GU system patho

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marshenski
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208588
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GU system patho
Updated:
2013-03-20 18:11:11
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Boston College CRNA patho
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Boston College CRNA patho
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  1. What are the three processes that the nephron carries out?
    • Glomerular fitration
    • tubular reabsorption
    • tubular secretion
  2. What is the normal GFR?
    125 ml/min
  3. What is the normal specific gravity for urine?
    1.010 - 1.025
  4. What is the normal urine output per hour?
    60 ml/hr
  5. What conditions have high specific gravity?
    • dehydration
    • SIADH, too much ADH
    • Dye injected for surgery
  6. What is specific gravity?
    the solute concentration of the urine
  7. What are some examples of decreased specific gravity?
    DI
  8. Why does creatinine reflect the GFR?
    Because creatine is freely filtered in the glomeruli
  9. What is the normal creatine level?
    115 - 125
  10. How could you estimate the functional capacity of the kidneys?
    • serum creatinine can give you an estimate of kidney function
    • Levels wont show until damage has already been done
  11. Where does the BUN come from?
    the liver
  12. What will raise the levels of BUN?
    • protein digestion
    • GI bleeding
  13. What is the normal BUN:creatinine ration?
    10:1
  14. Is BUN specific to renal failure?
    Not Really
  15. What is the benefit of the kidney injury molecule marker?
    It will show kidney damage earlier
  16. What is the function of the kidney?
    maintain a stable environment for optimal cell and tissue metabolism
  17. What endocrine functions does the kidney carry out?
    • Activate Vit-D
    • Secrete erythropoetin
    • control of blood pressure- see slide for specifics
    • regulate the commonality of the extracellular fluid
  18. Where is ADH secreted from?
    the posterior pituitary gland
  19. What are some patho processes related to kidney failure?
    • fluid volume excess
    • electrolyte and acid base balance abnormalities
    • accumulated nitrogenous wastes
    • hormonal inadequacies
  20. What is Acute renal failure?
    • hours to days - clears up in 3 weeks
    • about half of the nephrons not working
    • can become chronic
  21. What is chronic renal failure?
    • months to years
    • 90-95% of nephrons irreversibly damaged
    • requires renal replacement therapy
  22. What is the most common type of ARF
    prerenal
  23. What is the most common type of intrarenal ARF?
    ATN
  24. What causes ATN?
    Direct damage to the tubule will precipitate in downstream obstruction causes pressure to build in the tubule. The pressure can cause damage to the tubule and necrosis follows
  25. What are the three phases of ATN?
    • Onset
    • Maintenance phase
    • recovery phase
  26. What is the treatment for ARF?
    • Identify and treat the underlying process
    • Minimizing infection
    • proper nutrition
    • fluid restriction
    • dialysis
  27. What is CKD?
    • permanent loss of nephrons
    • GFR less than 60 ml/min for three months or longer
  28. What are the five stages of CKD see slide
  29. See slide # 23 for manifestations of CKD
  30. What is nephrotic syndrome?
    An increased in glomerular permeability that results in a loss of plasma proteins in the urine
  31. What are some characteristics of Nephrotic syndrome?
    • proteinuria
    • hypoalbuniemia
    • hyperlipidemia
    • generalized edema
  32. What is Glomerular nephritis?
    Damage caused by antigen antibody complexes, causes direct golmerular injury
  33. What are some common characteristics of acute GN?
    • Group A poststreptococcol
    • 7-10 days throut, skin infection
    • 10-21 days following infection
    • - hematuria, protienura, see the slide
  34. What are some common characteristics of Chronic GN?
  35. What is the treatment of CKD?
    • Should compliment the original precipitating event
    • -lower BP
    • -stop smoking
    • treat urinary tract infections
    • Dialysis
  36. What are the advantages of hemodialysis?
    • More efficient
    • shorter time needed
  37. What are some disadvantages of hemodialysis?
    • Disequalibrium syndrome
    • muscle cramps
    • hemorrhage
    • air embolus
    • hemodynamic instability
  38. What are some advantages of perotineal dyalisis?
    • Easy access
    • Few hemodynamic complications
  39. What are the complications of PD?
    • Protein loss
    • peritonitis
    • hyperglycemia
    • respiratory distress
    • bowel perf
  40. What is Hyperacute rejection?
    onset within 48 hrs
  41. What are the clinical manifestations of hyperacute rejections?
    • Increased temp
    • BP
    • pain
  42. What is the treatment of Hyperacute rejections?
    immediate removal of transplanted kidney.
  43. What is acute re
    rejection occuring during the first sveral months
  44. What are the clinical manifestations of acute
    • oliguria or anuria
    • increased temperature
    • increased BP
    • elarged, tender kidney
  45. What is chronic rejection?
    Occurs over months to years
  46. What is spastic bladder dysfuntion?
  47. What is the most common type of renal CA?
    renal cell carcinoma
  48. What is a manifestation of bladder carcinoma?
    bloody unire
  49. What do we call lower UTI?
    cystitis
  50. What do we call upper UTI?
    pylonephritis
  51. What does obstruction cause?

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