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Patho > Renal Disorders 1 > Flashcards

Renal Disorders 1 Flashcards

1
Q

Function of kidneys

A

regulate volume/conc of ECF, pH, and osmolarity
excrete metabolic end products
activate Vit D
secrete renin and erythropoietin

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2
Q

Vit D

A

needed for absorption of Ca

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3
Q

erythropoietin

A

stimulates bone marrow for RBC production

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4
Q

Atrial Natriuretic factor

A

secreted from cells in r. atria

dec BV and BP

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5
Q

aldosterone

A

promotes Na and H20 reabsorption/ k excretion

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6
Q

renin

A

released from kidneys
regulates BP and maintenance of ECF volume
if BP drops, renin is excreted

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7
Q

antidiuretic hormone

A

conserves h20 and dec urine vol

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8
Q

nephron

A

functional unit of the kidney

each kidney contains 1.2. million nephrons

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9
Q

reabsorption

A

moving substances from tubules into blood

retained, not in urine

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10
Q

secretion

A

moving substances from blood into tubule- filtrate (excreted in urine)

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11
Q

glomerulus/filtration

A

filtered thru semi-perm membrane

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12
Q

GFR

A

glomerular filtration rate

amount of blood filtered by glomeruli in a given time

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13
Q

normal GFR

A

125 cc/min

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14
Q

changes in GFR due to changes in

A
  1. permeability of glom
  2. hydrostatic press
  3. oncotic press
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15
Q

Proximal tubule

A

reabsorption of 80% of elytes and H20.
reabsorption of glucose, amino acid, bicarb
secretion of H+ and creatinine

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16
Q

Loop of Henle

A

reabsorption of Na and Cl

important in conserving water

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17
Q

Distal tubule

A

final regulation of H20 balance and acid-base balance.
reabsorption of H20 occurs with ADH
reabsorption of Na, H20 due to aldo.
regulation of Ca and phosphate

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18
Q

collecting ducts

A

final concentration of urine

water reabsorbed by ADH

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19
Q

Serum BUN

A

blood, urea, nitrogen
measures amt of urea nitrogen
urea- waste product of protein metab.

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20
Q

Serum Creatinine

A

Cr- waste product of muscle metab.

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21
Q

inc Cr

A

causes damage to large number of nephrons

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22
Q

creatinine clearance test

A

collect urine over 24 hrs. measure amt. of Cr. in urine.

more accurate

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23
Q

why is serum BUN not the best indicator for renal “f”

A

if someone is eating really high protein levels, serum BUN can show elevated levels, if dehydrated, on steroids

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24
Q

why is serum Cr a better indicator

A

bc not affected by diet, hydration status

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25
Q

UTI can occur

A

anywhere along urinary tract

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26
Q

most common site for UTI

A

bladder

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27
Q

diagnosing UTI

A

urine sample, look for presence of bact.

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28
Q

UTI defense mechs

A

normal voiding with complete bladder emptying
normal antibac abilities of bladder mucosa and urine
competence of ureterovesicular junction
peristaltic activity that propels urine toward bladder

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29
Q

predisposing factors of UTI

A 
renal scarring from previous UTI
urinary retention
diminished ureteral peristalsis
diabetes
presence of urinary stones
compression of ureters
age
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30
Q

Cystitis

A

imflam. of bladder, due to inf.

most common organism- E. coli

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31
Q

cystitis more common in

A

women bc shorter urethra, closer to anus

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32
Q

patho of cystitis

A

bact introduced to urethra and spreads to bladder

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33
Q

CM for cystitis

A 
frequency and urgency
suprapubic pain
painful urination
foul-smelling urine
pyuria- puss in urine
34
Q

diagnostic tests for cystitis

A

urine dipstick

urine culture

35
Q

treatment for cystitis

A

abx
meds to dec pain with urination
fluids to flush it down

36
Q

urethral syndrome

A

symptoms of cystitis with negative urine cultures

37
Q

patho of urethral syndrome

A

unknown cause

associated with dysfuncion of external sphincter, vaginitis, urethritis, and inflam. of glands near vagina and urethra

38
Q

CM for urethral syndrome

A

similar to UTI or cystitis

39
Q

most common age for urethral syndrome

A

20-30 y.o

“honeymooners” bc sexual activity

40
Q

treatment for urethral syndrome

A

abx

meds to relax external sphincter

41
Q

interstitial cystitis

A

non-bacterial cystitis

chronic painful inflam. disease

42
Q

patho of interstitial cystitis

A

inflam. leads to scarring and stiffening of bladder, dec capacity and ulcers of bladder lining

43
Q

CM for interstitial cystitis

A

bladder fullnes
frequency and urgency
dec UO
pain

44
Q

diagnostic tests for interstitial cystitis

A

ultrasound- measure bladder size

cystoscope- visually see inside of bladder lining, look for ulcers

45
Q

treatment for interstitial cystitis

A

anti-inflam. meds
antispasmodics
antidepressants
bladder distention- surgery to stretch bladder, temporary defense

46
Q

acute pyelonephritis

A

inflam process of renal pelvis and parenchyma of kidney

reversible

47
Q

etiology of acute pyelonephritis

A

usually by infections, one kidney or both

48
Q

patho of acute pyelonephritis

A

infection usually ascends from lower urinary tract
inf. causes infiltration of WBC with renal inflam, renal edema, and purulent urine. abscesses may form in medulla of kidney and extend into cortex.

scar tissue forms, tubules atrophy

49
Q

predisposing factors for acute pyelonephritis

A

similar to bladder

  1. obstruction
  2. instrumentation
  3. pregnancy
  4. neurogenic bladder
50
Q

CM for acute pyelonephritis

A

similar to someone with bladder inf

  1. fever
  2. chills
  3. frequency
  4. painful urination
  5. tenderness at kidneys
51
Q

diagnostic tests for acute pyelonephritis

A

CBC
urinalysis
urine culture
intravenous pyelogram (IVP)

52
Q

treatment for acute pyelonephritis

A

usually requires hosp.

  1. abx
  2. fluids
  3. follow-up cultures
53
Q

chronic pyelonephritis

A

persistent/recurrent inf of kidney with inflam. and scarring

54
Q

causes of chronic pyelonephritis

A

relapse of acute pyelo.
unknown
usually asociated with obstruction

55
Q

patho of chronic pyelonephritis

A

obstruction/inf. causes progressive inflam. and destruction of tubules.
leads to scarring and destruction of nephrons
dec in kidney “f”. –> leads to renal failure

56
Q

CM for chronic pyelonephritis

A

HTN
frequency
dysuria
flank pain

57
Q

diagnostic tests for chronic pyelonephritis

A

similar to Acute pyelo

  1. urinalysis
  2. urine culture
  3. IVP, ultrasound
58
Q

what will a kidney look like with chronic pyelo

A

small bc scarring/ inflam

59
Q

what will a kidney look like with acute pyelo

A

enlarged bc edema

60
Q

treatment for chronic pyelonephritis

A

treat cause

61
Q

glomerulonephritis

A

inflam of glomerulus caused by immunological abnormalities, ischemia, infection vasc. disorders and systemic diseases

62
Q

patho of glomerulonephritis

A

antigen-antibody induced injury

a. antibodies have specificity for antigens with GBM. immunoglobulins deposited along basement membrane
b. antibodies react with circulating nonglomerular antigens and are deposited as immune complexes along GBM.

63
Q

result of glomerulonephritis

A 
tissue injury. 
membrane damage occurs--> affect perm. so blood/protein enters instead of getting filtered out
renal bld flow and GFR dec. 
coag. enhanced
clots
64
Q

CM for glomerulonephritis

A 
hematuria
proteinuria
oliguria
fluid retention
HTN
pain
65
Q

diagnostic tests for glomerulonephritis

A 
urine dipstick
serum titers
serum anti-glomerular basement membrance ab's
renal biopsy
serum BUN, Cr
66
Q

acute glomerulonephritis

A

reversible
associated with strep

antibodies to strep antigen
antigen-antibody complexes deposited in glomeruli

67
Q

treatment of acute glomerulonephritis

A

abx- hospitalized
dec fluid intake
meds to dec BP

68
Q

RPGN

A

rapidly progressive glomerulonephritis
rapid progressive loss of renal “f”
in weeks/months

69
Q

RPGN most common in

A

50-60 y.o

70
Q

etiology of RPGN

A

complication of inf.inflam disease
meds
idiopathic

71
Q

treatment for RPGN

A

meds to dec inflam.
plasmapheresis
dialysis
transplantation

72
Q

goodpastures syndrome

A

type of RPGN
characterized by circulating antibodies against GBM and alveolar basement membrane.
antibodies bind to basement membranes and cause inflam rxn that damages membrane

73
Q

treatment for goodpastures syndrome

A

same as RPGN

dec amt of antigen-antibody complexes

74
Q

chronic glomerulonephritis

A

reflect end stage of glomerular inflam disease
progresses to renal failure

develops slowly, insidious
we adapt so when diagnosed, its too late

75
Q

treatment for chronic glomerulonephritis

A 
same as renal failure
dialysis
fluid restrictions
elyte management
transplant
76
Q

nephrotic syndrome

A

disease states that cause glomerular injury.

excretion of 3.5g or more of protein lost in urine/day

77
Q

patho for nephrotic syndrome

A

injured glomerular membrane leads to loss of plasma proteins (albumin and immunoglobulins)
low albumin stimulates lipoprotein syntheis (hyperlipidemia) loss of immunoglobulins inc risk of infection

78
Q

CM for nephrotic syndrome

A

proteinuria
hypoalbuminemia
hyperlipidemia
edema

79
Q

diagnostic tests for nephrotic syndrome

A

24hr. urine collection
serum protein
serum albumin
cholesterol

80
Q

treatment for nephrotic syndrome

A 
treat cause
low salt/ low fat diet
albumin
protein supplements
dec edema

Patho (8 decks)

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