Renal

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Author:
servinggod247
ID:
286305
Filename:
Renal
Updated:
2014-10-19 19:43:22
Tags:
pathophysiology
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pathophysiology
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pathophysiology
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  1. What is BUN
    measures the concentration of urea in the blood.
  2. BUN rises in what disorders?
    • dehydration
    • ARF
    • CRF
  3. BUN value
    10-20 mg/DL
  4. Serum creatinine level
    0.7-1.2 mg/dL
  5. Serum creatinine is a byproduct of
    muscle metabolism
  6. _________________ levels are constant and proportional to muscle mass
    serum creatinine
  7. when creatinine rises in plasm, _____ decreasing
    • GFR
    • if doubled, renal function probably 1/2 normal
  8. Urinalysis abnormals
    • RBCs 
    • more than a few WBCs
    • bacteria 
    • protein
    • glucose
    • ketones
  9. Obstructive uropathy is what
    anatomical or functional defect causing blockage
  10. Hydroureter
    complete obstruction of upper urinary tract, dilates ureter
  11. Hydronephrosis
    dilation of renal pelvis and calyces
  12. Tubulointerstitial fibrosis
    collagen and proteins deposited in kidney
  13. All forms of obstructive uropathy predispose to __________ because ____________________
    hypertension 

    renin cascade is activated
  14. Compensatory hypertrophy and hyperfunction causes
    unobstructed kidney to increase size of individiual glomeruli and tubules not total number of nephrons
  15. what percent of stones are composed of Ca+
    70-80%
  16. Struvite stones contain __________ and are caused by __________. More prominent in what gender?
    Mg+, NH3, PO4

    bacteria

    females
  17. Uric acid stones are seen in combination with what disorder?
    gout
  18. pain in groin from renal calculi if located in
    • renal pelvis
    • proximal ureter
  19. pain in lower abdomen if renal calculi located in
    mid ureter
  20. urgency or incontinent if renal calculi located in
    lower ureter
  21. incendence of renal calculi increases in males after age
    40
  22. Symptoms of renal calculi
    • N/V
    • Pain radiates in flank area
    • sharp, sudden, sever pain (may be intermitent)
    • hematuria
  23. Risk factors-etiology of kideny stones
    • infection
    • urinary stasis
    • immobility
    • hypercalcemia
    • high uric acid
    • high urinary oxalate level
  24. diagnosis for kidney stones
    • UA
    • Cystoscopy
    • IVD
    • Renal stone analysis
    • KUB (x-ray)
    • Serum calcium 
    • Serum oxalate
    • Serum uric acid
  25. neurogenic bladder disrupts nml bladder filling/emptying is what?
    Lower urinary tract obstruction
  26. Lower urinary tract obstruciton caused by
    interruptionof nerve supply to bladder
  27. Lower urinary tract obstruction types
    • Retention or incompetence
    • Overactive bladder syndrome
    • urethral strictures
    • prostatic enlargement in men
    • pelvic organ prolapse in women
  28. Overactive bladder syndrome
    detrusor overactivity causes urgency, renention, stress incontinence
  29. renal adenomas
    • uncommon 
    • may become malignant so surgically removed
  30. renal cell carcinoma is R/T
    most common, usually in men.

    tobacco use, obesity, long-term analgesic uses
  31. renal cell carcinoma is unilateral and spreads to
    • lungs
    • liver
    • bones
  32. bladder tumors related to
    • smoking
    • working in chemical, rubber, textile industries
  33. bladder tumor symptoms
    • may be asymptomatic
    • hematuria
  34. Cystitis is inflammation of the
    bladder
  35. cystitis is what type of infection
    lower tract
  36. Symptoms of cystitis
    • low back/suprapubic pain
    • painful burining on urination
    • frequency 
    • urgency
    • hematuria
    • cloudy urine
  37. cystitis is caused by
    • urinary obstruction
    • prostatitis
    • ascending infection with E. coli
  38. most common cause of UTI
    e coli
  39. pyelonephritis is inflammation of the
    kidney tubules, pelvis, interstitious
  40. pyelonephritis is what type of infection
    upper tract
  41. symptoms of pyelonephritis
    • fever
    • chills
    • backache
    • abd pain
    • N/V
    • urgency
    • frequency 
    • CVA tenderness
    • Hypertension
  42. Pyelonephritis caused by
    inflammation or scarring of tubules, ascending infection with E.coli, fungi or viruses, obstruction that causes urine reflux or residual urine
  43. Glomerulonephritis is what
    glomerular damage caused by immune responses, toxins or drugs, vascular disroders, DM, LE
  44. ______________ begins after antibodies against glomerular basement membrane have localized in glomerular capillarly wall
    glomerulonephritis
  45. glomerulonephritis causes changes in what
    membrane permeability
  46. glomerulonephritis permits passages of ___________________ into urine
    protien and blood
  47. Glomerulonephritis associated with
    poststreptococcal (group A beta-hemolytic streptococci)
  48. Nephrotic syndrome is
    increased permeability in glomeruli and protein leakage
  49. Key features of nephrotic syndrome
    • proteinuria
    • edema
    • hypoalbuminemia
    • hyperlipidemias
  50. Causes of nephrotic syndrome
    • genetic defects 
    • DM
    • SLE
  51. Acute kidney injury causes
    • Renal Failure
    • Rapid deterioration of renal function
  52. Oliguria results as a symptom of what
    acute kidney injury
  53. Acute kidney injury symptoms
    • decrease in glomerular filtration
    • elevated BUN and plasma creatinine
  54. Prerenal (before kidney) acute kidney injury causes
    hypoperfusion of kidney (i.e. cardiac failure, hypovolemia)
  55. Intrarenal (within kidney) acute kidney injury is caused by
    • nephrotoxic drugs such as antibiotics
    • causes acute tubular necrosis
  56. Postrenal (after kidney)
    causes obstruction of urinary flow

    caused by edema, tumors, stones, clots, prostatic, hyperplasia, urethral strictures
  57. stages of acute kidney injury
    Oliguria

    Diuresis


    Recovery of renal function
  58. Chronic kidney disease: Uremia usually has no signs or symptoms until
    GFR and renal function decline to 25% of normal
  59. Uremia associated with
    • hypertnetion 
    • DM
    • or intrinsic kidney disease
  60. In uremia, proteinuria contributes to
    tubulointerstitial inury leading to fibrosis
  61. In uremia, angiotensis 2 promotes
    systemic hypertension
  62. Uremic state is characterized by
    decline in renal function and accumulation of toxins in blood. 

    Electrolyte in imbalances, volume depletion and metabolic acidosis result
  63. What labs increase in Uremic State
    BUN and creatinine
  64. Symptoms of Uremic state
    • hypertension 
    • pericarditis
    • bone dmeineralization
    • fatigue
    • attention deficit
    • anemia
    • bleeding
    • diarrhea
    • N/V
    • Pruritis
    • Pigmentation
    • Infertility
    • Decreased Libido
  65. Neurologic symtoms of kidney failure
    • Fatigue
    • Drowsiness
    • Peripheral neuropathy 
    • irritability
    • depression
    • decreased concentration ability 
    • insomnia
  66. Ocular symtpoms of CRF
    • retinopathy
    • red eye
  67. Respiratory CRF
    • uremic lung
    • pleuritis
    • pulmonary edema
  68. Metabolic symptoms of CRF
    • infertility
    • decreased libido
    • impotence
    • amenorrhea
    • delayed puberty
  69. Dermatologic CRF
    • pallor
    • pruritis
    • dry skin
    • yellow-gray color
    • decreaed perspiration
    • brittle dry hair
  70. Endocrine CRF
    • hypothyroidism
    • hyperparathyroidism
  71. Cardiovascular CRF
    • CHF
    • HTN
    • pericarditis
  72. Hematologic CRF
    • anemia
    • bleeding tendency
    • susceptibility to infection
  73. Gastrointestinal CRF
    • N/V
    • anorexia
    • GI bleeding
    • Diarrhea
    • Uremic floor
  74. Musculoskeletal CRF
    • renal osteodystrophy
    • osteomalacia
    • osteitis fibrosa
    • osteosclerosis
    • soft tissue clacification 
    • retarded growth

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