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Pathopharm 1 - Exam 2 > Renal Conditions > Flashcards

Renal Conditions Flashcards

1
Q

Pyelonephritis clinical manifestations

A

CVA Tenderness
Dysuria
Hematuria
N/V
Anorexia
Fever
Chills

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2
Q

Pyelonephritis Treatment

A

Trimethoprim/Sulfemethaxole (Bactrim)
Ciprofloxacin

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3
Q

Pyelonephritis Risk Factors

A

Pregnancy
Recurrent lower UTIs
Antibiotic resistant strains

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4
Q

Complications of Pyelonephritis

A

Urosepsis (sepsis d/t UTI)

More systemic response
High mortality rate
More likely in elderly

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5
Q

Causes of Nephrolithiasis in the renal pelvis

A

Renal Calculi

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6
Q

Causes of nephrolithiasis in the ureter

A

Renal Calculi
Pregnancy
tumors

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7
Q

Causes of nephrolithiasis in the bladder/urethra

A

Bladder cancer
Neurogenic bladder
Prostate hyperplasia
Prostate cancer
Urethral strictures

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8
Q

Complications of nephrolithiasis

A

Stasis of blood flow
Back-up pressure

Back-up pressure can lead to hydroureter, hydronephrosis, postrenal acute kidney injury

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9
Q

What factors can enhance crystal formation in the kidneys?

A
  1. PH changes d/t UTIs
  2. Excessive concentration of insoluble salts in the urine d/t dehydration, bone disease, gout, renal disease
  3. Urinary stasis - Immobility/sedentary lifestyle
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10
Q

Risk factors for nephrolithiasis

A

Men
20-30s
White
Obesity
Family Hx
Congenital defects
Hot weather (dehydration)

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11
Q

Prevalence and risk factors for Struvite kidney stones

A

15%
UTIs

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11
Q

Prevalence and risk factors for calcium oxalate/phoshpate kidney stones

A

70-80%
Family Hx
Idiopathic
Increased calcemia
Increased oxaluria

Diet factors: Increased protein, Increased sodium, Increased oxalate

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12
Q

Prevalence and risk factors for Uric acid kidney stones

A

7%
Gout

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13
Q

Clinical manifestations of nephrolithiasis

A

Acute renal colic
Chills, fever (only if infection is present)
Dysuria
Hematuria
Foul smelling urine
Diaphoresis

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14
Q

Pharmacologic treatment for different kidney stones

A

Calcium = Thiazide diruetics
Struvite = abx
Urate = Allopurinol

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15
Q

Risk factors for renal cell carcinoma

A

Smoking
Obesity
Age
Male
Genetics

16
Q

When does diagnosis of renal cell carinoma usually happen

A

Once the cancer cells have metastized

17
Q

Renal cell carcinoma clinical manifestations

A

Early - NONE
Late -
1. CVA tenderness
2. Hematuria
3. Possible palpable abdominal mass

18
Q

Where does renal cell carcinoma usually metastize to

A

Bones or lungs

19
Q

How is renal cell carcinoma treated

A

Surgery to remove kidney

renal cell carcinoma is usually resistant to chemotherapy

20
Q

Risk factors for urethelial carcinoma

A

Smoking
Male
Occupations with exposure to toxins
Low fluid intake

21
Q

Clinical manifestation of urethelial carcinoma

A

Early - Hematuria
Late -
1. Frequency
2. Urgency
3. Dysuria

22
Q

Types of chemo treatments for urethelial Carcinoma

A

Stage 1 - Intravesical chemo
Advanced stages - Systemic chemo

23
Q

BCG vaccine

Indications, MOA, and adverse effects

A

Indications: 1st stage of urethelial carcinoma
MOA: Stimulates inflammatory response to the bladder
Adverse effects: Bladder irritation, systemic infection

24
Q

BCG Vaccine

Patient instructions

A
  1. Empty bladder
  2. Instill BCG vaccine into the bladder through I/O Catheter (Dwells for 2 hours)
  3. Change positions q 15 minutes
25
Q

BCG vaccine

safety precautions

A

Live vaccine - Contraindicated in immunocompromised

HIV, AIDS, etc

26
Q

Type 2 vs Type 3 Sensitivity Reactions

A

Type 2: Reactions occur on the cell surface and result in cell death or malfunction
Type 3: Immune complexes are deposited into tissues and the resulting inflammation destroys the tissue

27
Q

2 Types of injuries resulting in glomerulonephritis

A
  1. Antibodies attach to antigens of the glomerular basement membrane (“Anti-GBM Antibodies) - 5%
  2. Antibodies react with circulating antigens and are deposited as immune complexes in the GBM - 95%
28
Q

Clinical manifestations of acute glomerulonephritis

A

Hematuria
Azotemia
Retention of Na+ and water (decreased uOP leads to HTN and edema)
Proteinuria

HARP

29
Q

Causes of acute glomerulonephritis

A

Poststreptococcal infection
Berger disease
Goodpasture syndrome
Systemic lupus erythematosus (SLE)
Vasculitis

30
Q

Pathogenesis of acute glomerulonephritis

A
  1. Trigger
  2. Immune complexes form
  3. Complement activated
  4. release of mediators
  5. tissue injury
  6. Hematuria, proteinuria, decreased GFR
31
Q

Prognosis for chronic glomerulonephritis

A

Slow progressive desruction of glomerulus leading to ESRD

32
Q

What is nephrotic syndrome?

A

The glomerulus is too permeable leading to plasma proteins leaking into the urine

Elimination of >3g of protein per day into the urine

33
Q

What diseases cause nephrotic syndrome

A

Glomerulonephritis
Diabetes mellitus

34
Q

Pathogenesis of nephrotic syndrome

A
  1. Increased glomerular permeability
  2. Proteinuria
  3. Hypoalbuminemia
35
Q

Clinical manifestations of nephrotic syndrome

A
  1. Edema
  2. HTN
  3. Liver problems -
    * Hyperlipidemia
    * Hypercoagulation
    * Loss of antithrombin III and plasminogen (DVTs and PE)
36
Q

DM complications r/t nephrotic syndrome

A

Diabetic neuropathy
* Major complication
* Gross thickening of GBM
* Ultimately leads to ESRD

37
Q

HTN complications r/t nephrotic syndrome

A

Hypertensive glomerular disease
Decreased renal perfusion leads to scarring of glomerulus

38
Q

Clinical manifestations of glomerulopathy

A

FLuid retention
increased BUN/Cr ratio
Proteinuria
Decreased albumin (blood protein)

Pathopharm 1 - Exam 2 (1 decks)

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