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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
UTI can occur
anywhere along urinary tract
26
most common site for UTI
bladder
27
diagnosing UTI
urine sample, look for presence of bact.
28
UTI defense mechs
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
29
predisposing factors of UTI
``` renal scarring from previous UTI urinary retention diminished ureteral peristalsis diabetes presence of urinary stones compression of ureters age ```
30
Cystitis
imflam. of bladder, due to inf. | most common organism- E. coli
31
cystitis more common in
women bc shorter urethra, closer to anus
32
patho of cystitis
bact introduced to urethra and spreads to bladder
33
CM for cystitis
``` frequency and urgency suprapubic pain painful urination foul-smelling urine pyuria- puss in urine ```
34
diagnostic tests for cystitis
urine dipstick | urine culture
35
treatment for cystitis
abx meds to dec pain with urination fluids to flush it down
36
urethral syndrome
symptoms of cystitis with negative urine cultures
37
patho of urethral syndrome
unknown cause | associated with dysfuncion of external sphincter, vaginitis, urethritis, and inflam. of glands near vagina and urethra
38
CM for urethral syndrome
similar to UTI or cystitis
39
most common age for urethral syndrome
20-30 y.o | "honeymooners" bc sexual activity
40
treatment for urethral syndrome
abx | meds to relax external sphincter
41
interstitial cystitis
non-bacterial cystitis | chronic painful inflam. disease
42
patho of interstitial cystitis
inflam. leads to scarring and stiffening of bladder, dec capacity and ulcers of bladder lining
43
CM for interstitial cystitis
bladder fullnes frequency and urgency dec UO pain
44
diagnostic tests for interstitial cystitis
ultrasound- measure bladder size | cystoscope- visually see inside of bladder lining, look for ulcers
45
treatment for interstitial cystitis
anti-inflam. meds antispasmodics antidepressants bladder distention- surgery to stretch bladder, temporary defense
46
acute pyelonephritis
inflam process of renal pelvis and parenchyma of kidney | reversible
47
etiology of acute pyelonephritis
usually by infections, one kidney or both
48
patho of acute pyelonephritis
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
predisposing factors for acute pyelonephritis
similar to bladder 1. obstruction 2. instrumentation 3. pregnancy 4. neurogenic bladder
50
CM for acute pyelonephritis
similar to someone with bladder inf 1. fever 2. chills 3. frequency 4. painful urination 5. tenderness at kidneys
51
diagnostic tests for acute pyelonephritis
CBC urinalysis urine culture intravenous pyelogram (IVP)
52
treatment for acute pyelonephritis
usually requires hosp. 1. abx 2. fluids 3. follow-up cultures
53
chronic pyelonephritis
persistent/recurrent inf of kidney with inflam. and scarring
54
causes of chronic pyelonephritis
relapse of acute pyelo. unknown usually asociated with obstruction
55
patho of chronic pyelonephritis
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
CM for chronic pyelonephritis
HTN frequency dysuria flank pain
57
diagnostic tests for chronic pyelonephritis
similar to Acute pyelo 1. urinalysis 2. urine culture 3. IVP, ultrasound
58
what will a kidney look like with chronic pyelo
small bc scarring/ inflam
59
what will a kidney look like with acute pyelo
enlarged bc edema
60
treatment for chronic pyelonephritis
treat cause
61
glomerulonephritis
inflam of glomerulus caused by immunological abnormalities, ischemia, infection vasc. disorders and systemic diseases
62
patho of glomerulonephritis
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
result of glomerulonephritis
``` 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
CM for glomerulonephritis
``` hematuria proteinuria oliguria fluid retention HTN pain ```
65
diagnostic tests for glomerulonephritis
``` urine dipstick serum titers serum anti-glomerular basement membrance ab's renal biopsy serum BUN, Cr ```
66
acute glomerulonephritis
reversible associated with strep antibodies to strep antigen antigen-antibody complexes deposited in glomeruli
67
treatment of acute glomerulonephritis
abx- hospitalized dec fluid intake meds to dec BP
68
RPGN
rapidly progressive glomerulonephritis rapid progressive loss of renal "f" in weeks/months
69
RPGN most common in
50-60 y.o
70
etiology of RPGN
complication of inf.inflam disease meds idiopathic
71
treatment for RPGN
meds to dec inflam. plasmapheresis dialysis transplantation
72
goodpastures syndrome
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
treatment for goodpastures syndrome
same as RPGN | dec amt of antigen-antibody complexes
74
chronic glomerulonephritis
reflect end stage of glomerular inflam disease progresses to renal failure develops slowly, insidious we adapt so when diagnosed, its too late
75
treatment for chronic glomerulonephritis
``` same as renal failure dialysis fluid restrictions elyte management transplant ```
76
nephrotic syndrome
disease states that cause glomerular injury. | excretion of 3.5g or more of protein lost in urine/day
77
patho for nephrotic syndrome
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
CM for nephrotic syndrome
proteinuria hypoalbuminemia hyperlipidemia edema
79
diagnostic tests for nephrotic syndrome
24hr. urine collection serum protein serum albumin cholesterol
80
treatment for nephrotic syndrome
``` treat cause low salt/ low fat diet albumin protein supplements dec edema ```

Patho (8 decks)

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