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Patho > renal failure > Flashcards

renal failure Flashcards

1
Q

AKI is a rapid ___ in kidney function, leading to the ____ of ____ ____

A

decrease
collection
metabolic
waste

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2
Q

pre- renal acute kidney injury

A

decreased blood flow to the kidney

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3
Q

effects of AKI

A

reduced GFR
damage to nephron cells
obstruction of urine flow

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4
Q

intra- renal acute kidney injury

A

damage to the glomeruli, interstitial tissue, tubles

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5
Q

post- renal acute kidney injury

A

obstruction of urine flow d/t stones, or BPH

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6
Q

causes of aki

A

poor perfusion- hypovolemic shock
toxins
infection
obstruction

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7
Q

in hypoperfusion/ shock, the kidney compensates by ___ renal blood vessels, activating the ____, and releasing ____

A

constricting
RAAS
ADH

*This will improve kidney perfusion but reduce urine volume and lead to the retention of N in blood

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8
Q

when the pressure in the ____ ____ (__ ___) exceeds ____ ____, the GFR stops. this allows __ to collect in the blood and will increase ___ and serum ____ levels

A 
kidney tubules
intra renal pressure 
glomerular pressure
N
BUN 
creatinine
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9
Q

phases of AKI

A

onset
oliguric
diuretic
recovery

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10
Q

early acute syndrome may be reversible by treatment to

A

correct blood volume
increase blood pressure
improve CO

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11
Q

Prolonged kidney injury

A

severe damage and intra- renal damage may occur

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12
Q

oliguria

A

reduced urine volume

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13
Q

azotemia

A

retention and build up of nitrogenous waste in the blood

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14
Q

toxins in the kidney cause

A

blood vessel constriction, leading to reduced kidney blood flow and ischemia

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15
Q

chronic renal failure (CRD)

A

progressive, irreversible disorder. kidney function does not recover

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16
Q

primary causes of crd

A

untreated ACF
DM
HTN- end organ damage to the kidney
intra-renal: glomerulonephrities, Systemic lupus erythematous, polycystic kidney disease

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17
Q

____ is staged using ____. the lower the _, the worse the kidney failure.

A

CRF
GFR
GFR

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18
Q

STAGE 1

A

kidney damage with normal or increased GFR

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19
Q

Stage 2

A

kidney damage with mild decrease in GFR

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20
Q

stage 3

A

moderate decrease in GFR

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21
Q

Stage 4:

A

severe decrease in GFR

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22
Q

Stage 5

A

kidney failure

23
Q

an early complication of CRD is ____, because there are fewer healthy nephrons to reabsorb ___, which can also cause p____

A

hyponaterima
Na
polyuria

24
Q

later in CRD excretion of sodium is ___ as urine production ____, so ____ occurs even with only modest increases in the diet

A

reduced
decreases
HYPERnatremia

25
Q

late in CRD there is ______, so these changes in potassium cause EKG changes and ____

A

hyperkalemia

dysrhythmias

26
Q

affect of CRD on pH: early stages

A

little changes because the remaining nephrons increase acid excretion

27
Q

as more ___ are lost in the later stages of CRD, ___ cannot be excreted as much, so __ occurs

A

nephrons
acid
acidosis

28
Q

in CRD ___ production decreases, and bicarb ___ doesn’t really occur so it is even more ____

A

ammonium
reabsorption
acidic

29
Q

kidney changes with CRD

A
  • healthy nephrons become larger and work harder
  • poor water excretion
  • abnormal urine production
  • electrolyte imbalances
  • metabolic abnormalities
30
Q

normally the kidney excretes excessive ____. it is controlled by ____

A

phosphate

parathyroid hormone

31
Q

early in CKD there is ___ secretion of phosphorus, which leads to a ___ of _ levels. this in turn results in __ levels decreasing

A

reduced
increase
phosphourus
ca

32
Q

____ controls phosphate in the blood by causing tubular ____ in excess

A

PTH

excretion

33
Q

chronic low levels of ca, cause the parathyroid gland to release more ___. calcium then comes from ___ ____ and can lead to ____ ____ ___ “renal __”

A

PTH
bone reabsorption
bone density loss
“renal osteodystrophies”

34
Q

the decrease in kidney function leads to metabolic abnormalities like ___ (from protein metabolism) and ___ (from protein in skeletal muscle) build up

A

urea

creatinine

35
Q

BP is ____ by causing ___ and __ overload, and dysfunction of the ____

A

elevated
fluid
sodium
RAAS

36
Q

the heart is ___ due to long term stress

A

enlarged

37
Q

hyperlipidemia occurs due to changes in __ metabolism that increase ____, total ____, and __ levels

A

lipid
triglycerides
cholesterol
LDL

*Pt is more at risk for CAD and acute cardia events

38
Q

___ occurs in the late stages of CKD and worsens manifestations. d/t decreased ___, RBC dies because of uremia, __ deficiency, and __ because of poor platelet function

A

anemia
erythropoietin
iron
bleeding

39
Q

uremia is ___ in blood. this affects the entire ___. the normal flora of the mouth changes, there is ___, N/V, and ____

A

urea
GI
anorexia
hiccups

40
Q

uremia causes changes to the GI and can cause

A

peptic ulcer disease
uremic cholitis
erosion of blood vessels in the stomach, small intestine, large intestine-> blood loss -> hemorrhagic shock

41
Q

uremic cholitis

A

watery diarrhea and colitis

42
Q

CM of CKD

A 
neurological 
respiratory 
cardiovascular 
GI 
skeletal
urinary 
skin
*d/t changes in fluid volume, electrolyte and acid base imbalance, N waste build up*
43
Q

neuro sx of CKD

A

lethargy
seizures or coma
encephalopathy
weakness in extremities

44
Q

cardio sx of CKD

A 
fluid overload 
HTN 
CHF 
pericarditis 
K+ induced dysthrythmias
45
Q

respiratory sx of CKD

A 
halitosis- breathe smells like urine
deep sighing
yawning
SOB
severe metabolic acidosis= kussmal's breathing
46
Q

hematologic sx of CKD

A 
Anemia and abnormal breathing causing: 
fatigue
pallor 
lethargy 
weakness
SOB 
dizziness
47
Q

GI sx of CKD

A

Foul breath
mouth ulcerations
mouth inflammation

48
Q

Skeletal sx of CKD

A

thin fragile bones= increased risk for fractures
break easily with slight trauma
compact vertebrae, bend forward, loss of height

49
Q

urinary sx of CKD

A

Dilute, clear urine because of tubular reabsorption of water reduced

end stage= oliguria

50
Q

skin sx of CKD

A

yellowish discoloration due to uremia

51
Q

potiential complications of Chronic renal failure

A 
HTN and edema
uremia 
anemia 
metabolic acidosis 
hypocalcemia 
hyperphosphatemia
encephalitis (end stage)
52
Q

treatment of end stage renal disease

A 
hemodialysis 
peritoneal dialysis
kidney transplant 
diet modification 
medication modification
53
Q

dialysis

A

removes excess fluids and waste products; restores chemical and electrolyte balance

54
Q

diet modification for pt in end stage renal disease

A

control protein intake
limit fluid intake
restrict na, k, p
supplements of vitamin d, calcium and iron

Patho (17 decks)

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