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Pathology Block 12 > Renal/urinary Problems > Flashcards

Renal/urinary Problems Flashcards

1
Q

What is the approximate volume of urine production every minute by a normal adult

A

1ml per minute

1-2Liter per day

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2
Q

Urinalysis of UTI

A 
WBCs
Leukocyte esterase 
May have some proteins 
Might see blood and nitrites 
-certain bacteria will convert nitrates to nitrites
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3
Q

Is the amount of blood and nitrites in urine an indicator of the severity of the infection of UTI?

A

No

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4
Q

UTI of liver disease

A

Increased bilirubin

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5
Q

Urinalysis of low carb diet

A

Ketones

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6
Q

Urinalysis of diabetes

A

Protein, micoralbuminuria

  • low level of albumin, not small sized albumin
  • tells if kidney damage is starting to occur
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7
Q

What is the earliest indicator of kidney damage in diabetes

A

Microalbuminuria

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8
Q

Rate at which fluid crossed the glomerular filter

A

GFR

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9
Q

What does GFR reflect

A

Kidney function

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10
Q

Why is creatinine clearance preferred over inulin

A

Inulin has to be given IV, and creatinine clearance doesn’t so it’s just easier

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11
Q

Why is inulin considered the gold standard even though it is not used as commonly as createnine clearance

A

Freely filtered, neither excreted nor reabsorbed

-required IV infusion of inulin

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12
Q

How much creatinine is cleared per minute

A

115-125ml

  • think of it as a %
  • if it is above 100, there is probably a 100% kidney function
  • if only 50, probably only 50% kidney function
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13
Q

When do you need to calculate creatinine clearance more accurately

A

When the individual is of an older age and an unhealthy weight

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14
Q

How do we normally calculate createnine clearance

A

If you take creatinine clearance and divide by 100%, that gives you kidney function

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15
Q

When is the creatinine clearance rule of thumb applicable

A

Only accurate in healthy adults

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16
Q

How do you get BUN levels from creatinine clearance

A

Multiple by 10

CC of 2=20BUN

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17
Q

Most common type of kidney stone

A

Calcium oxalate

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18
Q

If you see someone with calcium oxalate in their urine and they suddenly go into renal failure, what is it?

A

They probably drank antifreeze

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19
Q

If someone suddenly stops urinating and has pain

A

Kidney stone

-pain usually only on one side

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20
Q

Uremia/azoemia

A

Showing up in the blood, signs and symptoms caused by kidney failing

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21
Q

Anuria

A

No urine production

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22
Q

Amount of plasma filtere/unit time

A

GFR

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23
Q

How many nephrons per kidney

A

1 mill

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24
Q

How many nephrons can you lose before losing kidney function

A

75%

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25
Q

What is the only organ that can get rid of H ions to maintain acid base balance

A

Kidney

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26
Q

Uremia

A

Urine in the blood
Signs and symptoms of toxins building up
Creatinine is good indicator

27
Q

Casts

A

Proteins that congeal into tubules in the kidney

  • normal to see some occasionally
  • if seeing a lot of them, urine is flowing very slowly through the kidneys
28
Q

what is the normal protein found in the kidneys responsible for hyaline casts

A

TAMs-horsfall

29
Q

Concentration of creatinine clearance is promotional to

A

Muscle mass

30
Q

Does creatinine clearance overestimate or underestimate GFR

A

Overestimate

31
Q

Does BUN overestimate or underestimate GFR

A

Underestimate

32
Q

Between BUN and creatinine, which one is influenced by diet

A

BUN

33
Q

Stomach ulcer and BUN

A

Will increase BUN if there is a bloody stomach ulcer

34
Q

Kidney stones

A

Deep, dull pain

Flank pain on one side

35
Q

Treatment of stones

A

Manage pain

Get rid of stone

36
Q

Cysts

A

Can show up in kidneys and other places

  • can be simple or many
  • adult is 40 and older, autosomal dominant
  • pain or unexplained HTN and blood in urine
37
Q

Stag horn cysts

A

Magnesium ammonium phosphate stones

38
Q

List symptoms of UTI

A

Burning and pain on urination, lower abdominal comfort

39
Q

What is the number one cause of UTI

A

E. coli

Staph saprophyticus is common in women too

40
Q

What’s the difference between and upper and lower UTI

A

The urinalysis will be pretty much the same

Upper UTI will make the person feel very sick and have a fever

41
Q

Pyelonephritis

A

Bladder infection that goes up
Infectious agents and effects of drugs and toxins
Inflammation of the kidneys

42
Q

Acute pyelonephritis

A

Caused by UTIs

E. coli

43
Q

Chronic pyelonephritis

A

Slowly progressive
Responsible for 20% ESRD
-polyuria
-mild proteinuria

44
Q

What is associated with WBC cases

A

Infection caused by polynephrtis

45
Q

Most common form of acute glomerulonephritis

A

Post streptococcal glomerulonephritis after URI or pharyngitis that happened about 1-3 weeks ago

46
Q

What hypersensitivity is acute glomerulonephritis

A

III (some II)

47
Q

Acute gomerulonephritis

A
  • Protein, hematuris (cola colored urine)
  • HTN, RBC casts
  • ASO
  • kids recover quick from it
  • inflammation of nephron
  • leaking blood and RBC
  • restrictive so you lose ability of kidneys to filbert blood and lose GFR
  • azetemia
48
Q

Nephritis syndrome

A

Protein levels go up in urine (proteinuria) <3.5g/day

RBC and RBC casts

Edema around the eyes with increased BP

49
Q

Signs and symptoms of nephrotic syndrome

A
  • Massive proteinuria
  • going to lose albumin so edema will follow (pitting)
  • hypercoagulation due to the loss of ATIII
  • body compensates for losing protein by increasing lipids, leading to HLD
50
Q

Differentiate renal insufficiency, renal failure, and ESRD

A

Renal insufficiency
-GFR=20-50%

Renal failure

  • GFR=5-15%
  • uremia

ESRD

  • GFR<5%
  • atrophy
51
Q

Acute renal failure: prerenal

A

Prevents blood flow to kidney, low BP

52
Q

Acute renal failure: intrarenal:

A

Disrupts structures in the kidney

53
Q

Acute renal failure: postrenal

A

Interfere with the elimination of urine from the kidney

54
Q

Uremia

A

Accumulation of waste products in the blood

55
Q

Micoralbuminuria in diabetics

A

Important predictor of future diabetic nephropathies

56
Q

E. coli

A
  • Gram neg
  • One of the only lactose fermenting rods
  • UTI
  • stains pink
57
Q

Staph saprophyticus

A
  • gram +
  • catalase +
  • coagulate negative
  • novobiocin resistant
  • causes UTI in women
58
Q

Difference in the presence of WBCs in an upper UTI and lower UTI

A

Lower UTI will have WBCs

Upper UTI will have WBC casts

59
Q

What are the “opathies” of DM

A

Neuropathy
Retinopathy
Nephropathy

60
Q

What percent of type I DM gets glomerulosclerosis

A

30%

61
Q

Most sensitive screening test for diabetics with glomeruclosclerosis

A

Micoralbuminuria

  • normal is less than 30mg in 24 hours
  • 30-300 is a predictor they go into renal failure eventually
62
Q

When do we see WBC casts

A

Pyelonephritis

63
Q

When will we see RBC casts

A

Glomerulonephritis

64
Q

Acute tubular necrosis

A
  • destruction of tubular epithelial cells with acute loss or renal failure
  • reversible usually
  • aminoglycosides (gentamicin)
  • low BP and nephrotoxic drugs

Pathology Block 12 (7 decks)

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