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Pathophysiology > Urinary and Renal Disorders > Flashcards

Urinary and Renal Disorders Flashcards

1
Q

What are some of the functions of the kidney?

A

Maintain stable internal environment, filter blood, excrete metabolic waste, maintain acid-base balance, retain nutrients, manage water/solute transport, regulate endocrine functions

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2
Q

What is erythropoietin?

A

Produced by the kidneys, important in the production of RBC’s

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3
Q

What is a nephron?

A

Tubular structure, the main functional unit of the kidney

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4
Q

What is included inside the nephron?

A

Glomerulus, proximal convuluted tubule, loop of Henle, distal convuluted tubule, collecting duct

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5
Q

What is special about glomerular capillaries?

A

Have specialized, fenestrated epithelium

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6
Q

What is filtrate?

A

Fluid and molecules filtered out of Bowman’s capsule–contains sodium, glucose, amino acids, etc.

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7
Q

What occurs in the proximal convoluted tubule?

A

Sodium and water absorption, glucose is reabsorbed via protein transporters

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8
Q

What occurs in the distal tubule?

A

Hormones such as aldosterone and vasopressin will act to fine tune the reabsorption of water and salts

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9
Q

Which part of the nephron does ADH act upon?

A

The collecting duct and distal convoluted tubule

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10
Q

What is the muscle that lines the bladder called?

A

Detrusor muscle

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11
Q

What are the cells that line the bladder?

A

Transitional epithelial cells that expand to accomodate large amounts of fluid

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12
Q

What should not be present in the urine?

A

Glucose, ketones, protein, bacterial/parasitic organisms

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13
Q

What is GFR?

A

Glomerular filtration rate, amount of fluid filtered through Bowman’s capsule per unit of time

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14
Q

What happens to the aging kidney?

A

Get smaller, number of nephrons decreases, loses ability to respond to changes in pH, changes to muscles and nerves

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15
Q

What happens as a result of a urinary blockage?

A

Causes backup to Bowman’s capsule, affects filtering abilities of nephrons, decreases GFR and sustained pressure with cause damage, promote scar tissue. Also creates urinary stasis

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16
Q

What is considered the upper urinary tract?

A

Kidneys, ureters

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17
Q

What is considered the lower urinary tract?

A

Bladder, urethra

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18
Q

What is a nephroliathiasis?

A

Kidney stone–formation of crystals, protein, other substances within kidney or ureters and can block flow downstream

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19
Q

What are some anatomical obstructions that cause resistance to urine flow?

A

Prostate enlargement, urethral stricture, severe pelvic organ prolapse, low bladder wall compliance, neurogenic alterations

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20
Q

What would be the result of damage between C2 and S1?

A

Detrusor hyperreflexia with veiscosphincter dyssynergia

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21
Q

What would be the result of damage below S1?

A

Detrusor areflexia with or without urethral sphincter incompetence

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22
Q

What would be the result of damage/lesions above C2?

A

Detrusor hyperflexia

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23
Q

What are some possible symptoms of urinary obstruction?

A

Abdo pain, renal colic, urgency, frequency, disruption of flow and retention, hematuria ?

24
Q

What is the most common UTI organism?

A

E.Coli

25
Q

What occurs in chronic pyelonephritis?

A

Persistent/recurring infections, cause scarring, release of ROS and cytokines that cause damage. If too many nephrons killed off, can lead to chronic kidney failure

26
Q

What are glomeruli?

A

Intricate capillary networks where filtration takes place

27
Q

What is glomerulonephritis?

A

Inflammation of the glomerulus caused by injury, prevents efficient filtration of blood and poor control on what is filtered into the nephrons

28
Q

What are some potential causes of primary glomerulus?

A

Immunological responses, ischemia/lack of blood flow to kidney, infection, toxins

29
Q

What are some potential causes of secondary glomerulus?

A

Another systemic disease, such as diabetes (excess sugar in blood can damage)

30
Q

What is the typical cause of acute glomerulonephritis?

A

Antigen-antibody complexes–can either result in type III or type II hypersensitivity, can also have cell-mediated/type IV reactions

31
Q

What are some clinical manifestations of glomerulonephritis?

A

Hematuria, proteinuria, severe cases can result in oliguria/hypertension/renal failure

32
Q

What can glomerulonephritis result in?

A

Chronic glomerulonephritis, kidney failure, nephrotic syndrome or nephritic syndrome

33
Q

What are the clinical manifestations of nephrotic syndrome?

A

Massive proteinuria, hypoalbuminemia, edema, hyperlipidemia

34
Q

What are the clinical manifestations of nephritic syndrome?

A

Hematuria, oliguria, decreased GFR, hypertension

35
Q

What type of pressure does albumin provide?

A

Provides 80% of colloid-oncotic pressure (serves to hold water in vascular space)

36
Q

What is renal insufficiency?

A

Decline of function to approx 25% of normal

37
Q

What is renal failure?

A

Significant loss of renal function

38
Q

What is end-stage renal failure?

A

When less than 10% of renal function occurs

39
Q

What is the criteria to guide diagnosis of renal injury?

A

RIFLE (risk, injury, failure, loss, end-stage disease)

40
Q

How can the pathophysiology be divided for renal injuries?

A

Prerenal, intrarenal, and postrenal

41
Q

What typically causes prerenal injury?

A

Hypoperfusion, could be d/t renal artery thrombosis or hypotension/hypovolemia from hemorrhage and dehydration

42
Q

What typically causes intrarenal injury?

A

Damage within kidney itself, could be from glomerulonephritis, acute tubular necrosis, acute interstitial nephritis

43
Q

What could be the cause of postrenal injury?

A

Rare, usually consequence of urinary tract obstruction

44
Q

What is the intact nephron hypothesis?

A

Surviving nephrons sustain normal kidney function

45
Q

What is stress urinary incontinence?

A

Associated with sudden increase in intra-abdominal pressure (laughing, coughing, sneezing, exercise)

46
Q

What is urge urinary incontinence?

A

Loss of urine, strong/unstoppable urge to urinate–can be neurologic or non-neurologic (depending on where lesion is)

47
Q

What is overflow urinary incontinence?

A

Overdistension of bladder resulting in involuntary urine loss

48
Q

What is mixed urinary incontinence?

A

Combination of stress and urge incontinence

49
Q

What is functional urinary incontinence?

A

Involuntary loss of urine due to dementia or immobility, cannot get to and from the bathroom

50
Q

What is benign prostatic hyperplasia?

A

Enlarged prostate, not cancerous, can restrict the urethra

50
Q

What is the flow of filtrate?

A

Bowman’s capsule–>proximal convoluted tubule–> descending loop of Henle—> distal tubule—> collecting duct–> renal papillae–> minor calyces–> renal pelvis–> ureter–> bladder

51
Q

What would result in a decreased GFR?

A

Increased hydrostatic pressure in Bowman’s capsule (could happen from an obstruction)

52
Q

Which capillaries can accept filtrate from Bowman’s capsule?

A

Peritubular capillaries

53
Q

Which ions are actively secreted into the filtrate by the renal tubules?

A

Hydrogen and potassium

54
Q

What % of filtered creatinine is excreted into the urine?

A

100%, renal tubules are impermeable to creatinine

55
Q
A

Pathophysiology (12 decks)

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