Renal patho Flashcards
why is kidney pain often described as flank pain rather than deep viseral pain?
this is because there are few pain receptors located within the kidney
if there is injury or infflamation inside the kidney it can lead to discomfort and minfests how? and why?
as flank pain radiating to the groin due to capsular or cortical irritation
what does ipsilateral mean?
on one side of the body
what dermatomes are involved around pain related to kidney issues?
T10 to L1
issues above the kidney are classified as…
Pre-renal
issues within the kidney are classified as…
intra renal
issues below that kidney are refered to as?
post renal
in your own words explain pre renal issues
anything that can cause indirect injury to the kidneys ie. reduced perfusion to the kidneys such as shock, or CHF
what is the percentage of ARF that are pre renal in nature? what is this caused by?
60% ; caused by decreased blood flow to the kidneys
what is the afferent arteriole?
the vessel that veeds blood into the glomerulus
Oliguria
low urine output ; suggests problem with filtration and fluid reabsorption.
what is the problem with holding onto fluids
the body is not getting rid of metabolic wastes and when it accumulates it can lead to complications like uremia
uremia
accumulation of urea in the blood which can contribute to acidosis
a retntion of acidic urine can cause what to happen?
the hydrogen ions migrate to tissues leading to renal acidosis
when kidney perfusion is compromised the RAAS system kicks in to retain sodium and water. this is beneficial however it can be problomatic in what cases?
systemic issues like distributive shock because the retained fluid make leak into tissues due to the increased capillary permeability leading to edema
what are nitrogenous wastes?
they are byproducts of protein metabolism and can accumulate in kidneys that are not filtering properly
during renal failure what vasoacvtive mediators are released and what are their roles?
nitric oxide (vasodialator) and endothelin (vasooconstrictor)
why is nitric oxide not helpful during renal failure
because the vasodialation it causes will worsen capillary permiability
why is endothelin not helpful during renal failure?
because the vasoconstriction occurs in tiny peritubular cappilaries (blood vessels in kidney) which further impairs kidney perfusion
urine is typically sterile except for when it reaches what portion of the urethra (esspecially for men)
the distal portion of the urethra
how do mucosal cells help the urinary tract?
they have anti adherence properties which prevent bacteria from sticking to the urinary tract as the bactera can get flushed out with urination
when urine isnt properly expelled from the body stasis occurs contributing to bacterial colinization of the urinary tract. what are 3 reasons stasis can occur?
- nerve damage in which the bladder is effected
- blackages due to tumours or BPH
- catherization can also increase the risk of bacterial colonization
what is the length of treatment for antibiotics with women and men respectivly?
women: 3-4 days and men: 6-7 days
why do men have a longer treatment period than with women?
because of the higher liklyhood of complications and reoccurence
what would hematauria in a UIT look like in comparison to a severe kidney trauma
streaky or light where ; cranberry juice like respectivly
other than streaky bloody urine for UITs what other ways might urine present?
it can appear cloudy with particulate matter that settles at the bottom of the catheter bag. it could also be pink or orange tinged
how does women having a shorter urethra increase the risk of UIT’s and pyleonephritis?
because the urethra is in close proximity to fecal matter
how does women aging contribute as a risk factor to the getting a UIT
because aging causes atrophy of the urethral epithelium decreasing force of the urinary stream and leading to stasis and retention of the bacteria
antibacterial properties of prostatic secretions are effective until what age?
40
UTI’s are the most common cause of acute bacterial sepsis in PTs over the age of 65 with a mortality rate of _____%
65
what is vesicoureteral reflux
urine flows backwards from the bladder into the ureters which can lead to increased risk of infections
what is a neurogenic bladder?
a condition where there is impaired bladder function due to nerve issues
what is the 9 cross attic?
this is the area where the bladder connects to the prostate gland and the abdominal portion of the urethra
what is renal colic
intermitten severe pain due to the formation of insoluble stones in the urinary tract
what are these kidney stones made of?
super saturation of solutes such as calcium, magnesium, cysteine, or uric acid
how can increased calcium levels occur to form calcium kidney stones?
- immobility (LTC, # recovery)
- bone diseases that break down bone
these lead to osteoclastic activity mobilizing calcium from bones - hyperparathyroidism
why are kidney stones are more common during hotter months?
because increased sweating leads to more concentrated solutes in urine
what is the most common cause of Acute renal failure?
acute tubular necrosis
how can transfusions contribute to acute kidney injury?
reactions to the transfusion can cause agglutination of the red blood cells blacking glomeruli and renal tubules
how does increased hydrostatic pressure in the bowmans capsule impact renal fX
this elevate pressure can compress the glomeruli, impacting the filtration process
what is creatinine?
a byproduct of muscle metabolism and typically filtered out of the bloodstream by the kidneys
what does elevated creatinine levels indicate?
muscle breakdown or renal insufficiency
Azotemia
the presence of excess nitrogenous waste in blood due to imparied renal Fx
what is end stage renal disease?
irreversible damage to the kidneys
why is loosing proteins in the urine problematic?
because proteins are important for fxs such as clotting factors, structure to tissues, enzymes for biochemical reactions, and osmotic pressure regulation
how does the liver respond to hypoalbuminemia?
the liver synthesizes more cholestrol and lipids resulting in hyperlipidemia
how do NSAIDs affect renal function?
NSAIDs decrease prostiglandin synthesis which is crucial for maintaining renal auto regulation
Acute Kidney Injury
a sudden and sever decline in kidney fx
