Week 12: Renal Disorders Flashcards
1
Q
What is Acute Tubular Necrosis (ATN)?
A
ATN is a type of kidney damage where tiny tube-like structures inside the kidneys (called tubules) get destroyed.
2
Q
What effect does ATN have on kidney function?
A
This damage makes it hard for the kidneys to clean the blood properly, leading to a buildup of waste (urea and creatinine) in the body and possible kidney failure.
3
Q
What percentage of acute kidney failure cases is ATN responsible for?
A
ATN is responsible for about 75% of acute kidney failure cases.
4
Q
What is the most common cause of ATN?
A
The most common cause of ATN is ischemic injury, which occurs due to lack of blood flow to the kidneys.
5
Q
What are some causes of ischemic injury leading to ATN?
A
Causes include low blood pressure, severe dehydration, major blood loss, heart-related problems, infections, surgery complications, and trauma.
6
Q
What is nephrotoxic injury?
A
Nephrotoxic injury occurs when the kidneys react badly to certain drugs or toxins.
7
Q
What are some examples of substances that can cause nephrotoxic injury?
A
Examples include heavy metals, certain anesthetic drugs, strong antibiotics, dyes used in medical imaging, and industrial chemicals.
8
Q
What happens to kidney tissue in ischemic injury?
A
In ischemic injury (low blood flow), kidney tissue dies in patches, damaging not just the tubules but also other supportive structures in the kidney.
9
Q
How does nephrotoxic injury affect the kidneys?
A
In nephrotoxic injury (toxic substances), damage is usually limited to the surface of the tubules, so the kidney has a better chance of healing.
10
Q
What is a common symptom of Acute Tubular Necrosis (ATN)?
A
Decreased urine output (less than 400 mL/day) – often the first noticeable sign
11
Q
What symptom of ATN is caused by fluid buildup?
A
Swelling (edema) due to fluid buildup
12
Q
What neurological symptoms can occur in ATN?
A
Lethargy, confusion, or agitation (caused by toxins affecting the brain)
13
Q
What physical symptoms may indicate dehydration in ATN?
A
Dry skin and mouth
14
Q
What cardiovascular symptoms can occur due to electrolyte imbalances in ATN?
A
Irregular heartbeat or muscle weakness (due to electrolyte imbalances, especially high potassium levels)
15
Q
What are signs of internal bleeding in ATN?
A
Vomiting blood or bruising easily
16
Q
What is the survival rate for ATN if urine output is very low?
A
The risk of death is high (up to 70%)
17
Q
What is the prognosis for ATN if urine output remains normal?
A
Chances of recovery are much better
18
Q
What are common complications of Acute Tubular Necrosis (ATN)?
A
Infections (sepsis) are very common and can be life-threatening.
19
Q
What is a potential complication related to the gastrointestinal system in ATN?
A
Bleeding in the stomach or intestines (GI hemorrhage).
20
Q
What type of imbalances can occur in ATN?
A
Serious imbalances in body fluids and electrolytes.
21
Q
What cardiovascular issues may arise from ATN?
A
Heart and blood pressure problems.
22
Q
What type of issues can ATN cause related to the nervous system?
A
Nerve-related issues, especially in older patients.
23
Q
What metabolic condition may occur during recovery from ATN?
A
High calcium levels (hypercalcemia) during recovery.
24
Q
What is Benign Prostatic Hyperplasia or BPH?
A
BPH is when the prostate gland gets bigger and squeezes the urethra (the tube that carries urine out of the body). This can make it harder to urinate properly.
25
What is the exact cause of BPH?
The exact cause isn’t fully understood, but hormones seem to play a big role.
26
How do testosterone and estrogen levels change as men age?
Testosterone (androgens) decrease, while estrogen increases.
27
What effect does the hormone imbalance have on the prostate?
It leads to an increase in dihydrotestosterone (DHT), which makes the prostate grow.
28
What are some possible causes of BPH?
Inflammation, poor blood flow (arteriosclerosis), or tumors
29
What are some risk factors for BPH?
Family history, obesity, high blood pressure, diabetes, and high cholesterol
30
What lifestyle factors may contribute to BPH?
Sedentary lifestyle, poor diet, alcohol use, and a weak immune system
31
How do higher estrogen levels affect the prostate?
Higher estrogen levels make the prostate more sensitive to hormones.
32
What is hyperplasia in the context of BPH?
Hyperplasia is the overgrowth of prostate cells, especially around the urethra.
33
What effect does an enlarged prostate have on the urethra?
An enlarged prostate blocks or narrows the urethra, making it harder for urine to pass.
34
What can reduced blood flow over time lead to in prostate tissue?
Reduced blood flow can lead to tissue damage (necrosis).
35
What is a symptom of BPH related to urine flow?
Weak urine flow (small or slow stream)
36
What symptom indicates straining to urinate?
Straining to pee and feeling like you haven’t emptied your bladder
37
What is frequent urination at night called?
Nocturia
38
What is a potential severe symptom of BPH?
In some cases, blood in urine
39
What can untreated BPH cause?
Severe urinary blockage, leading to urinary tract infections (UTIs) or kidney stones.
40
What happens to the bladder wall in untreated BPH?
The bladder wall thickens or weakens, leading to urine retention in a pouch (diverticulum).
41
What is a complication of BPH related to bladder control?
Incontinence (loss of bladder control).
42
What kidney problems can arise from untreated BPH?
Kidney problems like chronic kidney failure or hydronephrosis (kidney swelling from urine buildup).
43
What gender and age group is affected by BPH the most?
BPH is common in older men and is caused by hormone changes that make the prostate grow.
44
What are the main symptoms of BPH?
It mainly causes urination problems due to pressure on the urethra.
45
What is Glomerulonephritis GN?
GN is a kidney disorder where the small filters in the kidneys (glomeruli) become inflamed.
46
What are the symptoms of Glomerulonephritis GN?
The symptoms include swelling (edema), high blood pressure (hypertension), and blood in the urine (red or dark-colored urine).
47
What are common infections that can cause GN?
Commonly follows a strep throat or skin infection, especially in kids aged 2-10.
48
What autoimmune diseases can cause GN?
Diseases like lupus (SLE), Goodpasture syndrome, or IgA nephropathy.
49
Can genetic conditions cause GN?
Yes, some cases run in families.
50
What is Acute Glomerulonephritis GN?
Happens suddenly, often after an infection.
51
What is Rapidly Progressive GN?
Worsens quickly due to immune system overreaction.
52
What is Chronic GN?
Long-term damage that may lead to kidney failure.
53
What happens to the glomeruli in Rapidly Progressive (autoimmune-related) GN?
The immune system mistakenly attacks the glomeruli, damaging their filtering ability.
54
What can trigger immune complexes to get stuck in the kidneys?
Infections (like strep) can trigger immune complexes to get stuck in the kidneys, causing inflammation.
55
What is Goodpasture’s syndrome?
In Goodpasture’s syndrome, the immune system attacks both the lungs and kidneys.
56
What is the long-term effect of GN on kidney function?
Over time, kidney function declines, leading to waste buildup and possible kidney failure.
57
What is a symptom of GN related to urine color?
Dark or smoky-colored urine (due to blood)
58
What is a common urination symptom in GN?
Less urination than normal
59
What type of swelling is associated with GN?
Swelling (especially around the eyes)
60
What is a cardiovascular symptom of GN?
High blood pressure
61
What respiratory symptom may occur in GN?
Shortness of breath
62
What lung sounds may be present in GN?
Lung sounds (crackles)
63
What are some general symptoms of GN?
Nausea, tiredness, joint pain, and weight loss
64
What are the key takeaways of GN?
GN inflames the kidney’s filters, leading to swelling, blood in urine, and high BP.
It can be caused by infections, autoimmune diseases, or genetic conditions.
If severe, it can lead to kidney failure.
65
What is Hydronephrosis?
Hydronephrosis happens when one or both kidneys swell because urine can’t drain properly.
66
What causes Hydronephrosis?
It is caused by the renal pelvis stretching abnormally due to urine not draining properly.
67
What is hydronephrosis?
Hydronephrosis occurs when something blocks urine flow in the urinary system.
68
What is a common cause of hydronephrosis in older men?
Enlarged prostate (BPH)
## Footnote
Common in older men.
69
What is another cause of hydronephrosis?
Narrowing of the urethra (strictures).
70
What are potential blockages that can lead to hydronephrosis?
Blockage at the bladder outlet or ureter.
71
What are some less common causes of hydronephrosis?
Birth defects affecting the urinary tract
Abdominal tumors
Blood clots
Nerve problems affecting bladder control (neurogenic bladder)
Cancer in the bladder or ureter
72
How does hydronephrosis affect both kidneys?
If the blockage is in the bladder or urethra, both kidneys can be affected.
73
How does hydronephrosis affect one kidney?
If the blockage is in one ureter, only one kidney is affected.
74
What happens if urine is completely blocked?
It damages the kidney tissue, stopping kidney function over time.
75
What are the symptoms of mild cases of hydronephrosis?
No symptoms or slight pain with reduced urine flow
76
What are the symptoms of severe cases of hydronephrosis?
Sharp, cramping kidney pain (colicky pain)
## Footnote
Example: Intense pain that comes and goes.
77
What type of pain is associated with severe hydronephrosis?
Dull pain in the lower back or sides (flank pain) that spreads to the groin
78
What is hematuria?
Blood in urine
79
What is dysuria?
Painful urination
80
What are the urine flow variations in severe hydronephrosis?
Swings between too much urine (polyuria) and very little urine (oliguria)
81
What is anuria?
Complete inability to urinate
82
What are other symptoms of hydronephrosis?
Nausea, vomiting, bloating, weak urine stream, and trouble starting urination
83
What is a complication of hydronephrosis related to kidney infections?
Urine buildup allows bacteria to grow, leading to serious infections.
## Footnote
This condition is known as pyelonephritis.
84
What can happen if hydronephrosis is untreated?
Severe kidney damage may occur, potentially resulting in permanent loss of kidney function.
85
What bowel problem can arise from hydronephrosis?
A blocked urinary system can slow or stop movement in the intestines, leading to paralytic ileus.
86
What are key takeaways for hydronephrosis?
Hydronephrosis is kidney swelling due to blocked urine flow.
It can be mild (no symptoms) or severe (pain, blood in urine, kidney damage).
If untreated, it can cause infections, kidney failure, and bowel issues.
87
What are Kidney Stones?
Hard mineral and salt deposits that form in the kidneys.
88
Where do Kidney Stones usually develop?
Usually develop in the renal pelvis or calyces.
89
Can Kidney Stones form anywhere in the urinary tract?
Yes, they may form anywhere in the urinary tract.
90
What can lead to the formation of kidney stones?
1. Not drinking enough water (leading to dehydration)
2. Too much calcium, oxalate, or uric acid in urine
3. Eating a lot of salt, protein, or sugar
4. Family history of kidney stones
5. Certain medical conditions like gout or urinary infections
91
What is a symptom of kidney stones related to pain?
Severe pain in your back, side, or lower belly (this can spread to the groin area)
92
What symptom might occur while urinating with kidney stones?
Pain while urinating
93
What change in urine color can indicate kidney stones?
Blood in urine (making it look pink, red, or brown)
94
What frequent sensation might someone with kidney stones experience?
Feeling like you need to pee often
95
What gastrointestinal symptoms can accompany kidney stones?
Feeling sick (nausea) or throwing up
96
What systemic symptoms may indicate an infection related to kidney stones?
Fever and chills (if there’s an infection)
97
What are some oxalate-rich foods that could contribute to the formation of kidney stones?
Spinach
Bran flakes
Rhubarb
Beets
Potato chips/fries
Nut and nut butters
98
How do kidney stones form?
Urine becomes concentrated with substances that can’t dissolve easily.
99
What happens after urine becomes concentrated?
Crystals start to form and stick together, creating kidney stones (calculi).
100
What are kidney stones made of?
These stones are made of minerals like calcium, oxalate, phosphate, uric acid, and others, all held together by a protein framework.
101
How do kidney tubules contribute to stone formation?
The kidney tubules reabsorb some proteins, creating a site for more crystals to form.
102
Where do stones usually stay in the body?
Stones usually stay in the kidney (renal pelvis), causing pressure and tissue damage.
103
What condition can occur if stones move into the ureter?
Stones can block urine flow, causing hydronephrosis (kidney swelling).
104
What happens when large stones block urine flow?
Large stones can block the flow of urine, making the kidneys swell.
105
What symptoms can occur if stones move or cause damage?
Pain and bleeding can happen if the stones move or cause damage.
106
What is Acute Renal Failure (ARF)?
Acute Renal Failure (ARF) is when the kidneys suddenly stop working properly.
107
What causes Acute Renal Failure (ARF)?
ARF can happen because of an obstruction, poor blood flow, or kidney disease.
108
Can Acute Renal Failure (ARF) be treated?
Yes, ARF can be treated and reversed.
109
What happens if Acute Renal Failure (ARF) is not treated in time?
If not treated in time, ARF can cause permanent kidney damage, leading to chronic kidney failure.
110
What causes prerenal failure?
Prerenal failure is caused by insufficient blood flow to the kidneys, leading to low kidney perfusion (hypoperfusion).
## Footnote
Examples include dehydration, low blood pressure, blood loss, or heart problems.
111
What is the result of prerenal failure?
The kidneys do not receive enough blood, causing waste to build up in the blood, known as azotaemia (presence of extra nitrogenous waste like urea and creatinine).
112
Can prerenal failure be reversed?
Yes, if blood flow is restored quickly, prerenal failure can be reversed, and kidney function can improve.
113
What causes intrarenal failure?
Intrarenal failure occurs when the internal structures of the kidneys, especially the filters (nephrons), are damaged.
## Footnote
Examples include diseases like glomerulonephritis, acute tubular necrosis from infections or toxins, or toxic medications.
114
What is the result of intrarenal failure?
The kidneys cannot filter blood properly, leading to a buildup of waste.
115
What causes postrenal failure?
Postrenal failure is caused by a blockage in the urinary tract, preventing urine from leaving the kidneys.
## Footnote
Examples include enlarged prostate (benign prostatic hyperplasia) or bladder obstruction.
116
What is the result of postrenal failure?
Urine backs up into the kidneys, causing swelling and damage.
117
What is the Oliguric Phase?
The Oliguric Phase is characterized by a dramatic decrease in urine output, lasting from 2 weeks to several months.
## Footnote
Symptoms include fluid retention, swelling, weight gain, high blood pressure, and buildup of waste products like urea and creatinine in the blood.
118
What are the symptoms of the Oliguric Phase?
Symptoms include the kidneys trying to conserve water and sodium, fluid retention causing swelling (edema), weight gain, high blood pressure, and buildup of waste products.
## Footnote
Untreated, it can lead to acute tubular necrosis (ATN).
119
What is the Diuretic Phase?
The Diuretic Phase involves the kidneys producing more urine, often in large amounts (up to 4-5 liters a day).
## Footnote
Symptoms include the inability to concentrate urine, leading to loss of water, sodium, and potassium.
120
What are the potential dangers of the Diuretic Phase?
Without proper treatment, the Diuretic Phase can cause life-threatening imbalances.
## Footnote
Electrolyte imbalances like hypokalemia (low potassium) and dehydration can occur.
121
What is the Recovery Phase?
The Recovery Phase occurs when the cause of kidney failure is treated, leading to gradual improvement in kidney function.
## Footnote
Urine output stabilizes to around 1-2 liters per day, and waste products in the blood start to return to normal levels.
122
What is the outcome of the Recovery Phase?
Most people recover fully, but recovery depends on the severity of the kidney damage.
## Footnote
Urine output stabilizes and waste products normalize.
123
What can happen if the kidneys are severely damaged?
Intrarenal failure may occur, potentially leading to chronic kidney disease.
124
What can cause permanent harm to kidney tissue?
Damage from toxins or lack of blood flow (ischemia) can lead to long-term kidney problems.
125
What can occur if waste builds up in the body?
Infections can occur, a condition known as uremia.
126
What may be required in cases of severe kidney damage?
Dialysis may be necessary.
127
What are prerenal causes of ARF?
Prerenal causes are due to low blood flow.
## Footnote
Symptoms might include low urine output, fast heart rate, low blood pressure, dry mouth, low blood volume, fatigue, confusion, or even coma.
128
What is oliguria?
Oliguria refers to low urine output.
129
What is tachycardia?
Tachycardia is a fast heart rate.
130
What is hypotension?
Hypotension is low blood pressure.
131
What are symptoms of uremia as kidneys fail?
Symptoms of uremia can include confusion, stomach issues, fluid buildup in the lungs, and infections due to waste buildup.
## Footnote
Examples include mental fog, nausea, vomiting, shortness of breath.
132
What can cause confusion or mental fog in ARF?
Uremia (high waste in the blood) can cause confusion or mental fog.
133
What stomach issues can arise from ARF?
Stomach issues like nausea or vomiting can arise.
134
What can fluid buildup in the lungs cause?
Fluid buildup in the lungs can cause shortness of breath.
135
What percentage of hospitalized patients develop ARF?
About 5% of hospitalized patients develop ARF.
136
Is ARF reversible with treatment?
Yes, ARF is often reversible with treatment, and kidney function can return to normal.
137
What can happen without treatment for ARF?
Without treatment, ARF can lead to end-stage renal disease, which is life-threatening.
138
What type of bacteria causes 'Honeymoon cystitis?
Staphylococcus saprophyticus
139
What is a Urinary Tract Infection (UTI)?
A UTI is an infection in any part of the urinary system: kidneys, bladder, ureters, or urethra.
140
What is the normal state of the urinary tract?
Normally, the urinary tract is sterile, meaning it doesn't have bacteria.
141
How does urine help the urinary tract?
Urine helps keep the urinary tract clean by flushing out germs.
142
What role does IgA play in the urinary tract?
IgA is an immune protein that helps stop infections in the urinary tract.
143
How can bacteria cause a UTI?
Sometimes bacteria can get into the urinary tract and cause an infection.
144
What is the primary cause of most UTIs?
Most UTIs are caused by bacteria from your bowel (your intestines).
145
Which bacteria is most commonly associated with UTIs?
E. coli is the bacteria most commonly associated with UTIs.
146
How do bacteria travel to cause a UTI?
Bacteria can travel from the anus to the urethra.
147
What is the urethra?
The urethra is the tube that carries urine out of your body.
148
Where can bacteria travel after the urethra?
From the urethra, bacteria can travel up to the bladder and sometimes the kidneys.
149
What can increase the risk of getting a UTI?
Several factors can increase the risk of getting a UTI, including catheters, gender, sexual activity, blockages in the urinary system, incomplete bladder emptying, and metabolic factors.
150
How do catheters increase UTI risk?
Catheters can introduce bacteria into the urinary system. The longer the catheter stays in, the higher the risk of infection.
151
Why are women at higher risk for UTIs?
Women are at a much higher risk of UTIs compared to men because the female urethra is shorter, allowing bacteria to reach the bladder more easily.
152
What is 'honeymoon cystitis'?
Honeymoon cystitis is a term used to describe UTIs in women that can occur after sexual activity, often caused by Staphylococcus saprophyticus.
153
What conditions can cause blockages in the urinary system?
Conditions like kidney stones, enlarged prostate, or abnormal urinary flow (such as vesicoureteral reflux in children) can prevent proper urine flow, making it easier for bacteria to grow.
154
How does incomplete bladder emptying contribute to UTIs?
Incomplete bladder emptying leaves residual urine in the bladder, which can allow bacteria to grow.
155
What metabolic factors can increase UTI risk?
Certain health issues like diabetes, which affect the body’s ability to fight infections, can make it easier for UTIs to occur.
156
What is urethritis?
Urethritis happens when harmful germs get into the urethra, causing irritation.
157
What is cystitis?
Cystitis happens when the infection moves up and affects the bladder.
158
What are urethritis and cystitis types of?
Both of these are types of lower urinary tract infections (UTIs).
159
What can happen if the infection moves to the kidneys?
It can cause a more serious condition called pyelonephritis.
160
What is the main cause of most UTIs?
The main cause of most UTIs is a type of bacteria called E. coli.
161
What are nosocomial UTIs?
Nosocomial UTIs are infections acquired in hospitals.
162
What bacteria can cause nosocomial UTIs?
Other bacteria like Proteus, Klebsiella, Pseudomonas, and Enterococcus faecalis can cause nosocomial UTIs.
163
What are the signs & Symptoms of Urethritis or Cystitis:
Painful urination (dysuria)
Frequent need to urinate
Urgency to urinate
