Week 6 Flashcards
signs and symptoms of ureteral (kidney) stones
intense renal colic pain abrupt in onset and may radiate
hematuria
sweating
kidney stone causes
solute supersaturation
low urine volume
abnormal urine pH
What are kidney stones made of?
calcium crystal aggregates of organic and inorganic material, uric acid, struvite, cystine, etc
What is the cause of Polycystic Kidney disease?
Genetic
S/S of Polycystic Kidney disease
evident at birth
big kidney
respiratory distress
hypertension
What chromosome is Polycystic Kidney disease affected by?
Chromosome 6p, 16 and 4
What causes Polycystic Kidney disease and what does it lead to?
lowered Ca+ levels and too much cAMP
creates cysts in the liver
Polycystic Kidney disease clinical manifestation (3)
hypertension
can’t concentrate urine
pain
What is the etiologic cause of acute Glomerulonephritis?
immune response which attract immune cells to lyse everything in their path
Whtat’s the pathophysiology of acute Glomerulonephritis?
immune cells call over immune cells. A battle begins and lysosomal degradation happens in the basement membrand and mesangial cells contract because less surface area for filtration
Clinical manifestations of acute Glomerulonephritis?
azotemia
hypertension
oliguria
proteinuria
edema
what happens in post infectious acute Glomerulonephritis?
follows impetigo and throat infections,
developing countries usually
common in kids
coffee colored urine
(berger disease) aka?
IgA nephropathy
Crescentic Glomerulonephritis
RPGN (rapidly progressive Glomerulonephritis)
Causes of Crescentic Glomerulonephritis?
drugs exposure
hallmark of Crescentic Glomerulonephritis?
crescent shaped lesions
what happens to the blood in acute onset of crescentic Glomerulonephritis?
hematuria
proteinuria
red cell cases
decline in renal function w/in 6 mos
Progress of chronic Glomerulonephritis?
sclerosis and kidney fibrosis progresses into end-stage renal disease
What does uric acid crystals of kidney stones mean?
gouty arthritis
From what area is the most common type of pyelonephritis?
ascending infection from lower UT
What is the most effective way to prevent pyelonephritis?
take catheters out early
What is acute pyelonephritis caused by?
uti cases infection of renal pelvis
What is a risk factor for pyelonephritis ?
pregnancy
S/S for acute pyelonephritis?
CVA tenderness
fever/chills
anorexia
fever-induced dehydration
urosepsis- organism in the b/s from UTI
what infection does the presence of WBC casts mean?
upper UTI
Difference between acute and chronic pyelonephritis?
acute: UTI infection
chronic: reflux or obstructive leads to scarring
what can chronic pyelonephritis turn into?
CKD
what happens with inflammation from chronic pyelonephritis ?
scarring and loss of functional nephrons
S/S of pyelonephritis?
abdominal/flank pain,
fever, malaise,
anorexia
What are the most common obstructions for the UG tract?
stones
tumors
prostatic hypertrophy
strictures
What are some characteristics of AKI?
sudden kidney function loss
disruptions influid/electolytes, pH
retention of nitrogenous waste
increase serum creatinine
decreased GFR
Three sites of Disruption of AKI?
renal perfusion (prerenal)
urine flow after kidney (postrenal)
problem with kidney vessels, tubules, glomeruli, or interstitium (intrinsic)
What are some causes of prerenal AKI?
Burns, drugs and diretics (ACE inhibitors, angiotensin II blockers, NSAIDS
What are some S/S of prerenal kidney injury?
hypovolemia, hypotension, HF,
Renal artery obstruction
fever, vomiting, diarea
prolonged prerenal ARF can lead to what?
acute tubular necrosis
Diagnosis of prerenal kidney injury
low GFR, oliguria, high urine gravity
osmolality
low urine sodium
What causes post renal kidney injury
obstruction with urinary cases Bowman capsule pressure, impeding glomerular filtration
What can prolonged postrrenal ARF lead to?
acture tubular necrosis and irreversible kidney damage
What is the most common result with intrinsic KI?
acture tubular necrosis
What does acute tubular necrosis cause?
Nephrotoxic insult (contrast media)
iscemic insults (sepsis)
What are two pathologies for acute tubular necrosis?
vascular and tubular
What happens in vascular intrinsic kidney Injury?
decrease in renal blood flow
hypoxia
vasoconstriction
What happens in tubular intrinsic kidney Injury? Pathophysiology
inflammation and reperfusion injury causing cases, obstructing urine flow, tubular backleak
What are the three phases of Acute Tubular
Necrosis?
prodromal
oliguric
post-oliguric
What are some s/s of prodromal phase of Acute Tubular Necrosis?
normal or declining pee output
What are some lab signs of Acute Tubular Necrosis?
serum BUN and creatine increase
What characterizes the oliguric phase of Acute Tubular Necrosis?
usual urine
oliguria (less)and uremia (protein)
decreased GFR
hyperkalemia
Does the oliguric phase of Acute Tubular Necrosis need dialysis?
sometimes
What are s/s of post-oliguric phase of Acute Tubular Necrosis?
increase in pee vol. (diuresis)
tubular function impared
azotemia
What is the post-oliguric phase of Acute Tubular Necrosis?
in recovery 2-10 dyas and full recover takes 1 year until BUN and creatine levels normalizes
What is the progression of Chronic Kidney Disease?
CKD
CRF
ESRD
What is Chronic Kidney Disease linked to? (comorbidities)
hypertension
diabetes mellitus
What defines Chronic Kidney Disease?
decreased kidney function or damage of three month’s duration OR
GFR is less thatn 60ml/minute/1.73 mL
def of Chronic Kidney Disease
loss of functional nephrons
Progression of Chronic Kidney Disease
progressive and irreversible
what happens with the GFR of Chronic Kidney Disease?
GFR reduction of 75%-80%
what are the five stages of Chronic Kidney Disease?
1&2 minimizing risk factors
3- symptoms appear; maybe need treatment
4: plan/start dialysis/treatment
5: transplant needed and dialysis
complication of Chronic Kidney Disease
Hypertension and CVD (hypervolemia, raised RAAS and SNS)
Uremic syndrome (impaired healing, pruitus, uremic frost, dermatitis
Metabolic acidosis (hypercalemia, and inability to secrete H+ ions)
Malnutrition
Electrolyte imbalance (retained K, phosphorus, Mg)
Anemia
Pain and depression
Bone and mineral disorders (PTH elevated)
how to prevent acute kidney injury
maintain fluid volume and CO
avoid and monitor nephrotoxic chemicals
treat infections
remove catheters ASAP
NO dopamine
no contrast media complications
hemodialysis access frequency
arteriovenou fisutula
3x/week, four hours long
Continuous renal replacement therapy
hemofiltration uninterupted, ususally IC patients
peritoneal access/frequency
SAPD and CCPD everyday
What leads to acute tubular necrosis
ischemia
Anemia in Chronic Kidney Disease
lack of erythropoetin
uremia shortens RBC’s
HF
Osteodystrophy in Chronic Kidney Disease
elevated phophorus and PTH causes more bone breaking, but kidnesy can reabsorb all Ca+ and deficient in Vit D
What is the most frequent and initial symptom of bladder cancer?
hematuria
What is a cause of recurrent cystitis
vesicoureteral reflux
What is Vesicoureteral reflux?
reflux of pee from bladder to ureter and renal pelvis
Vesicoureteral reflux s/s
recurrent UTU
voiding dysf
renal insufficiency
pediatric hypertension
Physiology of Micturition coordination
internal sphincter and contraction of bladder controlled by pontine micturition center
cerebral cortex inhibits process of conscious control of external sphincter
What nerve innervate the bladder?
L1&L2
What are the nerves for bladder contraction and relaxation?
S2-S4
Ureterocele is defined as
cystic dilation at the distal end of ureter
Ureterocele results in
uretural and renal calyx dilation
reflux and infection
hydronephrosis
What is hydronephrosis swelling and caused by?
kidney swelling from urine
Treatment for Ureterocele
surgery
What is the cause of Ureterocele?
congenital
how common is bladder cncer?
fourth in males and ninth in females
What increases the risk of bladder cancer?
age, smoking, carcinogen exposure
Where does bladder cancer originate?
transitional epitnelium (urothelium- urinary tract lining)
s/s of bladder cancer
hematuria, frequency and urgency and painless hematuria
Urethritis causes
STD or frequent catheterization
poor hygiene
urethritis s/s
dysuria, burning and incontinence
causes of Cystitis
infection, chemical irritants, stones, trauma
what is the bacteria responsible for most UTI’s
E. coli
Cystitis s/s
f/u
dysuria
cloudy pee
kids- fever, irritability, poor feeing, vomiting, diarrhea, ill looking
older adults- lethargy, anorexia, confusion and anxiety
Cryptorchidism is a risk for what kind of cancer
Testicular cancer 
testicular torsion looks like what?
twizzlers
Testicular Torsion occurs in what type of people?
prepubertal males
Testicular Torsion s/s
severe sudden pain in one testis
scrotum swelling
nausea and vomiting
Benign Prostatic Hyperplasia (BPH) etiology
unknown, but probably aging male hormone system
Benign Prostatic Hyperplasia (BPH) pathology
if prostate tissue increases, in compresses urethra and bladder outlet
Benign Prostatic Hyperplasia (BPH) s/s
hold pee
obstruction for flow and stream
hesitancy (initiation
interruption
infection from retention
Benign Prostatic Hyperplasia (BPH) tratment
alpha blockers or 5-alpha reductase inhibitors
What bacteria is associated with Prostatitis?
E. coli
What is the most prevalent form of cancer in men?
Prostate Cancer
how many stages of Prostate Cancer
four
Amenorrhea
Absence or suppression of menstruation
Amenorrhea causes
hormonal shifts
stress
neoplasms
Metrorrhagia
Bleeding between menstrual periods from endometrium during ovulation
Metrorrhagia causes
uterine malignancy
cervical erosions
endometrial polyps
Hypomenorrhea
Deficient amount of menstrual flow; reduced flow
Hypomenorrhea is caused by 
Endocrine or systemic problems. Also menstrual flow block. 
Oligomenorrhea
Infrequent menstruation
Oligomenorrhea causes
Endocrine/systemic disorder causing failure to ovulate
Polymenorrhea
Increased frequency of menstruation
Polymenorrhea causes
Endocrine/systemic disorder causing ovulation
Menorrhagia
Increase in amount or duration of bleeding; prolonged and heavy bleeding
Menorrhagia causes
Lesions of reproductive organs
Dysfunctional uterine bleeding
causes
Most common around time of menarche and menopause
Dysfunctional uterine bleeding
what is it?
Abnormal endometrial bleeding not associated with tumor, inflammation, pregnancy, trauma, or hormonal effects
Dysmenorrhea primary
Painful menstruation
Dysmenorrhea secondary associated with
Associated with pelvic disorders such as endometriosis or pelvic adhesions
Uterine Prolapse
sinking of the uterus from its normal position into the vagina;
relaxation of pelvic structures and the cervix
Uterine Prolapse
causes
Congenital defects
Pregnancy
Childbirth
Uterine Prolapse
how many degrees
3
s/s of Uterine Prolapse
Depend on severity of prolapse
Sensation of fullness, vaginal discomfort
Discomfort in walking/sitting
Difficulty urinating
Bleeding/ulceration
Ulceration of cervix from friction
Uterine Prolapse treatment
Hysterectomy
Pessary (device to support bladder, vagina, uterus, rectum, etc)
Pelvic Inflammatory Disease
Types
Salpingitis
Cervicitis
Oophoritis
Parametritis
Endometritis
Pelvic Inflammatory Disease
bacterial causes
Neisseria gonorrhoeae
Chlamydia trachomatis
Pelvic Inflammatory Disease
Abdominal tenderness/pain
Cervical/adnexa pain or tenderness on palpation
Fever; elevated WBC count
Purulent vaginal discharge
Vulvovaginitis bacterias
Candida albicans
Bartholinitis
cysts and inflammation at the vaginal opening
Uterine Leiomyomas aka
myomas of fibrids
Uterine Leiomyomas causes
high estrogen and growth hormone levels
Uterine Leiomyomas definition
fibroids off of uterus
Uterine Leiomyomas s/s
bleading
discharge
pain and pressure
constipation
f/u
Endometriosis affects who
nulliparous women younger than 30-40
Endometriosis definition
enodmetrial tissue outside of uterine cavity lining in ovary, peritoneum, oviduct, outer layers of uterus
intestine
Endometriosis transplantation theories
transportation
metaplasia
induction
Endometriosis causes
ectopic tissues get implanted incorrecty and rupture and bleed
rupture and irritate peritoneum
Stress incontinence is caused by
weakening of or damage to muscles
Urge incontinence is caused by
overactivity or contraction of detrusor muscles
