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pylo/neoplasms urina

pylonephritis and neoplasms of kidney

QuestionAnswer
Blood pressure is determined by cardiac output (influenced by blood volume) and peripheral resistance of arterioles.
Peripheral resistance is regulated by vasoconstrictors and vasodilators.
This causes the small renal arteries to become thickened and leads to microscopic ischemic changes (arteriolonephrosclerosis) which produces glomerular damage, tubular atrophy, and interstitial fibrosis BENIGN (ESSENTIAL) HYPERTENSION
What occurs pathologially with benign htn? As scar tissue replaces the damaged renal tissue, the surface of the kidney becomes granular and renal function decreases.
This results from an accelerated progression of previously "benign" hypertension and leads to a rapid increase of blood pressure to extremely high levels. MALIGNANT HYPERTENSION -
Clinically, there may be abrupt onset of cardiovascular or CNS symptoms (headache, nausea and vomiting, visual scotomas, etc). MALIGNANT HYPERTENSION -
Unless treated, death by cardiovascular disease, stroke, or uremia generally follows within a year.
The most frequent form of renal cancer in adults, RENAL CELL CARCINOMA (RCC)
When does renalcell carcioma generally occur? late adult life.
Whend do client swithrenal cel carcinoma generlly seek medical assistane? tumor reaches a sufficient size to cause space-occupying problems or it may present as hematuria with or without a palpable mass.
Renal cel carcinoa may have endocrine-like effects and cause what three symptoms? polycythemia, hypercalcemia, hypertension
Grossly, the tumor is usually solitary, bulky, unilateral, and yellow in color with foci of necrosis and hemorrhage RENAL CELL CARCINOMA (RCC
rel cell carcinoma like to invade the renal vein.
The clinical course of renal cell carinoma is very unpredictable; the tumor can metastasize widely with the most common locations being lung and bone.
This is the most common primary renal malignancy of childhood and comprises about 5% of all childhood cancers. WILMS’ TUMOR -
clinical manifestations of wilms tumor They frequently present as abdominal swelling or large unilateral (90%) masses with or without abdominal pain and gross hematuria.
In most wilm's tumor cases, abnormalities of the short arm of chromosome ___ are present. 11
The most common sites of metastasis with wlms tumor are the lung and liver.
(5-10% of adult renal cancer) - This arises from the epithelium which lines the calyces and pelvis of the kidney. TRANSITIONAL CELL CARCINOMA
Because of their location, they tend to produce early hematuria and are therefore identified earlier then renal cell carcinomas. TRANSITIONAL CELL CARCINOMA
They may be associated with concurrent transitional cell carcinomas elsewhere within the urinary tract and the presence of multicentric lesions suggests this may be the effects of a carcinogen in urine. TRANSITIONAL CELL CARCINOMA
type of renal failure, This is most often due to ischemic or toxic damage to renal tubules (acute tubular necrosis). ACUTE -
Clinical onset of acute renal failure generally begins _______ after the initiating insult. 24-36 hours
Oliguria and decreased blood filtration by the glomeruli, with acute renal failureeee leads to fluid overload, uremia and electrolyte retention.
During this phase,clinical symptoms of acute renal failure (which may last up to 3 weeks), patients must be supported by dialysis.
can clients with acute renal failure regain normal kidney function? yes
When blood filtration is 20-30% of normal, azotemia (increased blood urea nitrogen and creatinine) will develop, frequently accompanied by hypertension. CHRONIC -
When filtration is _________of normal, azotemia is complicated by the symptoms of the uremic syndrome. 15-20%
this syndrome reflects dysfunction of many organ systems as well as fluid, electrolyte, and acid/base disturbances uremic syndrome
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