Renal IV Flashcards
transitional cell carcinoma
papillary growth lined by epithelium
of urinary tract system
with phenacetin, smoking, aniline, cyclophosphamide
SCC of bladder
chronic irritation - squamous metaplasia
risk fx - schistosoma haematibium
chronic cystitis, smoking, chronic stones
UTI causes
MCC E. coli
staph sapro
klebsiella
proteus mirabilis - urine smell like ammonia
labs with UTI
leukocyte esterase +
nitrite + for gram negatives
sterile pyuria UTI
neisseria gonorrhea
chlamydia trachomatis
chronic pyelonephritis
predisposed - with VUR or chronic obstruction
see scarring and blunted calyx
also - eosinphilic casts can resemble thyroid tissue
-thyroidization of kidney
drug induced lupus interstitial nephritis
tubulointerstitial
eosinophils and azotemia
-after drug admin
diffuse cortical necrosis
infarct both kidneys
vasospasm or DIC
with obstetric catastrophe
acute tubular necrosis
hosp patients
- can resolve
- can be fatal
stages of acute tubular necrosis
1 - inciting event
2 - maintenance - oliguria - hyperK, acidosis, uremia
3 - recovery - polyuria, BUN Cr low, hypoK
causes of acute tubular necrosis
ischemia - PCT and TAL susceptible
nephrotoxic - PCT susceptible
renal papillary necrosis
gross hematuria and proteinuria
with sickle cell, acute pyelo, NSAID, DM
abrupt decline renal fxn
acute kidney injury - acute renal failure
prerenal azotemia
decreased RBF - decreased GFR
Na H2O and BUN retained by kidney - to conserve volume
elevated BUN/Cr ration
-BUN reabsorbed and Cr not
intrinsic renal failure
acute tubular necrosis or ischemia/toxin
ATN - patchy necrosis
decrased GFR
BUN reabsorption impaired
-BUN/Cr ration decreased
postrenal azotemia
outflow obstruction
stone, BPH, neoplasia, congenital anomaly
with B/L obstruction
renal osteodystrophy
failure vit D hydroxylation
hypoCa
hyperP
secondary hyperPTH
hyperP - also decrease serum Ca - tissue calcification
PKD1
auto dom
CH16
PDK2
auto dom
CH4
ADPKD cause of death
complication of chronic kidney disease or HTN
ADPKD associations
berry aneurysm
mitral regurg
benign hepatic cyst
medullary cystic disease
inherited disease - tubulointerstitial fibrosis
progressive renal insufficiency
shrunken kidney or poor prognosis
simple renal cyst
ultrafiltrate
found incidentally - asymptomatic
complex renal cyst
septated, enhanced, solid components - need to remove
risk of renal cell carcinoma
