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Renal > When good beans go bad > Flashcards

When good beans go bad Flashcards

1
Q

renal roles (3)

A
  1. filtration 2. reabsorption 3. secretion
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2
Q

how much blood is filtered/ minute

A

1 L

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3
Q

kidneys activate __________ to __________

A

vitamin D to 1,25-dihydroxy-vitamin D

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4
Q

RBC production stimulated by

A

erythropoietin released by kidneys

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5
Q

renal artery is at what level

A

L1-L2

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6
Q

renal lymph vessels drain into?

A

lumbar lymph nodes

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7
Q

renal nerve plexus arising from T11-T12 possesses (3)

A
  1. sympathetic
  2. parasympathetic
  3. visceral afferent fibers
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8
Q

low birth weight adults may have as few as _________ nephrons/kidney. Normal is __________

A

250K

-1 Mil (^ surface area)

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9
Q

2 types of nephrons

A
  1. cortical
  2. juxtamedullary
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10
Q

Majority of nephrons are ________, short loop of Henle. Most glomerular filtration done by these nephrones.

A

cortical nephrons

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11
Q

Glomeruli located at border of cortex and outer medulla–long Loops of Henle. Focus on urine concetnratration.

A

Juxtamedullary nephrons

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12
Q

when kidney is injured, other kidney will

A
  1. enlarge
  2. ^ GFR
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13
Q

ESRD

A

end stage renal disease

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14
Q

there is a “________ _____” where primary nephron loss leads to maladaptive deterioration which is why you as a PA want to help your pts protect their kidneys.

A

“tipping point”

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15
Q

one of the highest vaso-constrictors in the body

A

angiotensin II

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16
Q

UTI presentation (3)

A
  1. frequency
  2. urgency
  3. burning
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17
Q

Classic differentiation btwn UTI and pyelonephritis

A

no fever vs. febrile

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18
Q

CVAT

A

Costro-vertebral angle tenderness

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19
Q

w/ pyelonephritis you’ll see ______ and ____ ______ vs. UTI

A

proteinuria and WBC casts

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20
Q

high nitrogenous waste in urine

A

azotemia

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21
Q

UTI aka should be considered complicated if found in

A

cystitis, urethritis–men, pregnant women, and children

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22
Q

those at risk for UTI

A

Diabetic, foley, pregnancy, immuno comprimissed

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23
Q

UTI most likely bug

A

85% E. coli

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24
Q

normal urine pH

A

acidic

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25
Q

signs and symptoms of UTI (6)

A
  1. burning
  2. frequency
  3. urgency
  4. blood
  5. dysuria
  6. suprapubic abd pain
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26
Q

A Chem-strip 9 is not a full

A

urinalysis

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27
Q

_______ every UTI

A

culture

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28
Q

____ day course adequate for most uncomplicated UTI cases

A

3

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29
Q

___, ____, or ____ day course for complicated cases

A

7, 10, 14

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30
Q

^ nighttime urination

A

nocturia

31
Q

interstitial cystitis is a dx of ______

A

exclusion–pain on distention of bladder

32
Q

UTI appearance in older middle aged women w/ negative chem strip/ culture–pain on bladder distention and relief on voiding

A

interstitial cystitis–triggered by anticholinergics

33
Q

acute pyelonephritis aka ^ due to

A

upper UTI, E. coli (95%)

34
Q

PE of acute pyelonephritis

A
  1. look sick
  2. flank pain
35
Q

infection of kidney–contrasted w/ non-infectious AKI

A

acute pyelonephritis

36
Q

febrial patient sicker than UTI w/ flank pain

A

acute pyelonephritis

37
Q

small kidneys associated w/

A

Chronic kidney disease

38
Q

Renal ultrasound can show (4)f

A
  1. # of kidneys
  2. size
  3. hydronephritis?
  4. renal cysts?
39
Q

hydronephritis suggests

A

obstruction

40
Q

hematuria can be from (3)

A
  1. infection
  2. inflammation
  3. malignancy–anywhere along urinary tract
41
Q

Prerenal causes of AKI (3)

A
  1. volume depletion
  2. low BP
  3. renal hemodynamci changes
42
Q

Intrinsic renal causes of AKI (3)

A
  1. vascular
  2. glomerular
  3. tubular
43
Q

Postrenal causes of AKI (2)

A
  1. mechanical obstruction
  2. neurogenic bladder (lack of bladder control due to brain, SC, or nerve condition)
44
Q

full urine work/up (6)

A
  1. electrolytes
  2. Ca++
  3. Phosphorus
  4. creatinine
  5. BUN
  6. albumin
45
Q

oliguria

A

>300-500 cc urine

46
Q

KUB

A

kidney, uriter, bladder X-ray

47
Q

make-up of stone will effect

A

pH

48
Q

GROSS hematuria associated w/ (3)

A
  1. stones
  2. acute glomerulonepritis
  3. tumor
49
Q

OCCULT hematuria (not visible to naked eye) caused by

A
  1. benign prostatic hyperplasia BPH
  2. bladder or urethral infection
50
Q

AKI is a _______ _________, decline in renal function leading to build-up of _________ _________

A

Potentially reversible,

nitrogenous waste

51
Q

most commone form of acute kidney injury

A

acute tubular necrosis (intrinsic)

52
Q

major causes of Acute Tubular Necrosis

A
  1. ischemia
  2. tonxins (NSAIDS, contrasts, etc.)
53
Q

WBC casts associated w/ tubulointerstitial disease such as

A
  1. pyelonephritis
  2. acute interstitial nephritis
54
Q

nearly 100% of intrinsic AKI will be (2)

A
  1. Acute tubular necrosis 85%
  2. acute interstitial nephritis 10-15%
55
Q

unique to acute interstitial nephritis

A

eosinophils in UA sediment

56
Q

urea in the blood

A

uremia

57
Q

nausea, FLANK/BACK PAIN

A

polycystic kidney disease

58
Q

+large palpable kidneys, HTN, Abdominal mass, and +FH (75%)

A

poylcystic kidney disease (dz w/ H&P and US then CT)

59
Q

be careful of using constrast in __________

A

diabetics

60
Q

____% of renal cell carcinoma pt’s have hematuria

A

60%

61
Q

Tx of renal cell carcinoma

A
  1. radical vs. partial nephrectomy
  2. chemo no effective
62
Q

w/ renal cell carcinoma– check liver function looking for

A

metastisis

63
Q

RAS

A

renal artery stenosis

64
Q

renal artery stenosis etiologies (3)

A
  1. atherosclerosis (85%)
  2. fibromuscular dysplasia (15%)
  3. HTN (5%)
65
Q

glycoprotein that controls RBC production

A

erythropoietin

66
Q

a disease or symptom due to the presense of cancer in the body–not a form of mass effect

A

paraneoplastic syndrome

67
Q

unexplained HTN in under 40 yo woman think

A

fibromuscular dysplasia

68
Q

S and Sx of renal artery stenosis (5)

A
  1. refractory HTN
  2. new HTN onset in older pt
  3. Pulm edema
  4. AKI after initiating ACEI
  5. ABDOMINAL BRUIT
69
Q

gold standard for renal artery stenosis

A

renal andiogram

70
Q

renal disfunction w/ finding of hematuia, proteinuria, edem, HTN, oliguria, azotemia, renal failure – along spectrum of nephritic / nephrotic

A

glomerulonephritis aka GN

71
Q

^ proteinuria >3g/24hr, HYPOalbuminemia <3g/dl, Edema think

A

nephrOTIC syndrome

72
Q

Hematuria, RBC CASTS, Proteinuria .3-3 g/d think

A

NephrITIC syndrome

73
Q

Disorders manifesting hematuria on nephritic side

A
  1. post-infectious GN
  2. IgA nephropathy
  3. Good Pastures Syndrome
  4. Lupus
  5. Hep C
74
Q
A

Renal (5 decks)

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