Kidney part 2

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Author:
ambirc
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170754
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Kidney part 2
Updated:
2012-09-18 12:58:38
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Kidney part
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second half of the kidney chapter
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  1. What is Pyelitis
    • - Inflamation of the renal pelvis, the outher basin-like portion of the kidney at the attachment of the ureter
    •  -Common in young childern escpecially girls due to the shorter urethra that in boys
    •  - untreated, infection may spread to kidney tissue leading to  pyelonephritis
  2. What are the causes of pyelitis
    • - Caused by pyogenic (pus forming) Bacteria
    •     - bacteria may orginate from a unrinary bladder infection or blood
    •     - or from fecal contamination and travel up the urethra to urinary bladder then up the uretea or to the renal pelvis
  3. Pyelitis - Symptom
    Dysuria
  4. Treatments of Pyelitis
    Antibotics
  5. What is Pyelonephritis
    Bacterial infection of the kidney and the renal pelvis
  6. What causes Pyelonephritis
    • Caused by pyrogenic (pus forming) bacteria
    • leads to the obstruction of the unrinary tract slows urine flow which increased risk of infection
  7. Causes of obstruction of Pyelonephritis
    • 1 - cogenital defect
    • 2- kidney stone
    • 3-Enlarged prostate gland
  8. Consequences of Pyelonephritis include
    • 1- abscesses from and rupture, draining pus into the renal pelvis and urine
    • 2 - Abscesses can fuse and fill the entire kidney with pus
    • 3-left untreated, may lead to renal failure and uremia
    • 4-Kidneys shrink, describeed as granular contracted kidney
  9. Pyelonephritis
    • Bacterial infection of the kidney and renal pelvis
    •  - Leads to obstruction of the unrinary tract slows urine flow which increase risk of infecton
  10. Pyelonephritis- Causes or and Cause of the obstruction
    Caused by Pyogenic (pus-forming) bacteria

    • Causes of obstruction include 
    • - Congential defect
    • -kidney stone
    • -enlarged prostate gland
  11. Pyelonephritis consequences include
    • 1- abscesses form and rupture draining pus into the renal pelvis and wrine
    • 2-abscesses can fuse and fille the entire kidney and wremia
    • 3-kidneys shrink, descibed as granular contracted kidney
  12. Pyelonephritis Diagnoses
    • [1] Urinalysis
    •     [a] Urine turbid or cloudy in appearance
    • [2] Microscopy
    •     [a] Cells and bacteria
  13. Pyelonephritis Symptoms
    • Chills
    • high fever
    • sudden back pain
    • dysuria
  14. Pyelonephritis Treatment
    Antibotics
  15. Kidney stones AKA urinary calculi
    (1) A solid mass made up of tiny crystal

    (2) One or more stones can be in kidneys or ureter at the same time
  16. Four different types or kidney stones
    • [1] Calcium stones- most frequent (~80%)
    • [2] Uric acid stones (~10%)
    • [3] Struvite stones (~10%)
    • [4] Cystine stones- least frequent (~1%)
  17. Calcium stones- 
    • [a] Occurs 4X more often in men that in women
    • [b] Likely to reoccur
    • [c] Causes include
    •    {1} Unexplained hypercalciuria (causes elevated urinary Ca2+)
    •    {2} Hyperparathyroidism (causes excess serum Ca2+)
    •    {3}Sarcoidosis (raises serum Ca2+ levels due to overproduction of vitamin D by sarcoid granuloma)
    •    {4} Cancers
  18. Uric acid stones 
    • [a] More common in men than in women
    • [b] Associated with gout, chemotherapy, or high protein diet
    • [c] Causes urine to become more acidic leading to excess uric acid levels and stone formation
    • [d] Conditions producing acidic urine include dehydration, colon surgery, or high protein diet
  19. Struvite stones 
    • [a] Found in women who have a urinary tract
    • infection
    • [b] Grow very large blocking the kidney, ureter, or
    • urinary bladder
    • [c] Bacterial enzymes increase ammonia urinary
    • concentrations so urine becomes more alkaline triggering stone precipitation
  20. Cystine stones
    • [a] Least common
    • [b] Inherited disorder involving the amino acid
    • cystine (the least soluble of naturally occurring amino acids)
    • [c] Formed in people who have cystinuria
    • [d] Kidneys fail to reabsorb cystine which then
    • crystallizes and precipitates anywhere in the urinary tract
  21. Kidney Stones Symptoms
    Primary symptom

    [1] Severe pain that begins and ends abruptly- Pain in abdomen or side of the back, may move to groin or testicles

    • (c)Other symptoms
    • [1]Abnormal urine color
    • [2] Hematuria
    • [3]Chills
    • [4]Fever
    • [5]Nausea (Pete class)
    • [6] Vomiting
  22. Kidney Stone Causes
    • [1] Dehydration
    • [2] Urinary tract infection by blocking urinary flow permitting bacterial growth in urinary tract
    • [3] Urinary stasis caused by some type of obstruction such as tumors, strictures, or anatomical abnormalities
  23. Kidney Stone - Diagnosis
    • [1]Computed tomography (CT) scans
    • [2]Intravenous pyelogram (IVP)
    • [3]Renal ultrasound/scan
    • [4]KUB (x-ray for examining kidneys-ureters-bladder)
  24. Kidney Stones Treatments
    • 1- Hydration
    • 2-Medications
    •    [a]Allopurinol (for uric acid stones)
    •    [b]Antibiotics (for struvite stones)
    •    [c]Diuretics
    •        {1}Thiazide diuretics plus potassium citrate
    •         {2}Potassium-sparing diuretics
    •      [d]Phosphate solutions (reduces Ca2+
    • release into the bloodstream)

    • [e]
    • Sodium bicarbonate or sodium citrate (makes
    • urine more alkaline)
  25. Kidney Stones Surgery
    • [a] Extracorporeal shockwave lithiotripsy (ESWL)
    • [b] Laser lithotripsy
    • [c] Percutaneous nephrolithotomy (PNL)
    • [d] Ureteroscopic stone removal
    • [e] Open (incisional) surgery
  26. Hydronephrosis
    Swelling of one (unilateral hydronephrosis) or both (bilateral hydronephrosis) kidneys due to a backup of urine
  27. Hydronephrosis
    • (2) Considered a condition, not a disease
    • (a) May result from anatomic or functional processes
    • interrupting the flow of urine
    • (b) Increased ureteral pressure leads to decreased
    • glomerular filtration rate, tubular function, and renal blood flow
    • (c) Brief disruptions in urine flow are limited and
    • reversible
    • (d) Chronic disruptions in urine flow can lead to
    • tubular atrophy and nephron loss
  28. Structural abnormalities contributing to hydronephrosis include
    • [1] Birth defects
    • [2] Ureterocele (swelling at the base of one of the
    • ureters)
    • [3] Ureter prolapse
    • [4] Kidney stones or blood clots in the renal pelvis
    • [5] Compression of the ureter due to fibrous bands,
    • an abnormally located artery or vein, or tumor
  29. Polycystic kidney
    • Kidney cyst that is a dilated renal tubule that does not
    • open into the renal pelvis

    Cysts enlarge, fuse together, and may become infected
  30. Polycystic kidney -Although cause of cyst formation is unknown, possible factors include
    • [1] Congenital defects
    • [2] Autosomal dominant hereditary disease
    •      [a] Symptoms usually begin in middle age
    • [3] Autosomal recessive hereditary disease
    •      [a] Symptoms appear in infancy or early childhood
  31. Polycystic kidney - diagnosis
    • [1] Physical examination
    • [2] Renal ultrasound
    • [3] Computed tomography (CT) scan
    • [4] Intravenous pyelogram (IVP)
  32. Polycystic kidney - Treatments
    • [1] Antihypertensive medications
    • [2] Diuretics
    • [3] Low-salt diet
    • [4] Antibiotics
    • [5] Drainage of cysts
    • [6] Surgical removal of affected kidney
    • [7] Kidney transplantation
  33. Cystitis
    Inflamation of the urinary bladder casue by bacterial infection

    More common in women then men due tothe women shorter urthea
  34. Cystitis- Causes
    • [1] In women, E. coli from colon could enter urethra
    • [2] Sexual intercourse
    • [3] Coughing or exertion squeezes urinary bladder pushing some urine into the urethra then urine reenters urinary bladder
  35. Cystitis -Diagnosis & treatment
    • (c) Diagnosis
    • [1] Microscopic examination reveals
    •     [a] Bacteria
    •     [b] Pus
    •     [c] Casts
    •     [d] Leukocytes
    •  (d) Treatment - Antibiotics
  36. Urinary incontinence
    • Loss of urinary bladder control or the involuntary
    • release of urine
  37. Two types of urinary incontinence
    • 1 -Temporary urinary incontinence
    • 2- Persistent urinary incontinence
  38. Temporary urinary incontinence Causes include
    • [a] Alcohol
    • [b] Overhydration
    • [c] Dehydration
    • [d] Caffeine
    • [e] Urinary bladder irritation
    • [f] Medications
    • [g] Urinary tract infection
    • [h] Constipation
  39. Persistent urinary incontinence - causes include
    • [a] Pregnancy
    • [b] Changes with aging
    • [c] Hysterectomy
    • [d] Painful urinary bladder syndrome (interstitial
    • cystitis)
    • [e] Prostatitis
    • [f] Enlarged prostate
    • [g] Prostate cancer
    • [h] Urinary bladder cancer or urinary bladder stones
    • [i] Neurological disorders
    • [j] Obstruction
  40. Three basic forms of urinary incontinence
    • 1- Overflow incontinence - urinary bladder overfills and urine leask from the urethra
    • 2-Stress incontinence - urethral sphincter is either weakend or damaged allowing leakage of urine following increased abdominal preasure
    • 3-Urge incontinence - Strong sudden need to urinate due to urinary bladder spasms or contractions
  41. urinary incontinence - treatments
    • 1- Behavioral techniques
    • 2- Physical Therapy
    • 3-Medical devices
    • 4-Inerventional therapies
    • 5-Surgery
    • 6-Miscellaneous
  42. urinary incontinence - treatments

    i.e of Behavorial tech
    [1] Urinary bladder training

    [2] Scheduled toilet trips

    [3] Fluid and diet management
  43. urinary incontinence - treatments
    i.e Physical Therapy
    [1] Pelvic floor muscle exercises

    [2] Electrical stimulation
  44. urinary incontinence - treatments
    i.e. Medications
    [1] Anticholinergics

    [2] Topical estrogen

    [3] Antidepressant
  45. urinary incontinence - treatments
    i.e Medical Devices
    [1] Urethral inserts

    [2] Pessary
  46. urinary incontinence - treatments
    i.e Intervention Therapies
    [1] Radiofrequency therapy

    [2] Botulinum toxin type A

    [3] Bulking material injections

    [4] Sacral nerve stimulator
  47. urinary incontinence - treatments
    i.e Surgery
    [1] Artificial urinary sphincter

    [2] Sling procedures

    [3] Urinary bladder neck suspension
  48. urinary incontinence - treatments
    i.e MISC
    [1] Absorbent pads and protective garments

    [2] Catheters

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