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2011-06-09 14:20:31

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  1. retrograde pylography
    • contrast dye into kidney to view
    • retro (backwards thru kidney, against b flow)
    • usually arterial
    • (angio pylography arterial, veno venous)
  2. PSA
    prostate specific antigen, if elevated, prob w prostate

    over 4, can be BPH, can mean cancer
  3. KUB
    • kidneys ureter bladder
    • x ray of abdomen
    • can use dye but usually don't. bladder full is better
  4. CT scan
    • computerized tomography
    • contrast or without
  5. MRI
    more specific longer and expensive than CT
  6. IVP
    • Intravenous Pylogram
    • going through the veins using contrast dye
  7. Endoscopic
    tiny camera taking pictures of things
  8. Renal scan
    x ray
  9. BUN creatnine
    • creatnine 1.7- renal insufficiency maybe-depends on baseline
    • Normal values are 0.8-1.4 guys
    • women lower
  10. Voiding cystourethrography
    (cysto means bladder) when someone pees, use contrast dye into bladder via scope
  11. Renal biopsy
    • take a piece out
    • only definitive test for cancer
  12. Renal angiogram
    • angio (arterial) gram (picture w contrast dye) + renal (whole thing)
    • can stick a stent in arteries to improve blood flow to kidneys
  13. 24 h Creatnine clearance
    • blood and urine, 24 h how well are blood and kidneys filtering?
    • discard 1st void, start there
  14. Osmolarity, specific gravity
    dipstick in urine- concentrated or not, same w spec gravity
  15. Specific gravity
  16. Ultrasound
    sound waves to look at structures
  17. Renal venogram
    same as angio except veins
  18. transrectal ultrasound
    go through rectum to look at structures from the back
  19. UA if find wbcs, sent for a ______
    ____ most accurate, not as common
    • C&S
    • 24 h
  20. pH of urine
  21. Specific gravity
  22. Cloudy usually means_____
  23. Autonomic dysreflexia
    remove stimulus first, then treat bp can be life threatening
  24. UTIs
    have to pee because of stretch receptors
  25. Urinary retention
    can't pee everything out
  26. urethritis
    • inflamm of urethra
    • gonorrhea usually
    • lots of fluid
    • pericare
    • use condoms
    • antibiotics
  27. cystitis
    inflammation of the bladder
  28. prostatitis
    • men inflammation of prostate
    • different than BPH but some same symptoms
    • antibiotics pushing fluids
  29. pyelonephritis
    • inflammation of kidney and structures
    • includes renal pelvis tubules, interstitial tissues, usually e.coli
    • Congested b vessels assoc w chronic health probs
    • DM, trauma, HTN, kidney disease, obstructions or injury
  30. #1 cause of end stage ARF
    diabetes, untreated HTN, obstruction
  31. pyelonephritis
    • chills, fever, flank pain, loudy pyuria, mucus, blood in urine
    • Bi or unilateral
    • can lead to a chronic infections destroying nephrons-atrophy of kidney
    • dx
    • UA/C&S-bacteria
    • IVP -degenerative changes
    • BUN and Cr may be elevated
  32. How do you get in for IVP
    femoral artery
  33. BUN creatnine
    if nephrons are being destroyed, they will be______
  34. Treating pyelonephritis
    • find bug that causes, 72 h to isolate bug, find resistance
    • broad spectrum to start, grow out bug to look for resistance
  35. nephrostomy
    • catheter into renal pelvis, drain urine
    • high inc of infection
  36. Ureterostomy
    • diversion
    • bypasses bladder
  37. Hydronephrosis
    • kilation of renal perv and calyces
    • unilateral or bilateral (congenital)
    • obstruction of urinary tract

    • dull flank pain
    • severe stabbing pain
    • n/v
    • freq dribbling, burning, difficulty starting urination
  38. Get rest from lecture up to renal tumors
  39. urolithiasis
    stones- form of urinary calculi (stones) dev from minerals identified according to location, nephrolithiasis, ureterolithiasis, cystolithiasis
  40. renal tumors
    • adenocarcinomas that dev unilaterally
    • renal cell carcinomas arise from cells of the prox convoluted tubules
  41. What if foley occludes?
    • call physician
    • no matter what, ok to pull foley, but don't insert foley into fresh surgical pt
  42. prostate cancer
    • the earlier the better
    • same sx as BPH
  43. Nephrotic syndrome
    • protein!!
    • proteinuria
    • hypoalbuminia
    • leaking protein through urine
    • low protein in blood
    • diet- high protein
    • edema-protein loves water, so not a lot of protein in blood, fluid can leak out
    • altered renal function (BUN and creatnine)
    • oliguria
  44. Nephrotic syndrome
    changes in glomeruli interfere w selective perm

    • proteinuria, hypoalbumenemia
    • blood work- low albumin, hyperlipidemia
    • renal biopsy

    high protein (compensate) low Na diet (minimize edema), diuretics, corticosteroids
  45. nephritis (aka glomerulonephritis)
    • inflammation of glommeruli, inflammation of kidney, glomeruli, tubules, interstital tissue, preceded by inf sore throat/skin inf most common B hemolytic streptococci
    • common w preexisting conditions like lupus, inf triggers immune response
  46. nephritis clinical man
    • edema of face, pallor, malaise, anorexia, dyspnea w exertion, hematauria, changes in voiding patterns, oliguria; dysuria
    • sx infection