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Advanced Pathology > Renal System and Disorders- Notes from Slideshow (quiz 3) PART 2 > Flashcards

Renal System and Disorders- Notes from Slideshow (quiz 3) PART 2 Flashcards

1
Q

An infection in any part of your urinary system — your kidneys, ureters, bladder and urethra

A

UTI

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2
Q

What are the two types of UTIs?

A
  • Pyelonephritis

- Cystitis

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3
Q

What is the difference between Pyelonephritis and Cystitis?

A
  • Pyelonephritis- kidney infection

- Cystitis- bladder infection

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4
Q

Symptoms of UTI: Pyelonephritis

A
  1. Flank pain
  2. High fever
  3. Malaise
  4. WBCs and bacteria in urine
  5. Urinary symptoms similar to cystitis
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5
Q

Symptoms of UTI: Cystitis

A
  1. Increased urinary frequency
  2. Urgency
  3. Dysuria
  4. Pain above the pubic region
  5. WBCs and bacteria in urine
  6. More common in women
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6
Q

Are UTIs common?

A

yes

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7
Q

Who is it most common to see with a UTI?

A

young females

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8
Q

Who is it most uncommon to see with a UTI?

A

males under 50

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9
Q

What organisms most commonly cause UTIs?

A
  • E.Coli

- Staph

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10
Q

Which organisms cause catheter-asscoiated UTIs?

A

Usually bacterial (gram neg)

  • proteus
  • pseudomonas
  • kiebsiella
  • seratia
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11
Q

Which type of UTI is WBCs in urine more common?

A

Pyelonephritis

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12
Q

Why do pts with cystitis sometimes end up with Pyelonephritis?

A

organisms can ascend up from the bladder the ureters into the urinary tract

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13
Q

“backflow” or retrograde flow of urine from the bladder into the ureters, and usually up to the kidneys

A

vesicoureteral reflux (VUR)

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14
Q

What is VUR a risk factor for?

A

Upper tract infection (Pyelonephritis)

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15
Q

What population is VUR common in?

A

Children

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16
Q

How common is VUR in children who get UTIs?

A

found in 50%

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17
Q

How many children does VUR effect out of all children?

A

1%

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18
Q

What gender is most at risk for VUR?

A

Female

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19
Q

What gender get a worse case of VUR?

A

Male

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20
Q

What is the female to male ratio of VUR

A

6:1

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21
Q

What race is most likely to get VUR?

A

Whites

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22
Q

What is comparisons of occurrence of VUR- whites to blacks?

A

whites 10x more likely

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23
Q

Major risk factor for VUR

A

Inheritance

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24
Q

What % increase does a person have if their parents had VUR? siblings?

A

parents- 50%

siblings- 22-45%

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25
Q

Why do girls get it more often than boys?

A

girls have longer ureters

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26
Q

What are the different types of nephritis?

A
  1. Glomerulonephritis
  2. Lupus nephritis
  3. Interstitial nephritis
  4. pyelonephritis
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27
Q

Inflammation of the glomeruli

A

Glomerulonephritis

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28
Q

Inflammation of the spaces b/w renal tubules

A

Interstitial nephritis

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29
Q

When a UTI has reaches the pyelum (pelvis) of the kidney

A

pyelonephritis

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30
Q

A disease of the immune system

A

Lupus nephritis

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31
Q

What usually causes Glomerulonephritis?

A

Strep infection that advances to kidneys and heart valves

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32
Q

When diagnosing a pt and they have a red throat be sure to think of what when thinking of differential diagnoses?

A

strep and Glomerulonephritis

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33
Q

If Glomerulonephritis is left untreated it can lead to…

A

renal failure

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34
Q

Symptoms of Glomerulonephritis

A
  1. Headache
  2. increased BP
  3. Facial/periorbital edema
  4. Lethargic
  5. Low grade fever
  6. Weight gain (edema)
  7. Proteinuria
  8. Hematuria
  9. Oliguria
  10. Dysuria
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35
Q

The antigen- antibody complex from a recent strep infection can effect the kidneys how?

A

They can be in the strep and Glomeruli and cause inflammation and decreased GFR causing Glomerulonephritis

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36
Q

Inflammation disrupting glomerular basement membrane

A

Nephritic Syndrome

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37
Q

Podocyte damage leading to glomerular charge-barrier disruption

A

Nephrotic Syndrome

38
Q

Group of symptoms that occur with some disorders that cause swelling and inflammation of the glomeruli in the kidney, or glomerulonephritis.

A

Nephritic Syndrome

39
Q

Often caused by damage to small blood vessels in the kidneys that filter waste and excess water from the blood. An underlying health condition usually plays a role.

A

Nephrotic Syndrome

40
Q

What is the different between nephritic and nephrotic syndrome?

A

Nephritic- excess blood in urine

Nephrotic-excess proteins in urine

41
Q

How to remember the difference

A

Inflammation and pOdocyte

42
Q

What is the most common cause of Nephritic syndrom?

A

Berger’s Disease

43
Q

What is Berger’s Disease

A

IgA Nephropathy

44
Q

Symptoms of Nephritic Syndrome

A
  1. Inflammation of the glomeruli
  2. HTN
  3. Oliguria
  4. Cola-colored urine (hematuria)
45
Q

Symptoms of Nephrotic Syndrome

A
  1. Hypoalbuminemia
  2. Hyperlipidemia
  3. Peripheral Edema
  4. Massive proteinuria
46
Q

Hard deposits of minerals and acid salts that stick together in concentrated urine.

A

Kidney stones

47
Q

Kidney stones are also known as

A

Renal Calculi

48
Q

Where in the kidney can a stone lodge?

A

Anywhere including

inside kidney
pelvis
bladder
urethra

49
Q

What are the majority of stone composed of?

A

Calcium and uric acid

50
Q

Are kidney stones more common in males or females?

51
Q

What is the risk of stone reoccurrence for a first time stone former?

A

50% within 5-10 years

52
Q

What tests should the APRN run if there is a suspected kidney stone?

A
  1. Blood
  2. Urine
  3. Urine analysis
53
Q

Flank pain caused by kidney stones may radiate to what?

A
  1. groin
  2. testicles
  3. abdominal area
54
Q

How is pain caused by kidney stones characterized ?

A

Can be sharp/sudden severe or intermittent depending on stone movement

55
Q

Symptoms of Kidney Stones

A
  1. N&V
  2. Sharp/ sudden/ severe or intermittent pain in flank, groin, testicles. abdominal area
  3. Hematuria
  4. Dysuria
  5. Urinary frequency
56
Q
  1. N&V
  2. Sharp/ sudden/ severe or intermittent pain in flank, groin, testicles. abdominal area
  3. Hematuria
  4. Dysuria
  5. Urinary frequency
A

Symptoms of Kidney Stones

57
Q

What is done to diagnose kidney stones?

A
  1. Ultrasound
  2. CAT scan
  3. IVP
  4. Stone Analysis
  5. KUB(Xray)
  6. Blood test: calcium oxalate, uric acid
58
Q
  1. Ultrasound
  2. CAT scan
  3. IVP
  4. Stone Analysis
  5. KUB(Xray)
  6. Blood test: calcium oxalate, uric acid
A

What is done to diagnose kidney stones?

59
Q

What can be done preventatively to avoid kidney stones?

A
  1. Avoid substances that cause stones (calcium and vitamin D)
  2. Hydrate
  3. Move around often
60
Q

What population gets kidney stones often? why?

A
  1. Pts with malignancy

2. Pts with gout

61
Q

Why are pts with malignancy prone to kidney stones?

A

They have rapid turnover of cells

62
Q

When kidneys don’t work as well as they should

A

Renal Failure

63
Q

Two types of renal failure

A

acute vs chronic

64
Q

What lab values are used to differentiate acute vs chronic renal failure?

A

Labs cannot be used to differentiate b/w the two

65
Q

What can be used to identify acute renal failure?

A

Oliguria (small amounts of urine) is characteristic of Acute renal failure

66
Q

What can be used to identify chronic renal failure?

A
  1. Pre existing illness (DM, HTN, age, vascular disease)
  2. Uremic symptoms
  3. Small kidney’s by ultrasound
  4. Previous record
67
Q

Types of Acute Renal Failure

A
  1. Prerenal
  2. Postrenal
  3. Intrinsic
68
Q

Acute renal failure caused by transient renal hypoperfusion

A

Prerenal Acute Renal Failure

69
Q

What causes Prerenal Acute Renal Failure

A
  1. HTN
  2. Decreased cardiac output
  3. Decreased effective arterial blood volume
70
Q

Acute renal failure caused by obstruction of the urinary tract

A

Postrenal Acute Renal Failure

71
Q

What are the different types of intrinsic Acute Renal Failure?

A
  1. Acute glomerulonephritis
  2. Acute interstitial nephritis
  3. Acute tubular necrosis
72
Q

Intrinsic Acute Renal Failure that involves inflammation and damage to the glomular membrane

A

Acute glomerulonephritis

73
Q

Intrinsic Acute Renal Failure that is an allergic reaction.

A

Acute interstitial nephritis

74
Q

What causes an allergic reaction in Acute interstitial nephritis?

A

Can be caused by a variety of drugs

75
Q

Intrinsic Acute Renal Failure that accounts for more than 50% of cases of acute renal failure

A

Acute tubular necrosis

76
Q

What causes Acute tubular necrosis ?

A
  1. Nephrotoxic agents

2. Prolonged renal hypoperfusion

77
Q

“Transient renal hypoperfusion” means what?

A

before blood gets there

78
Q

What is an example of Prerenal Acute Renal Failure?

A
  1. Someone bleeds from a trauma
  2. loses blood
  3. blood cant get to kidney
79
Q

Example of nephrotoxins that can cause Acute tubular necrosis?

A

A lot of antibiotics are nephrotoxic

80
Q

What is an example of a postrenal Acute kidney failure?

A

A kidneys stone blocking the urinary tract and limiting urinary flow.

81
Q

Pathogenesis of CKD

A
  1. Half nephrons are lost
  2. Hyperfiltration occurs
  3. RAAS is activated
  4. Causes proteinuria
  5. Angiotensin 2 and proteins uptake at tubules
  6. Causes inflammation and fibrosis of glomerulus and tubules
  7. Progressive decline in GFR
  8. Systemic complications
82
Q
  1. Half nephrons are lost
  2. Hyperfiltration occurs
  3. RAAS is activated
  4. Causes proteinuria
  5. Angiotensin 2 and proteins uptake at tubules
  6. Causes inflammation and fibrosis of glomerulus and tubules
  7. Progressive decline in GFR
  8. Systemic complications
A

Pathogenesis of CKD

83
Q

Stages of CKD

A

Stage 1-Kidney damage with normal function
Stage 2- Kidney damage mild loss of function
Stage 3- Moderate to severe loss of function
Stage 4- Severe loss of function
Stage 5- Kidney failure need treatment to live

84
Q

% of working kidney function/GFR at each CKD stage

A 
Stage 1->90%
Stage 2- 60-89%
Stage 3- 30-59%
Stage 4- 15-29%
Stage 5- <15%
85
Q

What should you measure in CKD pts?

86
Q

Why do we need to know Stages of CKD?

A

To properly recoup money for procedures for the organization we work for.

87
Q

What does GFR tell you?

A

Amount of kidney function the pt has

88
Q

Symptoms of Chronic Renal Failure- Renal Insufficiency

A
  1. Headaches
  2. Decreased ability to concentrate urine
  3. Increased BUN and serum creatinine
  4. Edema
  5. GFR progressively decreases
  6. Mild Anemia
  7. Increased Serum K
  8. Increased BP
  9. Weakness and fatigue
89
Q
  1. Headaches
  2. Decreased ability to concentrate urine
  3. Increased BUN and serum creatinine
  4. Edema
  5. GFR progressively decreases
  6. Mild Anemia
  7. Increased Serum K
  8. Increased BP
  9. Weakness and fatigue
A

Symptoms of Chronic Renal Failure- Renal Insufficiency

90
Q

Symptoms of Chronic Renal Failure- ESRD

A
  1. Neurological weakness/ Fatigue/confusion
  2. Increased BP
  3. Pitting Edema
  4. Periorbital Edema
  5. Increased CVP
  6. Pericarditis
  7. SOB
  8. Depressed cough
  9. Thick sputum
  10. Ammonia odor breath
  11. Metallic taste
  12. Mouth/gum ulceration
  13. Anorexia
  14. N&V
  15. Withdrwan
  16. Behavior changes
  17. Depression
  18. Anemia
  19. Bleeding tendencies
  20. Increased serum K
  21. Dry flaky skin
  22. Pruritis
  23. Ecchymosis
  24. Purpura
  25. Yellow-grey skin
  26. Cramps
  27. Renal osteodystrophy
  28. Bone pain
91
Q

Pheochromocytoma

A
  1. Kidney tumor on top of adrenal galnds

2. Refractory to HTN meds

92
Q

Kidney Trauma Grades

A
  1. Subcapsular Hematoma
  2. Laceration <1 cm
  3. Laceration >1cm
  4. Laceration into collection system, ernal artery injury or blood clot
  5. Kidney shattered, avulsion my hilum

Advanced Pathology (27 decks)

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