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DPT 631 > Renal System > Flashcards

Renal System Flashcards

1
Q

T/f: the renal system gets rid of fluids of the body

A

True

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2
Q

What is a factor of the renal system that dictate hydration?

A

Urine color

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3
Q

T/f: it takes a lot to lose a damaging amount of fluids

A

False, it does not take much

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4
Q

What things does the renal system filter out?

A

Urea
Creatinine
Uric acid
Ammonia
Bilirubin
Excess ions
Drugs
Toxins
Excess water

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5
Q

What does the renal system reabsorb?

A

Water
Glucose
Amino acids
Electrolytes
Sodium
Chloride
Potassium
Calcium
Magnesium
Bicarbonate
Phosphate

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6
Q

What process of the renal system is “reabsorption in reverse”?

A

Tubular secretion

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7
Q

What is urine formed from?

A

Filtered and secreted substances

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8
Q

Where does secretion occur?

A

In the DCT (distal convoluted tubules) and collecting ducts

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9
Q

What hormones assist with the process of secretion?

A

AD
aldosterone
AND

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10
Q

What things make up the content of urine?

A

Water
Urea
Creatinine
Uric acid
Excess electrolytes
Ammonia
Bilirubin/urobilinogen
Hormone metabolites
Drugs/toxins
Other metabolic waste

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11
Q

What is a normal volume output of urine per day?

A

1-2L per day

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12
Q

What is the minimum volume of urine output?

A

400-500mL

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13
Q

What factors affect the volume of urine?

A

Intake
Diet
Activity
Temp
Health
Medication

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14
Q

Does high temp increase or decrease urine volume excretion?

A

Increases it

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15
Q

Does fluid volume cause muscle cramps?

A

Nope

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16
Q

What can we do to help muscle cramping?

A

Stretch

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17
Q

What is incontinence?

A

Inability to control urine output (esp women who’ve had children and men with prostate issues)

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18
Q

What is a HUGE issue with incontinence for patients?

A

QOL/embarrassment

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19
Q

What are the QOL issues that arise from incontinence?

A

Embarrassment

Burden of care

Risk of falls

Cost

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20
Q

Why are those with incontinence often a fall risk?

A

Bc they will restrict their fluid intake and then get dizzy when standing up, risking falls

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21
Q

40% of those who are incontinent are in what age range?

A

60-80 yo

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22
Q

What percent of those who are incontinent had 3 or more children?

A

36%

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23
Q

26% of those who are incontinent have a BMI over what?

A

25

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24
Q

26% of those who are incontinent are on what kind of medication?

A

A diuretic

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25
Q

18% of those who are incontinent have had what kind of procedure?

A

Hysterectomy or prostate removal

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26
Q

What medications put pts at risk of incontinence?

A

Diuretics
Calcium channel blockers
Antidepressants

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27
Q

What are risk factors for a UTI?

A

Immobility and inactivity

Catheterization

DM

Obstructions

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28
Q

Why does immobility and inactivity lead to a risk for UTIs?

A

Bc the longer urine sits stagnant, the more likely it is to get infected

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29
Q

T/f: UTIs can be caused by any one of fiber different bacteria

A

True

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30
Q

What are some s/s of urogenital pathology?

A

Pain with micturation

Leukocytes and bacteria in urine

Cloudy urine

Back pain

Fever and chills

Nausea

Loss of appetite

Pain with percussion over kidneys

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31
Q

T/f: UTIs can cause cognitive changes in the elderly

A

True

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32
Q

Is the average time from initial symptom claim to bladder CA dx is longer in men or women?

A

It is longer in women

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33
Q

T/f: the time from onset of hematuria to bladder CA dx is greater in women than in men

A

False, it is about the same when hematuria is the sole presenting symptom

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34
Q

What is renal calculi (kidney stones)?

A

Excess material that accumulates in the kidneys forming stones

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35
Q

T/f: kidney stones tear the ureter when coming out, which causes excruciating pain

A

True

36
Q

When is there an infection risk with kidney stones?

A

When the stone is too large to be passed and causes an obstruction

37
Q

What are the 3 sites of kidney stone obstruction (don’t really think we need to know this so feel free to skip)?

A

Ureteropelvic junction

Ureter crosses over illiac vessels

Ureterovesical junction

38
Q

If a pt presents with ipsilateral pain in the genitals, (+) percussion test of the kidneys, and hematuria, what should we be thinking may be going on?

A

Kidney stones obstruction

39
Q

What are the 4 types of kidney stones (again, don’t really think we need to know this).

A

Ca oxalate (most common)

Mg ammonium phosphate (rarely do people have excess mg)

Uric acid (more likely to manifest as Gout)

Cystine

40
Q

What are the risk factors for kidney stones?

A

Males 30-50
Females 60-80

Caucasians

High protein, low fiber diet

Dehydration

Warm climate

Poor mobility

Family hx

41
Q

Why does dehydration put you at risk for kidney stones?

A

Bc the body won’t have enough fluids to flush out the system

42
Q

What are the s/s of kidney stones?

A

Stabbing pain at the costovertebral angle

Intermittent excruciating pain into the ipsi genitals

Ureter spasms radiate into the medial thigh

Chills, nausea, vomiting

Frequent urge to urinate

Burning sensation with urination

Bloody, cloudy, smelly urine

Increased BP

43
Q

If we see someone in the waiting room pacing like a tiger, what might we think could be going on?

A

Kidney stones

44
Q

When does pain start with kidney stones?

A

Hen the stone moves into the narrow ureter and pressure builds up in the kidney

45
Q

How are kidney stones diagnosed?

A

US, MRI, CT

urinalysis

46
Q

What would a urinalysis for kidney stones show?

A

Hematuria

Infection

Crystals

pH

47
Q

The formation of various types of kidney stones is strongly influenced by what?

A

Urinary pH

48
Q

____ pH favors crystallization of calcium and phosphate containing stones

A

Alkaline

49
Q

_____pH promotes uric acid or cystine stones

A

Acidic

50
Q

What is the treatment for kidney stones?

A

Small stones will pass spontaneously

Pain meds

Antibiotics

Medical emergency if they have a fever

Removal

51
Q

How can kidney stones be removed?

A

With USE (ureteroscopic stone extraction) or ESWL (extracorporeal shock wave lithotripsy)

52
Q

T/f: once you get a kidney stone, you are more likely to get another one if you don’t change your lifestyle habits

A

True

53
Q

What % of those with kidney stones with get another stone within 5 years?

A

50%

54
Q

Is kidney stone pain a mechanical pain?

A

Nope

55
Q

T/f: if stone formation is associated with hyperparathyroidism (parathyroid controls calcium), it must be addressed

A

True

56
Q

What is polycystic kidney disease?

A

A genetic disorder that causes cysts to grow in the kidneys leading to degeneration of renal tissues and obstruction of tubular flow

57
Q

What is a leading cause of end stage kidney disease (ESRD)?

A

PKD (polycystic kidney disease)

58
Q

What VS should we watch for with kidney disese?

A

BP

59
Q

What is the most common cause of chronic kidney disease (chronic kidney disease)?

A

DM (44%)

60
Q

What are the three most common causes of chronic kidney disease (CKD)?

A

DM

HTN

Glomerulonephritis

61
Q

What are the functions of dialysis?

A

Waste removal
Fluid balance
Electrolyte balance
Acid base balance

62
Q

Who needs dialysis?

A

Those with kidney fxn <10-15% via ESRD or chronic kidney failure

Those with acute kidney failure temporarily

Those with severe electrolyte/fluid imbalances that can’t be managed with meds alone

63
Q

What are the two types of dialysis? What is the difference between them?

A

Hemodialysis (filters the blood)

Peritoneal dialysis (filters abdominal cavity)

64
Q

T/f: exercise for someone with kidney pathology can help decrease cortisol levels and increase wellbeing

A

Tru

65
Q

What is the typical age range affected by endometriosis?

A

30-40 yo

66
Q

What are s/s of endometriosis?

A

Worse symptoms with pre and during menses

Pain with intercourse

Infertility

Recurrent lumbosacral pain that comes and goes with the menstrual cycle and is non-mechanical

67
Q

If a female pt presents with lumbosacral pain that comes and goes intermittently and can’t be reproduced with motions, what might we suspect is going on?

A

Endometriosis

68
Q

What are the most common primary sites of metastatic tumors?

A

Prostate
Breast
Lung
Renal
Colon

69
Q

What are some typical s/s of lung cancer?

A

Over 60yo

Smoker

Cervical spine, shoulder, and chest pain

TOS symptoms

Chronic cough

Bloody sputum

Weight loss, malaise

Fever

Dyspnea, wheezing

Fecal breath odor
Neural s/s secondary to spinal fluid metastasis

70
Q

What are some typical s/s of renal cancer?

A

55-60 yo

Weight loss

Hematuria

Malaise

Fever

Palpable posterior lateral abdominal mass

71
Q

What are some typical s/s of prostate cancer?

A

> 50yo

Lumbar spine pain

Frequent urination

Weak urine stream

Difficulty starting urination

Sacral plexus symptoms

72
Q

T/f: prostate cancer is slow developing and likely to not be the thing that kills the pt

A

True

73
Q

T/f: only about 30% of the time does elevated PSA indicate prostate cancer bc it is also increased with age

A

True

74
Q

Some guidelines state that men should generally be referred for a prostate tissue biopsy when PSA > ___ ng/mL

A

3

75
Q

T/f: the number of false positive PSA tests increases with age

A

True

76
Q

If a PSA shows an elevation, what should be done?

A

A series of more PSA tests b4 a biopsy to make sure the elevation is a pattern

77
Q

What is one guideline on the cutoff score for PSA to get a biopsy?

A

> 10 ng/mL

78
Q

T/f: best evidence supports the use of serum PSA for early detection of prostate cancer

A

True

79
Q

Panel members agreed that PSA testing should only be offered T to men with what life expectancy?

A

> 10-15 years

80
Q

T/f: some say that if someone with a life expectancy less than 5 years wants a prostate screening, it would be useless bc something else will probably kill them before than can+er ever does

A

True

81
Q

What are some foods claimed to reduce prostate risk?

A

Greens

Cooked tomatoes

Citrus fruits

Olive oil

Soy foods

82
Q

What are some common s/s of prostate cancer?

A

Men >50 yo

Difficulty starting or stopping urine flow

Change in frequency of urine flow (decreased)

Nocturia

Hematuria

Incontinence

Sexual dysfunction

PSA >4ng/mL

83
Q

What are some gynecological s/s that may indicate a referral out?

A

Cyclic pain

Abnormal bleeding

Nausea, vomiting

Vaginal discharge

Chronic constipation

Low BP (blood loss)

Missed/irregular periods

Pain with cough/incontinence

Evan’s sign

84
Q

What is Evan’s sign?

A

Hot foot syndrome

Warm, dry foot caused by sympathetic interruption from lumbosacral plexus via tumors or other lesions

Vasodilation with loss of perspiration

Most common in cervical cancer

85
Q

What is Evan’s sign associated with?

A

Cervical cancer

DPT 631 (5 decks)

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