Renal Conditions

Question 1

What is Pyelonephritis?

Answer 1

upper UTI, kidney infection

Question 2

Pyelonephritis means

Answer 2

inflammation of the kidneys

Question 3

Causes of pyelonephritis

Answer 3

ascending infection (most common)
bloodstream infection (less common)

Question 4

Risk factors for pyelonephritis

Answer 4

pregnancy, recurrent lower UTIs, antibiotic resistant strain

Question 5

Untreated or recurrent pyelonephritis can lead to

Answer 5

abscesses, necrosis, permanent kidney damage (CKD), sepsis

Question 6

Pyelonephritis manifestations (7)

Answer 6

Sudden onset
Fever/chills
CVA tenderness
Lower UTI symptoms (dysuria)
Hematuria may be present
N/V
Anorexia

Question 7

Antibiotics used to commonly treat pyelonephritis

Answer 7

Bactrim, ciprofloxacin, nitrofuritonin (Macrobid)

Question 8

What is urosepsis

Answer 8

sepsis caused by a UTI (upper or lower)

Question 9

Urosepsis is more common in what population?

Answer 9

the ederly

Question 10

Urinary obstructions can occur at the

Answer 10

renal pelvis
ureter
bladder/urethra

Question 11

Cause of urinary obstruction at the renal pelvis

Answer 11

renal calculi (kidney stones)

Question 12

Cause of urinary obstruction at the ureter

Answer 12

renal calculi
pregnancy
tumor

Question 13

Cause of urinary obstruction at the bladder and urethra

Answer 13

Prostatic hyperplasia
Prostate cancer
Bladder cancer
Neurogenic bladder
Urethral strictures

Question 14

A urinary obstruction causes back up of urine and increased pressure in the ureter resulting in

Answer 14

hydroureter

Question 15

A urinary obstruction causes back up of urine and increased pressure in the kidney resulting in

Answer 15

Hydronephrosis

Question 16

Manifestations of acute obstruction depend on (3)

Answer 16

site
cause (kidney stones, prostate issue)
speed of onset

Question 17

Which factor determines the severity of pain of a urinary obstruction?

Answer 17

Speed of onset
Acute onset = more painful
Slow onset (like a prostate issue) = body has time to adjust and the pain is less severe

Question 18

Site of a stone: pain in the renal pelvis is ____ severe than pain in the ureter because the ureters are ____ and ____ difficult for the stone to pass through

Answer 18

Less; smaller; more

Question 19

Nephroliathis

Answer 19

Renal calculi or ‘Kidney Stones”
Definition: clumps of crystals in the urinary tract

Question 20

Most common cause of urinary obstruction

Answer 20

Renal calculi (Kidney Stones)

Question 21

Renal calculi crystal begin forming in the

Answer 21

NEPHRON

Question 22

Renal calculi crystal formation is enhanced by

Answer 22

PH changes -UTI
Excessive concentration of insoluble salts in the urine – dehydration, bone disease, gout, renal disease
Urinary Stasis - immobility/sedentary lifestyle

Question 23

Nephroliathis risk factors

Answer 23

Sex: Men
Age: 20s – 30s
Race: white
Family history
Congenital defect of the urinary tract
Hot weather
Obesity

Question 24

Most common type of kidney stone

Answer 24

calcium oxalate, calcium phosphate

Question 25

Specific risks for calcium oxalate/phosphate stones

Answer 25

Mostly idiopathic
Family history
↑ Calcemia intake
↑ Oxaluria intake
↑ Protein intake

Question 26

Specific risks for struvite (staghorn) stones

Answer 26

urinary tract infections

Question 27

Specific risks for uric acid/urate stones

Answer 27

gout

Question 28

Pain of acute “renal colic”

Answer 28

location – flank
radiation – lower abd and groin
spasms – “colicky” last 20-60 minutes
intermittent - ureter spasms
sharp - calculi scrape the ureter wall

Question 29

Accompanying symptoms of renal colic (besides pain)

Answer 29

N/V
Dysuria
Chills, Fever (ONLY if infection is present)
Hematuria
Foul smelling urine
Diaphoresis

Question 30

Nephrolithiasis pharmacotherapy for ACUTE PAIN

Answer 30

morphine, NSAIDS
IV fluids

Question 31

Nephrolithiasis pharmacotherapy for PREVENTION

Answer 31

Calcium = thiazide diuretics
Struvite = antibiotics
Urate = allopurinol