TEST 3 Flashcards
1
Q
rate at which a substance is excreted in the urine
A
renal clearance measures
2
Q
glomerular filtration rate is measures
A
the volume of plasma that is filtered each minute
3
Q
what tells you when a patient is in renal failure
A
GFR- glomerular filration rate
4
Q
GFR normal kidneys
A
anything 60 or above
5
Q
GFR kidney disease
A
15-60
6
Q
GFR kidney failure
A
15 or less
7
Q
what does blood urea nitrogen BUN tell you
A
dehydration- the higher the number the more dehydrated the patient is
8
Q
what does this serum creatinine tell you
A
how the kidney is functioning/filtering
9
Q
wastes product from muscles
A
creatinine
10
Q
comes from protein breakdown
A
urea
11
Q
ratio of bun to creatinine
A
10:1
12
Q
why should protein not be in the urine
A
protein is a big substance so for it to be filtered that means there is something wrong with the filtration rate
13
Q
proteinuria
A
protein in the urine
14
Q
osmolarity and specific gravity
A
tells you about particles whether the solutes in the urine are concentrated or not ; anything greater than 1.10
15
Q
higher the specific gravity in a urine test
A
more dehydrated ; higher the number the more solutes than water
16
Q
antidiuretic hormone
A
doesn’t let you diurease ; not pee; against the release of water
17
Q
normal pH of urine
A
4.5-8
18
Q
complete absence of development of one or both kidneys (unilateral RA or bilateral RA respectively
A
renal agenesis
19
Q
renal agenesis is a change in what gene
A
Pax2 gene- mutation
20
Q
renal agenesis is an autosomal
A
dominant
21
Q
most life threatening component of potter syndrome is
A
pulmonary hypoplasia; lungs not forming
22
Q
The kidneys are small in size and have less than the normal number of calyces and nephrons
A
renal hypoplasia
23
Q
Common cause for pediatric renal failure and adult onset disease
A
renal hypoplasia
24
Q
enlargement of the kidney. urine collects in the infected kidney so it forms fluid like sacs
A
multicystic dysplastic kidney disorder
25
first thing they see in a child with multi cystic dysplastic kidney disorder is a
palpable abdomen
26
if you know they have a wilms tumor you never want to what
palpate
27
children who survive MDKD are at more risk for
hypertension and wilms tumor
28
Most common of all inherited kidney disease
Autosomal Dominant Polycystic Kidney Disease (ADPKD)
29
ADPKD manifestations
progress is slow and chronic kidney disease is uncommon before 40; hypertension (RAAS), hematuria, kidney stones; flank pain
30
characterized by cystic dilation of the cortical and medullary collecting tubules
autosomal recessive polycystic kidney disease
31
what causes the autosomal recessive polycystic kidney disease
mutation in the PKHD1 gene
32
manifestations of autosomal recessive polycystic kidney disease
excessive urine, hypertension, enlarged spleen w low rbc and high wbc/platelets, breathing problems
33
fluid-filled sacs (cysts) develop deep within the kidneys, leading to chronic kidney disease with kidney failure.
medullary cystic kidney disease / nephronophthisis
34
who does medullary cystic kidney disease affect
children
35
Excessive thirst and abnormal urine starts in which ?
nephronophthisis
36
what happens with adolescence with medullary cystic kidney disease
turns into autosomal dominant tubulointerstitial kidney disease
37
What is the main concern with Simple and Acquired Renal Cyst
differentiate them from malignancies
38
an inflammatory response in the glomeruli of the kidney
Acute Nephritic Syndrome
39
what is the most causative organism for acute nephritic syndrome
Group-A beta-hemolytic streptococci
40
what does the glomerulus do
filters waste product from the blood
41
how do you diagnose a person with acute nephritic syndrome
serum test, urinalysis
42
manifestations of acute nephritic syndrome
sudden onset of hematuria, coke urine, oliguria, diminished GFR
43
less than 400 ml in a 24 hour period
oliguria
44
how much urine per hour
30 ml per hour
45
What is the best treatment option for an individual with acute nephritic syndrome?
antibiotics
| Provide supportive care
46
mishaping of the monocytes and macrophages
Rapidly Progressive Glomerulonephritis
47
manifestations for Rapidly Progressive Glomerulonephritis
progress rapidly 3 mo, weak immune system
48
Why would plasmapheresis be beneficial for the Rapidly Progressive Glomerulonephritis patient?
a process that filters the blood and removes harmful antibodies; immunosuppressed so dont have anything to fight off
49
What organs does Goodpasture syndrome affect?
basement membrane; lungs and kidneys
50
#1 risk factors for good pasture
smoking
51
an increase in the glomerular permeability causing albumins (plasma proteins) to be excreted in the urine.
nephrotic syndrome
52
damages clusters of small blood vessels; lose filtration, waste, and excess water
nephrotic syndrome
53
manifestations of nephrotic syndrome
massive proteinuria, dyspnea, lipiduria, Hypoalbuminemia, Pleural effusion, Hyperlipidemia
54
hallmark sign of nephrotic syndrome
generalized edema happens due to decrease in plasma proteins
55
edema in nephrotic syndrome usually begins where
lower extremities. as it worsens it becomes more generalized
56
why would you give diuretic for nephrotic syndrome
removes excess fluid
57
diuretic that would help in lope of henle
lasix
58
treatment of nephrotic syndrome
diuretic, statin, pril, beta-blocker slide56
59
difference between nephritic and nephrotic
nephrotic you are losing large amounts of protein
60
frothy urine means what
spilling proteins
61
All persons with systemic lupus Erythematous Glomerulonephritis should undergo routine urinalysis to monitor for
hematurina and proteinuria
62
first signs of systemic lupus erythematous glomerulonephritis is
in the urine test
63
Renal disease affecting the tubules, interstitium, and pelvis of the kidney
acute pyelonephritis
64
two types of pyelonephritis
acute-bacterial
| chronic-couldve been bacterial followed by viral
65
ascending infection
pyelonephritis
66
causative organism of acute pyelonephritis
e. coli
67
main clinical manifestation of acute pyelonephritis
malaise, moderate to high fever, nausea/vomitting, Painful palpation over the on the infected side (CVA), pyuria
68
how to stop pyelonephritis
teach girls to wipe back to front
69
Painful palpation over the on the infected side
costovertebral angle
70
positive CVA (painful) what does it indicate
pyelonephritis
71
The common factors in acute uncomplicated pyelonephritis included
healthy young women; no structural problems, lack of structural and urinary tract obstructions, lack of predisposing medical conditions
72
acute complicated pyelonephritis
children or adults with structural defects
73
most common cause of upper urinary tract obstruction
kidney stones ; urinary calculi
74
- acute, intermittent, excruciating
- stones 1 to 5 mm
- causes stretch of collecting system or ureter
- skin cool and clammy
renal colic pain- kidney stones
75
- dull, deep, aches in back
- stones produce distention of renal calyces or renal pelvis
- intensity of pain varies from mild to severe
- pain exaggerated by drinking large amounts of water
renal noncolicky pain-kidney stones
76
#1 causative factor of a kidney stone
calcium oxalate
77
lithotripsy
crushing of the kidney stones by shock sound waves
78
4 types of kidney stones
magnesium ammonium phosphate
uric acid
cystine stones
calcium
79
The rapid loss of kidney function from renal cell damage
acute kidney injury
80
acute kidney injury can be
reversible but has high mortality rate
81
prerenal acute kidney injury
Hypovolemia
Decreased cardiac output
Decreased peripheral vascular resistance
Decreased renovascular blood flow
82
intrarenal
Nephrotoxic injury
Interstitial nephritis
all diseases that are discussed
83
postrenal
```
BPH-benign prostatic hypertrophy
Bladder Cancer
Prostate Cancer
Calculi
Neuromuscular disorders
Spinal cord disease
Strictures
Trauma
slide 87
```
84
outflow problem
postrenal
85
use NSAIDS with caution why
aleve. ibuprofen are metabolized in the kidney.
86
which ones can be resolved
pre and postrenal ; internal is a longer recovery
87
Patients with AKI progress through phases
oliguric, diuretic, and recovery
88
AKI labs
proteinura and hematuria, cbc (4-12), serum increases creatinine , BUN
89
urine in the blood
uremia
90
signs of uremia
epistaxis, frost, red eye
91
classification staging for acute kidney injury
```
RIFLE; Risk
injury
failure
loss
ESKD
```
92
peaked T wave means
hyperkalemia
93
U wave means
hypocalcemia
94
AKI you should monitor which electrolyte
K+
95
treating hyperkalemia
Dietary restriction- limit intake to 40 mEq day of potassium rich foods and drink
96
give insulin to hyperkalemia why
potassium follows glucose back into rbc
97
hyperkalemia can cause
muscle cramps, EKG changes, oliguria, drowsiness, abdominal cramping
98
more susceptible to aki
elders;dehydrated, hypotensive, heart problems
99
nephrotoxic medications
```
Aminoglycosides- MYSIN
Amphotericin B
NSAIDs
ACE inhibitors
ARBs
IV contrast dye
```
100
nephrotoxic medications
```
Aminoglycosides- MYCIN
Amphotericin B
NSAIDs
ACE inhibitors
ARBs
IV contrast dye
```
101
two major side effects of aminoglycosides
ototoxicity and nephrotoxicity - IRREVERSIBLE
102
vancomyin side effect
infusing it too fast and they turn red
103
foods high in potassium
```
avocado
banana
potatoes
spinach
beans
citrus juices
fish
```
104
foods high in phosphorus
```
meat
fast food
cheese
seeds
milk
canned foods
cola
```
105
serious syndrome due to a direct or indirect muscle injury. It results from the death of muscle fibers and release of their contents into the bloodstream.
rhabdomyolysis
106
a hormone secreted by the kidneys that increases the rate of production of red blood cells in response to falling levels of oxygen in the tissues.
Erythropoietin
107
which genes are infected in autosomal dominant polycystic kidney disease
PKD1 and PKD2
108
Excessive thirst and urination start in childhood or adolescence for and in adolescence or adulthood for autosomal dominant tubulointerstitial kidney disease.
Nephronophthisis
109
gene problem for Nephronophthisis
NPHP
110
why would plasmapheresis be a treatment for rapid progressive glomerulonephritis
gets rid of toxins and antigens; macrophages become misshaped so this gets rid of them
111
treatments for rapid progressive glomerulonephritis
plasma
transplant
dialysis
112
treatments for nephrotic syndrome
Diuretic- remove excess fluid (edema)
”-statin”- treat hyperlipidemia
Ace-Inhibitor “-pril”- lower BP & restrict adrenal cortex from secreting aldosterone
Low sodium diet
Beta-Blocker- lower BP (decrease filtration rate)
113
blood is filtered through the
glomerulus of the kidney
114
treatment for lupus
oral corticosteriods
ace I
immunosuppressives
115
someone with SLE should get what test first
urine analysis
116
gene problems in medially cystic kd
MCKD1 and 2
117
3 main symptoms for nephron and medullary cystic kidney
polyuria, polydipsia, enuresis (bed wetting); treat with desmopressin
118
hallmark sign for pyelonephritis
significant malaise
119
is acute tubular necrosis reversible
yes if caught early enough
120
LES is suppose to relax and when it doesn’t its called
achalasia
121
hallmark sign for gerd
barrett cells
122
food relieves pain in
duodenal ulcers
123
food does not relieve pain in
gastric ulcers
124
ulcerative colitis eventually turns into
cancer
125
Carbohydrate metabolism glycogenesis, glycogenolysis
Protein metabolism-synthesis of nonessential amino acids, clotting factors, urea formation
Fat metabolism-synthesis of lipoproteins, synthesis of fatty acids, breakdown of cholesterol
Detoxification drugs/harmful substances
liver
126
what phase does distaste of smoking in hep happen
prodomal; first stage
127
treatment for fulminant hep
supportive care and liver transplant
128
triad for acute cholecystitis
constant pain in URQ
tenderness in URQ
inflammatory response
129
Rhabdomyolysis- triad
darkened ua(coke colored urine), myalgia (muscle aches), weakness
