Renal patho

Question 1

why is kidney pain often described as flank pain rather than deep viseral pain?

Answer 1

this is because there are few pain receptors located within the kidney

Question 2

if there is injury or infflamation inside the kidney it can lead to discomfort and minfests how? and why?

Answer 2

as flank pain radiating to the groin due to capsular or cortical irritation

Question 3

what does ipsilateral mean?

Answer 3

on one side of the body

Question 4

what dermatomes are involved around pain related to kidney issues?

Answer 4

T10 to L1

Question 5

issues above the kidney are classified as…

Answer 5

Pre-renal

Question 6

issues within the kidney are classified as…

Answer 6

intra renal

Question 7

issues below that kidney are refered to as?

Answer 7

post renal

Question 8

in your own words explain pre renal issues

Answer 8

anything that can cause indirect injury to the kidneys ie. reduced perfusion to the kidneys such as shock, or CHF

Question 9

what is the percentage of ARF that are pre renal in nature? what is this caused by?

Answer 9

60% ; caused by decreased blood flow to the kidneys

Question 10

what is the afferent arteriole?

Answer 10

the vessel that veeds blood into the glomerulus

Question 11

Oliguria

Answer 11

low urine output ; suggests problem with filtration and fluid reabsorption.

Question 12

what is the problem with holding onto fluids

Answer 12

the body is not getting rid of metabolic wastes and when it accumulates it can lead to complications like uremia

Question 13

uremia

Answer 13

accumulation of urea in the blood which can contribute to acidosis

Question 14

a retntion of acidic urine can cause what to happen?

Answer 14

the hydrogen ions migrate to tissues leading to renal acidosis

Question 15

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?

Answer 15

systemic issues like distributive shock because the retained fluid make leak into tissues due to the increased capillary permeability leading to edema

Question 16

what are nitrogenous wastes?

Answer 16

they are byproducts of protein metabolism and can accumulate in kidneys that are not filtering properly

Question 17

during renal failure what vasoacvtive mediators are released and what are their roles?

Answer 17

nitric oxide (vasodialator) and endothelin (vasooconstrictor)

Question 18

why is nitric oxide not helpful during renal failure

Answer 18

because the vasodialation it causes will worsen capillary permiability

Question 19

why is endothelin not helpful during renal failure?

Answer 19

because the vasoconstriction occurs in tiny peritubular cappilaries (blood vessels in kidney) which further impairs kidney perfusion

Question 20

urine is typically sterile except for when it reaches what portion of the urethra (esspecially for men)

Answer 20

the distal portion of the urethra

Question 21

how do mucosal cells help the urinary tract?

Answer 21

they have anti adherence properties which prevent bacteria from sticking to the urinary tract as the bactera can get flushed out with urination

Question 22

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?

Answer 22

1. nerve damage in which the bladder is effected
2. blackages due to tumours or BPH
3. catherization can also increase the risk of bacterial colonization

Question 23

what is the length of treatment for antibiotics with women and men respectivly?

Answer 23

women: 3-4 days and men: 6-7 days

Question 24

why do men have a longer treatment period than with women?

Answer 24

because of the higher liklyhood of complications and reoccurence

Question 25

what would hematauria in a UIT look like in comparison to a severe kidney trauma

Answer 25

streaky or light where ; cranberry juice like respectivly

Question 26

other than streaky bloody urine for UITs what other ways might urine present?

Answer 26

it can appear cloudy with particulate matter that settles at the bottom of the catheter bag. it could also be pink or orange tinged

Question 27

how does women having a shorter urethra increase the risk of UIT’s and pyleonephritis?

Answer 27

because the urethra is in close proximity to fecal matter

Question 28

how does women aging contribute as a risk factor to the getting a UIT

Answer 28

because aging causes atrophy of the urethral epithelium decreasing force of the urinary stream and leading to stasis and retention of the bacteria

Question 29

antibacterial properties of prostatic secretions are effective until what age?

Answer 29

40

Question 30

UTI’s are the most common cause of acute bacterial sepsis in PTs over the age of 65 with a mortality rate of _____%

Answer 30

65

Question 31

what is vesicoureteral reflux

Answer 31

urine flows backwards from the bladder into the ureters which can lead to increased risk of infections

Question 32

what is a neurogenic bladder?

Answer 32

a condition where there is impaired bladder function due to nerve issues

Question 33

what is the 9 cross attic?

Answer 33

this is the area where the bladder connects to the prostate gland and the abdominal portion of the urethra

Question 34

what is renal colic

Answer 34

intermitten severe pain due to the formation of insoluble stones in the urinary tract

Question 35

what are these kidney stones made of?

Answer 35

super saturation of solutes such as calcium, magnesium, cysteine, or uric acid

Question 36

how can increased calcium levels occur to form calcium kidney stones?

Answer 36

• immobility (LTC, # recovery)
• bone diseases that break down bone
  these lead to osteoclastic activity mobilizing calcium from bones
• hyperparathyroidism

Question 37

why are kidney stones are more common during hotter months?

Answer 37

because increased sweating leads to more concentrated solutes in urine

Question 38

what is the most common cause of Acute renal failure?

Answer 38

acute tubular necrosis

Question 39

how can transfusions contribute to acute kidney injury?

Answer 39

reactions to the transfusion can cause agglutination of the red blood cells blacking glomeruli and renal tubules

Question 40

how does increased hydrostatic pressure in the bowmans capsule impact renal fX

Answer 40

this elevate pressure can compress the glomeruli, impacting the filtration process

Question 41

what is creatinine?

Answer 41

a byproduct of muscle metabolism and typically filtered out of the bloodstream by the kidneys

Question 42

what does elevated creatinine levels indicate?

Answer 42

muscle breakdown or renal insufficiency

Question 43

Azotemia

Answer 43

the presence of excess nitrogenous waste in blood due to imparied renal Fx

Question 44

what is end stage renal disease?

Answer 44

irreversible damage to the kidneys

Question 45

why is loosing proteins in the urine problematic?

Answer 45

because proteins are important for fxs such as clotting factors, structure to tissues, enzymes for biochemical reactions, and osmotic pressure regulation

Question 46

how does the liver respond to hypoalbuminemia?

Answer 46

the liver synthesizes more cholestrol and lipids resulting in hyperlipidemia

Question 47

how do NSAIDs affect renal function?

Answer 47

NSAIDs decrease prostiglandin synthesis which is crucial for maintaining renal auto regulation

Question 48

Acute Kidney Injury

Answer 48

a sudden and sever decline in kidney fx