the bladder and the most common site of a UTI

A

Acute cystitis

46
Q

a UTI that shows acute hemorrhage

A

hemorrhagic cystitis

47
Q

A UTI with pus formation or suppurative exudates

A

Suppurative cystitis

48
Q

Prolonged infection that leads to the sloughing of the bladder mucosa with ulcer formation

A

Ulcerative cystitis

49
Q

The most severe UTI infection that may cause necrosis of the bladder wall

A

Gangrenous cystitis

50
Q

An unpleasant sensation (pain, pressure, discomfort) perceived to be related to the urinary bladder associated with lower urinary tract symptoms of more than 6 weeks’ duration in the absence of infection or other identifiable causes.

A

Interstitial cystitis/Painful bladder syndrome

51
Q

An infection of one or both upper urinary tracts (ureter, renal, pelvis, and kidney)

A

Pyelonephritis

52
Q

Which bacteria are associated with pyelonephritis?

A

E.coli, proteus, pseudomonas

53
Q

A person with acute fever, chills, flank or groin pain, frequency, dysuria, and cstovertebral tenderness may have

A

pyelonephritis

54
Q

A persistent or recurrent infection of the kidney leading to scarring of the kidney

A

Chronic pyelonephritis

55
Q

Lesions of chronic pyelonephritis are sometimes called

A

chronic interstitial nephritis

56
Q

What three imbalances tend to develop if someone has chronic pyelonephritis?

A

Inability to conserve sodium, hyperkalemia, and metabolic acidosis

57
Q

Glomerulonephritis caused by immunologic responses, ischemia, free radicals, drug toxins, vascular disorders, and infection is termed…

A

primary glomerular injury

58
Q

This renal disease develops from metabolic, inflammatory, macrovascular,and microvascular complications related to chronic hyperglycemia.

A

Diabetic nephropathy

59
Q

Diabetic nephropathy causes what kind of change in the glomberular basement and mesengial matrix?

A

Thickening and fibrosis of the glomerular basement membrane and expansion of the mesangial matrix

60
Q

This type of renal disease may be caused by the formation of autoantibodies against double-stranded DNA and nucleosomes with glomerular deposition of the immune complexes

A

Lupus nephritis

61
Q

Hematuria and red blood cell casts in the urine with less severe proteinuria and occurs with infectoin-related glomerulonephritis, RPGN, and lupus nephritis

A

Nephritic syndrome

62
Q

A decline in renal function to about 25% of normal or a GFR of 25 to 30 mL/minute

A

renal insufficiency

63
Q

A significant loss of renal function

A

Renal failure

64
Q

When less than 10% of renal function remains this is termed

A

end-stage kidney disease (ESKD)

65
Q

Characterized by increased serum urea levels and frequently increased creatinien levels and is caused by renal insufficiency or renal failure.

A

Azotemia

66
Q

The sudden decline in kidney function with a decrease in glomerular filtration and urine output with an accumulation of nitrogenous waste products in the blood as demonstrated by an elevation in plasma creatinine and blood urea nitrogen levels.

A

Acute Kidney Injury (AKI)

67
Q

The three categories of Acute Kidney Injury (AKI) are…

A

renal hypoperfusion, disorders involving the renal parenchymal or interstitial tissue, and disorders associated with acute urinary tract obstruction

68
Q

The most common cause of AKI and results from inadequate kidney perfusion.

A

Prerenal acute kidney

69
Q

Why does the GFR in prerenal acute injury ultimately decline?

A

the decrease in filtration pressure

70
Q

An acute kidney injury that results from iscehmic acute tubular necrosis, nephrotaxic ATN, acute glomerulonephritis, vascular disease, allograft rejection, or interstitial disease.

A

Intrarenal acute kidney injury

71
Q

What is the most common cause of intrarenal AKI?

A

Ischemia

72
Q

This type of acute tubular necrosis is caused by radiocontrast media and numerous antibiotics such as aminoglycosides because tehy accumulate in the renal cortex.

A

Nephrotoxic ATN

73
Q

The most rare form of acute kidney injury usually occurs with urinary tract obstruction that affects the kidneys bilaterally.

A

Postrenal acute kidney injury

74
Q

Less than 400 ml of urine output per day

A

Oliguria

75
Q

What are the three mecahnisms cause Oliguria?

A

Alteration in renal blood flow, Tubular obstruction, and tubular backleak

76
Q

What are the phases of acute kidney injury?

A

The initiation phase, extension phase, maintenance/oliguric phase, recovery phase

77
Q

Urine output less than 50 mL/day

A

Anuria

78
Q

This disorder is associated with toxin exposure or drug toxicity, the urine output may be greater than 2L/day but teh BUN and creatinine concentrations increase.

A

Nonoliguric renal failure

79
Q

The progressive loss of renal function associated with systemic diseases such as hypertension, diabetes mellitus, hypertension, SLE, or intrinsic kidney disease.

A

Chronic kidney disease

80
Q

A proinflammatory state with many systemic effects and is associated with the accumulation of urea and other nitrogenous compounds and toxins.

A

Uremic syndrome

81
Q

What is uremic fetor?

A

A form of bad breath caused by the breakdown of urea by salivary enzymes

Pathophysiology; McCance and Huether 8th addition (5 decks)

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