Renal/Urologic patho

Question 1

Transport maximum (Tmax)

Answer 1

molecules such as glucose need transport proteins for reabsorption

when Tmax for glucose is exceeded it can not be reabsorbed and is excreted thru the urine

glucosuria is a sign that blood glucose levels excees Tmax

Question 2

urinalysis

Answer 2

↑ specific gravity: concentrated w/ other molecules

↓ specific gravity: diluted urine

ketones: diabetes

blood/protein in urine means glomeruli issue

nitrate and leukocyte: UTI

crytals: dehydrated

epithelial cells: urinary tract cells sloth off

Question 3

RBC “Ghost”

Answer 3

will just see membrane because the cell is broken down

Question 4

urine odor

Answer 4

ammonia present

Question 5

casts

Answer 5

molds of renal tubules (composed of proteins)

Question 6

urine electrolytes

Answer 6

sodium

potassium

Question 7

urine cytology

Answer 7

cytologist assess abnormal cells shed from urinary tract

get done if hematuria and dont knwo cause

Question 8

creartinine clearance

Answer 8

not used as much
test reflects glomerular filtration rate (GFR)

requires 24hr urine spec and one blood specimen for plasma creatinine

↓creatinine clearance = ↓Glomerular function

Question 9

serum creatinine level

Answer 9

serum creatinine level rises as renal function declines

Question 10

blood urea nitrogen (BUN)

Answer 10

as BUN rise renal function declines

Question 11

Estimated GFR (eGFR)

Answer 11

obtainee with a single blood sample:
measures plasma creatinine and adjusted for:
*age
*sex
*confounding population factors

↓eGFR = ↓glomerular function

Question 12

CO2

Answer 12

70% bi carb
10% disolve in plasma

bicarb is a base so its mainly base so it can cause alkalosis if increased

Question 13

consequences of urinary tract obstructions

Answer 13

hydroureter
(ureter dilated due to hydrostatic pressure)

hydronephrosis
(kidney dilated due to hydrostatic pressure

UTI

Renal failure

Question 14

urinary tract obstructions

Inherited polycystic kidney disease

Answer 14

2 forms of genetic transmission

autosomal dominant (adult onset)

autosomal recessive (infant onset)

Question 15

urinary tract obstruction

urethralvesical reflux
vesicoureteral reflux

Answer 15

urethralvesical reflux
*from urethra into bladder

vesicoureteral reflux
*from bladder into ureter
flap isnt there and pressure pushed back up

Question 16

urinary tract obstruction

Neurogenic bladder (tone issue)

Answer 16

spastic bladder (overactivity)
*failure to relax and store urine

flaccid bladder
*failure to contract to empty urine

nonrelaxing external sphincter

Question 17

urinary tract obstruction

specific to men

Answer 17

benign prostactic hyperplasia

prostatic cancer

Question 18

urinary tract obstruction

kidney stones

Answer 18

calcium stones:
*calcium oxalate or phosphate

struvite stones:
*mg, phos, ammonium

uric acid stones

Question 19

urinary tract obstruction

kidney stones

clinical manifestations

Answer 19

pain

hematuria

N/V/D

Question 20

urinary tract cancer in adults

Answer 20

prostatic cancer

bladder

renal carcinoma

Question 21

urinary tract cancers in children

Answer 21

wilms tumor (nephroblastoma)
*embryonic origin

Question 22

urinary tract infections

cystitis
pyelonephritis

Answer 22

cystitis (bladder)

pyelonephritis (kidney)

Question 23

urinary tract infections

hemolytic uremic syndrome (HUS)
how we get
causes

Answer 23

ingesting undercooked meats contaminated with bacteria:
E coli

causes:
acute renal failure
hemolytic anemia
thrombocytopenia

preceded byt a GI infection (starts out and looks like that but its really urinary tract infection)

Question 24

immune mechanisms in glomerular disease

type 2 immunoglobulin-mediated hypersensitivity response

type 3 immune complex hypersenstivity response

Answer 24

type 2: IgA usually and they antigen and antibody bind and cause inflammation

type 3: antigen-antibody complex get out of the basement membrane and cause damage

Question 25

alterations in glomerular function acute glomerulonephritis (acute nephritic syndrome)

Answer 25

acute postinfectious glomerulonephritis: *post-streptococcal infection rapidly profressive glomerulonephritis: *autoimmune response to antibodies in glomerular basement membrane ad they also attack lungs

Question 26

alterations in glomerular function chronic glomerulonephritis risk factors

Answer 26

DM HTN IgA nephropathy systemic lupus erythematosis

Question 27

alterations in glomerular function nephrotic syndrome

Answer 27

glomerular damage— protien leak out— hypoproteinemia (bc its in urine now)— ↓plasma pressure due to less proteins and hyperlipidemia

Question 28

causes of acute kidney injury prerenal

Answer 28

decrease renal perfusion cause: hypovolemia shock

Question 29

causes of acute kidney injury intrarenal

Answer 29

some type of acute injury originating within the kidney itself EX: acute tubular necrosis

Question 30

causes of acute kidney injury postrenal

Answer 30

obstruction to outflow from kidney

Question 31

stages of chronic kidney disease

Answer 31

1-5 1: normal function 5: end stage (dialysis or transplant)

Question 32

chronic kidney disease clinical manifestations: altered fluid electrolyte balance

Answer 32

altered: *sodium and water: lead to HTN and cardiac dysfunction *postassium: hyperkalemia *acid-base balance: metabolic acidosis *phosphate and calcium: metabolic bone diasease

Question 33

chronic kidney disease clinical manifestations: urine output

Answer 33

decline in GFR: *oliguria *↓creatinine clearance *↑plasma creatinine *↑BUN azotemia: elevation of nitrogenous wastes only uremia: urine in blood (molecules normally eliminated in urine accumulate in blood and become toxic)

Question 34

chronic kidney disease clinical manifestations: skin hematologic status drug elimination

Answer 34

altered skin integrity: *formation of phos and ca crystals altered hematologic status: *circulating toxings contribute to: -chronic anemia -coagulopathies -altered immune function altered drug elimination *renal eliminition is decreased leading to prolonged half life of drug in blood (reduce dose)