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Phys > Week 6 > Flashcards

Week 6 Flashcards

1
Q

signs and symptoms of ureteral (kidney) stones

A

intense renal colic pain abrupt in onset and may radiate
hematuria
sweating

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2
Q

kidney stone causes

A

solute supersaturation
low urine volume
abnormal urine pH

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3
Q

What are kidney stones made of?

A

calcium crystal aggregates of organic and inorganic material, uric acid, struvite, cystine, etc

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4
Q

What is the cause of Polycystic Kidney disease?

A

Genetic

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5
Q

S/S of Polycystic Kidney disease

A

evident at birth
big kidney
respiratory distress
hypertension

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6
Q

What chromosome is Polycystic Kidney disease affected by?

A

Chromosome 6p, 16 and 4

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7
Q

What causes Polycystic Kidney disease and what does it lead to?

A

lowered Ca+ levels and too much cAMP
creates cysts in the liver

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8
Q

Polycystic Kidney disease clinical manifestation (3)

A

hypertension
can’t concentrate urine
pain

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9
Q

What is the etiologic cause of acute Glomerulonephritis?

A

immune response which attract immune cells to lyse everything in their path

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10
Q

Whtat’s the pathophysiology of acute Glomerulonephritis?

A

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

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11
Q

Clinical manifestations of acute Glomerulonephritis?

A

azotemia
hypertension
oliguria
proteinuria
edema

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12
Q

what happens in post infectious acute Glomerulonephritis?

A

follows impetigo and throat infections,
developing countries usually
common in kids
coffee colored urine

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13
Q

(berger disease) aka?

A

IgA nephropathy

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14
Q

Crescentic Glomerulonephritis

A

RPGN (rapidly progressive Glomerulonephritis)

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15
Q

Causes of Crescentic Glomerulonephritis?

A

drugs exposure

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16
Q

hallmark of Crescentic Glomerulonephritis?

A

crescent shaped lesions

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17
Q

what happens to the blood in acute onset of crescentic Glomerulonephritis?

A

hematuria
proteinuria
red cell cases
decline in renal function w/in 6 mos

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18
Q

Progress of chronic Glomerulonephritis?

A

sclerosis and kidney fibrosis progresses into end-stage renal disease

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19
Q

What does uric acid crystals of kidney stones mean?

A

gouty arthritis

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20
Q

From what area is the most common type of pyelonephritis?

A

ascending infection from lower UT

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21
Q

What is the most effective way to prevent pyelonephritis?

A

take catheters out early

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22
Q

What is acute pyelonephritis caused by?

A

uti cases infection of renal pelvis

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23
Q

What is a risk factor for pyelonephritis ?

A

pregnancy

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24
Q

S/S for acute pyelonephritis?

A

CVA tenderness
fever/chills
anorexia
fever-induced dehydration
urosepsis- organism in the b/s from UTI

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25
Q

what infection does the presence of WBC casts mean?

A

upper UTI

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26
Q

Difference between acute and chronic pyelonephritis?

A

acute: UTI infection
chronic: reflux or obstructive leads to scarring

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27
Q

what can chronic pyelonephritis turn into?

A

CKD

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28
Q

what happens with inflammation from chronic pyelonephritis ?

A

scarring and loss of functional nephrons

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29
Q

S/S of pyelonephritis?

A

abdominal/flank pain,
fever, malaise,
anorexia

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30
Q

What are the most common obstructions for the UG tract?

A

stones
tumors
prostatic hypertrophy
strictures

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31
Q

What are some characteristics of AKI?

A

sudden kidney function loss
disruptions influid/electolytes, pH
retention of nitrogenous waste
increase serum creatinine
decreased GFR

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32
Q

Three sites of Disruption of AKI?

A

renal perfusion (prerenal)
urine flow after kidney (postrenal)
problem with kidney vessels, tubules, glomeruli, or interstitium (intrinsic)

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33
Q

What are some causes of prerenal AKI?

A

Burns, drugs and diretics (ACE inhibitors, angiotensin II blockers, NSAIDS

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34
Q

What are some S/S of prerenal kidney injury?

A

hypovolemia, hypotension, HF,
Renal artery obstruction
fever, vomiting, diarea

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35
Q

prolonged prerenal ARF can lead to what?

A

acute tubular necrosis

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36
Q

Diagnosis of prerenal kidney injury

A

low GFR, oliguria, high urine gravity
osmolality
low urine sodium

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37
Q

What causes post renal kidney injury

A

obstruction with urinary cases Bowman capsule pressure, impeding glomerular filtration

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38
Q

What can prolonged postrrenal ARF lead to?

A

acture tubular necrosis and irreversible kidney damage

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39
Q

What is the most common result with intrinsic KI?

A

acture tubular necrosis

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40
Q

What does acute tubular necrosis cause?

A

Nephrotoxic insult (contrast media)
iscemic insults (sepsis)

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41
Q

What are two pathologies for acute tubular necrosis?

A

vascular and tubular

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42
Q

What happens in vascular intrinsic kidney Injury?

A

decrease in renal blood flow
hypoxia
vasoconstriction

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43
Q

What happens in tubular intrinsic kidney Injury? Pathophysiology

A

inflammation and reperfusion injury causing cases, obstructing urine flow, tubular backleak

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44
Q

What are the three phases of Acute Tubular
Necrosis?

A

prodromal
oliguric
post-oliguric

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45
Q

What are some s/s of prodromal phase of Acute Tubular Necrosis?

A

normal or declining pee output

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46
Q

What are some lab signs of Acute Tubular Necrosis?

A

serum BUN and creatine increase

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47
Q

What characterizes the oliguric phase of Acute Tubular Necrosis?

A

usual urine
oliguria (less)and uremia (protein)
decreased GFR
hyperkalemia

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48
Q

Does the oliguric phase of Acute Tubular Necrosis need dialysis?

A

sometimes

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49
Q

What are s/s of post-oliguric phase of Acute Tubular Necrosis?

A

increase in pee vol. (diuresis)
tubular function impared
azotemia

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50
Q

What is the post-oliguric phase of Acute Tubular Necrosis?

A

in recovery 2-10 dyas and full recover takes 1 year until BUN and creatine levels normalizes

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51
Q

What is the progression of Chronic Kidney Disease?

A

CKD
CRF
ESRD

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52
Q

What is Chronic Kidney Disease linked to? (comorbidities)

A

hypertension
diabetes mellitus

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53
Q

What defines Chronic Kidney Disease?

A

decreased kidney function or damage of three month’s duration OR
GFR is less thatn 60ml/minute/1.73 mL

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54
Q

def of Chronic Kidney Disease

A

loss of functional nephrons

55
Q

Progression of Chronic Kidney Disease

A

progressive and irreversible

56
Q

what happens with the GFR of Chronic Kidney Disease?

A

GFR reduction of 75%-80%

57
Q

what are the five stages of Chronic Kidney Disease?

A

1&2 minimizing risk factors
3- symptoms appear; maybe need treatment
4: plan/start dialysis/treatment
5: transplant needed and dialysis

58
Q

complication of Chronic Kidney Disease

A

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)

59
Q

how to prevent acute kidney injury

A

maintain fluid volume and CO
avoid and monitor nephrotoxic chemicals
treat infections
remove catheters ASAP
NO dopamine
no contrast media complications

60
Q

hemodialysis access frequency

A

arteriovenou fisutula
3x/week, four hours long

61
Q

Continuous renal replacement therapy

A

hemofiltration uninterupted, ususally IC patients

62
Q

peritoneal access/frequency

A

SAPD and CCPD everyday

63
Q

What leads to acute tubular necrosis

A

ischemia

64
Q

Anemia in Chronic Kidney Disease

A

lack of erythropoetin
uremia shortens RBC’s
HF

65
Q

Osteodystrophy in Chronic Kidney Disease

A

elevated phophorus and PTH causes more bone breaking, but kidnesy can reabsorb all Ca+ and deficient in Vit D

66
Q

What is the most frequent and initial symptom of bladder cancer?

A

hematuria

67
Q

What is a cause of recurrent cystitis

A

vesicoureteral reflux

68
Q

What is Vesicoureteral reflux?

A

reflux of pee from bladder to ureter and renal pelvis

69
Q

Vesicoureteral reflux s/s

A

recurrent UTU
voiding dysf
renal insufficiency
pediatric hypertension

70
Q

Physiology of Micturition coordination

A

internal sphincter and contraction of bladder controlled by pontine micturition center
cerebral cortex inhibits process of conscious control of external sphincter

71
Q

What nerve innervate the bladder?

A

L1&L2

72
Q

What are the nerves for bladder contraction and relaxation?

A

S2-S4

73
Q

Ureterocele is defined as

A

cystic dilation at the distal end of ureter

74
Q

Ureterocele results in

A

uretural and renal calyx dilation
reflux and infection
hydronephrosis

75
Q

What is hydronephrosis swelling and caused by?

A

kidney swelling from urine

76
Q

Treatment for Ureterocele

A

surgery

77
Q

What is the cause of Ureterocele?

A

congenital

78
Q

how common is bladder cncer?

A

fourth in males and ninth in females

79
Q

What increases the risk of bladder cancer?

A

age, smoking, carcinogen exposure

80
Q

Where does bladder cancer originate?

A

transitional epitnelium (urothelium- urinary tract lining)

81
Q

s/s of bladder cancer

A

hematuria, frequency and urgency and painless hematuria

82
Q

Urethritis causes

A

STD or frequent catheterization
poor hygiene

83
Q

urethritis s/s

A

dysuria, burning and incontinence

84
Q

causes of Cystitis

A

infection, chemical irritants, stones, trauma

85
Q

what is the bacteria responsible for most UTI’s

A

E. coli

86
Q

Cystitis s/s

A

f/u
dysuria
cloudy pee
kids- fever, irritability, poor feeing, vomiting, diarrhea, ill looking
older adults- lethargy, anorexia, confusion and anxiety

87
Q

Cryptorchidism is a risk for what kind of cancer

A

Testicular cancer 

88
Q

testicular torsion looks like what?

A

twizzlers

89
Q

Testicular Torsion occurs in what type of people?

A

prepubertal males

90
Q

Testicular Torsion s/s

A

severe sudden pain in one testis
scrotum swelling
nausea and vomiting

91
Q

Benign Prostatic Hyperplasia (BPH) etiology

A

unknown, but probably aging male hormone system

92
Q

Benign Prostatic Hyperplasia (BPH) pathology

A

if prostate tissue increases, in compresses urethra and bladder outlet

93
Q

Benign Prostatic Hyperplasia (BPH) s/s

A

hold pee
obstruction for flow and stream
hesitancy (initiation
interruption
infection from retention

94
Q

Benign Prostatic Hyperplasia (BPH) tratment

A

alpha blockers or 5-alpha reductase inhibitors

95
Q

What bacteria is associated with Prostatitis?

A

E. coli

96
Q

What is the most prevalent form of cancer in men?

A

Prostate Cancer

97
Q

how many stages of Prostate Cancer

A

four

98
Q

Amenorrhea

A

Absence or suppression of menstruation

99
Q

Amenorrhea causes

A

hormonal shifts
stress
neoplasms

100
Q

Metrorrhagia

A

Bleeding between menstrual periods from endometrium during ovulation

101
Q

Metrorrhagia causes

A

uterine malignancy
cervical erosions
endometrial polyps

102
Q

Hypomenorrhea

A

Deficient amount of menstrual flow; reduced flow

103
Q

Hypomenorrhea is caused by 

A

Endocrine or systemic problems. Also menstrual flow block. 

104
Q

Oligomenorrhea

A

Infrequent menstruation

105
Q

Oligomenorrhea causes

A

Endocrine/systemic disorder causing failure to ovulate

106
Q

Polymenorrhea

A

Increased frequency of menstruation

107
Q

Polymenorrhea causes

A

Endocrine/systemic disorder causing ovulation

108
Q

Menorrhagia

A

Increase in amount or duration of bleeding; prolonged and heavy bleeding

109
Q

Menorrhagia causes

A

Lesions of reproductive organs

110
Q

Dysfunctional uterine bleeding
causes

A

Most common around time of menarche and menopause

111
Q

Dysfunctional uterine bleeding
what is it?

A

Abnormal endometrial bleeding not associated with tumor, inflammation, pregnancy, trauma, or hormonal effects

112
Q

Dysmenorrhea primary

A

Painful menstruation

113
Q

Dysmenorrhea secondary associated with

A

Associated with pelvic disorders such as endometriosis or pelvic adhesions

114
Q

Uterine Prolapse

A

sinking of the uterus from its normal position into the vagina;
relaxation of pelvic structures and the cervix

115
Q

Uterine Prolapse
causes

A

Congenital defects
Pregnancy
Childbirth

116
Q

Uterine Prolapse
how many degrees

A

3

117
Q

s/s of Uterine Prolapse

A

Depend on severity of prolapse
Sensation of fullness, vaginal discomfort
Discomfort in walking/sitting
Difficulty urinating
Bleeding/ulceration
Ulceration of cervix from friction

118
Q

Uterine Prolapse treatment

A

Hysterectomy
Pessary (device to support bladder, vagina, uterus, rectum, etc)

119
Q

Pelvic Inflammatory Disease
Types

A

Salpingitis
Cervicitis
Oophoritis
Parametritis
Endometritis

120
Q

Pelvic Inflammatory Disease
bacterial causes

A

Neisseria gonorrhoeae
Chlamydia trachomatis

121
Q

Pelvic Inflammatory Disease

A

Abdominal tenderness/pain
Cervical/adnexa pain or tenderness on palpation
Fever; elevated WBC count
Purulent vaginal discharge

122
Q

Vulvovaginitis bacterias

A

Candida albicans

123
Q

Bartholinitis

A

cysts and inflammation at the vaginal opening

124
Q

Uterine Leiomyomas aka

A

myomas of fibrids

125
Q

Uterine Leiomyomas causes

A

high estrogen and growth hormone levels

126
Q

Uterine Leiomyomas definition

A

fibroids off of uterus

127
Q

Uterine Leiomyomas s/s

A

bleading
discharge
pain and pressure
constipation
f/u

128
Q

Endometriosis affects who

A

nulliparous women younger than 30-40

129
Q

Endometriosis definition

A

enodmetrial tissue outside of uterine cavity lining in ovary, peritoneum, oviduct, outer layers of uterus
intestine

130
Q

Endometriosis transplantation theories

A

transportation
metaplasia
induction

131
Q

Endometriosis causes

A

ectopic tissues get implanted incorrecty and rupture and bleed
rupture and irritate peritoneum

132
Q

Stress incontinence is caused by

A

weakening of or damage to muscles

133
Q

Urge incontinence is caused by

A

overactivity or contraction of detrusor muscles

Phys (5 decks)

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