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Renal A&P
Patho
| Question | Answer |
|---|---|
| GFR | glomerulo filtration rate |
| more blood floe through the kidneys = ______ | more urine output |
| if the kidneys dont perfuse they will ______ | stop |
| _____ of newborns are born with kidney and ureter abnormalities | 3-4% |
| kidneys develop in the ____ week of gestation | 5th week |
| urine formation begins the ____ week of gestation | 9th-12th week |
| ____ makes up the majority of amniotic fluid | urine |
| fetus renal px will develop _______, which is _______ | oligohydramnios, which is not enough amniotic fluid |
| failure of an organ to develop normally | dysgenesis |
| complete failure of an organ to develop | agenesis |
| renal agensis---wide set eyes, broad flat nose, epicanthic folds, low set ears, receding chin, and limb defects---usually do not live past a few minutes/hours | Potter's Syndrome |
| kidneys do not develop to normal size---rare---usually of one kidney---usually develops into renal failure | Renal hypoplasia |
| upper or lower poles of the kidney are fused together---common---does not always cause px | horseshoe kidney |
| hereditary dx characterized by cyst formation and massive kidney enlargement | polycystic kidney disease |
| mutation of PKD1 gene on chromosome 16, PKD2 on chromosome 4, or PKD3 | polycystic kidney disease |
| what are the 2 types of polycystic kidney disease? who do they effect? | Autosomal dominant: usually adults, progresses slowly-----autosomal recessive: usually affects children, no TX often die young |
| what happen when cysts develop in the kidneys in a polycystic kidney pt? | the kidneys enlarge and the renal vessles and nephrons become obstructed |
| inflammatory disorder of the renal pelvis and the functional portion of the kidney | pyelonephritis |
| ____ causes ascending bladder infections, blood-borne infections, frequent calculi | pyelonephritis |
| most common culprit of pyelonephritis | e. coli |
| TX for pyelonephritis that causes urination to be orange color and changes the pH | pyridium |
| most common primary neoplasms of young children around age os 3 | Wilm's Tumor |
| mixed tumor composed of epithelial and mesenchymal embryonic elements | Wilm's Tumor |
| associated with high BP and a solitary mass that can occur in any part of the kidney and is usually well-defined and encapsulated | Wilm's Tumor |
| most common primary tumor | Renal cell carcinoma |
| may produce hormone or hormone like substances and metastasizes commonly to the lung, mediastinum, bone, lymph nodes, liver, and CNS | Renal Cell Carcinoma |
| what are the 3 classic signs of Renal Cell Carcinoma? | triad-gross hematuria, flank pain, and papable abdominal mass |
| renal cell carcinoma is common in ____, ____, and ____ | men, smoking, and obesity |
| ______ are groups of capillaries with a basement membrane that filter the blood form urine filtrate | glomeruli |
| what are the glomeruli selectively permeable to? (3) | water, electrolytes, and dissolved particles (glucose and amino acids) |
| inflammation of the capillary loops of the glomeruli | glomerulonephritis |
| leading cause of chronic renal failre in US | glomerulonephritis |
| what are the 2 immune responses of glomerulonephritis? | injury resulting from antibodies reacting with fixed glomerular antigens.......injury resulting from circulating antigen=antibody complexes (DNA in SLE, strep) that become trapped in the glomeruli membrane |
| what 3 cellular changes occur in glomerulonephritis? | 1. proliferation- > in cellular componets....2. sclerotic- > in noncellular componets such as collagen.....3. membrane changes- > thickness |
| produces a proliferative inflammatory response (type of glomerulonephritis) | nephritic syndrome |
| _____ is characterized by hematuria with red cell casts, diminished GFR, azotemia, oliguria, and HTN | glomerulonephritis |
| usually in children...usually follows group A beta-hemolytic strep infection, but may also be a result of staph, measles, mumps, and chickpox | acute nephritic syndromes (glomerulonephritis) |
| inflammatory response is immune related-immue cells become trapped in the glomerular membrane and proliferation of the glomerular membrane > permeability to red cells and protein | acute nephritic syndromes (glomerulonephritis) |
| coke colored urine is a s/s because of the bl breakdown and the protein in the urine | acute nephritic syndromes (glomerulonephritis) |
| the glomerular cell proliferate along with macrophages forming cresent-shaped lesions that obstruct the Bowman's capsule | Chronic nephritic syndromes (glomerulonephritis |
| involves increased permeability of the glomerulus | Nephrotic syndrome (glomerulonephritis) |
| characterized by massive proteinuria, lipiduria, hypoalbuminemia, edema, and hyperlipidemia | Nephrotic syndrome (glomerulonephritis) |
| caused by diffused membrane thickening r/t immune cell deposits and is slow and progessive | Membranous Nephrotic syndrome (glomerulonephritis) |
| sclerosis of some but not all of the glmeruli | Focal segmental |
| end stage of glomerular disorders and are vague and slowly progressing | Chronis glomerulonephritis |
| kidneys fail to remove metabolic waste products, regulate pH, fluid, and electrolyte, has an abrupt onset, and is oftern reversible | Acute Renal Failure |
| what are the 3 categories of acute renal failure? | prerenal, intrarenal, postrenal |
| hypovolemia and CV failure; most common acute renal failure | prerenal (occurs before the kidney) |
| vascular diease, glomerulonephritis, nepritis (type of acute renal failure) | intrarenal (occurs in the kidney) |
| extrarenal obstruction, intrarenal obstruction, and bladder rupture | postrenal (occurs after the kidney) |
| what are the 3 phases of acute renal failure? | initiation, maintenance, and recovery |
| begins with the onset of the event causing tubular necrosis; this phase ends with tubular injury | initiation phase of acute renal failure |
| begins with in hours of the initiation ohase and typically lasts 1-2 weeks; it is characterized by persistent reduction in GFR and tubular necrosis | maintenance of acute renal failure |
| begins with the GFR and tubular function have recovered and there is no further elevation of the BUN and creatine; renal function improves rapidly the first 5-25 days and contiunes up to 1 year | recovery of acute renal failure |
| progressive inability over months to years of the kidneys to respond to change in body fluids and electrolytes with an ability to produce sufficient urine | chronic renal failure |
| GFR < 20% and serum creatine > 5mg/dl | chronic renal failure |
| what are the 3 stages of chronic renal failure? | early (renal impairment)....second (renal insufficiency)...third (ESRD) |
| what stage of chronic renal failure do px begin to occur? | second- renal insufficiency |
| when do you see a sharp > in BUN and creatine during chronic renal failure | third ESRD stage |
| what is the most common cause of renal failure in children? | glomerulonephritis and congenutal malformations |
| why is a transplant a good idea for the eldery with renal failure? | b/c they do not respond well to dialysis |
| renal calculi | kidney stones |
| are masses of crystals composed of minerals that are normally excreted in teh urine | calculi |
| what is the most common type of kidney stone? | Ca |
| stones in the UT | urolithiasis |
| stones in the kidney | nephrolithiasis |
| develop in the presence of alkaline urine or bacteria that posses the enzyme, urease; staghorned shaped; difficult to tx; too large to pass | struvite |
| urine-filled dilatation of the renal pelvis and calices with atrophy of renal pelvis and is caused by a urine obstruction | hydronephrosis |
| too much water in the kidneys | hydronephrosis |
| _____ when urine obstruction is below the ureters | bilateral |
| ____ if obstruction is at level of ureters or above | unilateral |
| infection of the bladder, kidney, urethra, or prostate and is classified by location | UTI |
| second most common type of bacterial infection | UTI |
| what are the two ways pathogens enter to cause an UTI? | ascending from the mucous membrane of the perineal area to the lower tract (most common)......and hematogenoulsy from the blood (rare) |
| what causes 90% of UTIs? | e. coli |
| what makes a UTI complicated? | having more than 2 UTIs in 1 year or being male |
| what is the elderly's most common s/s for an UTI? | confusion |
| what are the 3 main levels of neurological control for urine elimination? | spinal cord reflex center....micturation center in the pons.....cortical and subcortical centers |
| where are the centers for reflex control of the bladder emptying or micturition located? | b/t S1 - S4 and T11 - L2 |
| what are the 2 classes of causes of urinary obstruction and stasis? | congenital and aquired |
| what are the 2 classes of degrees of urinary obstruction and stasis? | partial or complete |
| what are the 2 classes of duration of urinary obstruction and stasis? | acute or chronic |
| what are the 2 classes of level of urinary obstruction and stasis? | upper or lower UT |
| loss of nerual control of the bladder | neurogenic bladder |
| failure to store urine d/t spasms; caused by spinal cord injury, herniated disks, vascular lesions, tumors, myelitis, stroke, multiple sclerosis, brain tumors | spastic bladder |
| bladder dysfunction caused by spinal cord injury | spinal shock |
| bladder atonic; requires cath; returns w/16 months; then the bladder becomes hyperactive | spinal shock |
| mild; can develop after a stroke, in early multiple sclerosis, of as a result of lesions located in the hibitory centers of hte cortex or the pyramidal tract; senstation remains, stream is normal, no residual urine; decreased bladder capacity | uninhibited spastic bladder |
| miscommunication in the muscles and spincter controlling unrication | detrustor-spincter dyssynergia |
| failure to empty urine; caused by peripheral neuropathies or failure of the extrernal spincter to relax | flaccid bladder |
| involuntary loss of urine that is sufficient to be a px | urinary incontinence |
| urinary incontinence that occurs during increases intrathorasic pressure | stress urinary incontinence |
| urinary incontinence that is due to an overactive bladder; frequnecy, uregency, dysuria, and nocturia | urge urinary incontinence |
| urinary incontinence due to bladder distention | overflow urinary incontinence |
Created by:
TayBay15
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