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Urological System

QuestionAnswer
Name three Intra-Renal obstructive disorders. Calculi, tumors, and congenital deffects.
Name the causes of calculi. Immobilization, bone cancer, urinary stasis, dehydration, pH of urine.
What are the most common calculi? Calcium stones
What is the definition of calculi? Anything that increases bone resorption.
What are the early and later S/S of urological tumors? None in the early stages and obstruction & Hematuria in the later stages
What are types of congenital intra-renal obstructive disorders? Agenesis, hypoplastic or dysplastic kidneys.
What are the two main types of Extra-renal obstructive disorders? Ureteral obstruction and Bladder obstruction.
What are some causes of ureteral obstruction? Calculi, scarring, stenosis/kinking, congenital-abnormal placement causing reflux.
What are some types of bladder obstructions? Neurogenic bladder, cystocele, tumors, BPH, prostate cancer.
What two types of bladder obstructions have the same S/S? BPH and prostate cancer.
What does the word micturition mean? Voiding or urination
What does the word incontinence mean? The inability to control urination.
When does BPH (benign prostatic hypertrophy) begin? About age 40.
Why does BPH occur? Due to changes in levels of androgens and estrogen.
What are the complications associated with BPH? (6) Increased bladder pressure, hydroureter, hydronephrosis, bladder diverticuli, altered kidney fxns, and infections.
An enlarged ASYMMetrical, nodular mass is usually indicative of what disorder? Prostate Cancer
Where can high PSA level be seen, in BPH or in Prostate Cancer? Both
What is the best diagnostic method for Prostate Cancer? Biopsy
What type of obstructive pathologies can cause kidney damage? Any obstructive pathology below the kidneys.
What is the riskiest of all urological diagnostic exams? A Renal angiogram.
What is the normal pH of urine vs a pH indicative of Cystitis? Normal pH 4.6-8.0 (usually 5-6). Abnormal is > 7.
What is the normal urine Osmolality? 1.003-1.030
How common is Urethritis? It is very rare and is usually indicative of gonorrhea in men.
What are the two types of cystitis? Bacterial (most common type) and non-bacterial.
What is the usual eitolgoy of bacterial cystitis? Ascending bacteria such as E. coli, Klebsiella, Pseudomonas, and Proteus.
Which has a greater risk of causing a UTI, indwelling catheter or a suprapubic catheter? Indwelling catheter
Confusion may be the only sign in the elderly for what type of manifestation? Cystitis
What are common manifestations of cystitis? Frequency, urgency, dysuria (painful urination)
What type of inflammation occurs in 25% of males and presents with frequency, urgency and dysuria that may be confused with cystitis? Prostatitis
How common is cystitis in males? Rare in males.
What is pyelonephritis? It is an ascending UTI that has reached the pyelum (pelvis) of the kidney.
What is a manifestation of pyelonephritis? CVA tenderness
What can chronic pyelonephritis lead to? Scarring and atrophy
What is glomerular filtration? Filtering of the blood by the glomerular capillary.
What is required for glomerular filtration? Adequate blood flow to the kidneys AND an intact glomerular membrane.
What is the normal glomerular filtration rate (GFR)? 120-125 ml/min
When and at what rate does GFR begin to decrease? At 1 ml per year after age 40.
How does a normal GFR vary? With the amount of muscle mass.
What is the most common cause of Acute glomerulonephritis in children? Post streptococcal infection from strep throat or skin infection.
What is the overall pathology of acute glomerularnephritis? Thickening of the membrane causing a decrease in GFR and a presence of RBC casts.
What are the manifestations of Rapidly Progressive Glomerulonephritis? Idiopathic, proliferative inflammation/post strep infection with renal insufficiency present at diagnosis.
What type of Glomerularnephritis is linked to ischemia, Diabetes Mellitus, immune disorders, vascular disorders, and drugs/toxins? Chronic Glomerularnephritis
What has occurred if RBC casts are present? Glomerular damage
What are the complications of Chronic Glomerular Damage? ESRF and nephrotic syndrome
How much protein is lost in proteinuria? > 3.5 g protein/day
What occurs in Nephrotic Syndrome after proteinuria has occurred? Hypoalbuminemia to a decrease in COP to edema.
In Nephrotic Syndrome, after the loss for Vitamin D transport globulin occurrs, what happens next? A decrease amount of Vitamin D.
In Nephrotic Syndrome, after hypoalbuminemia causes an increase in lipoprotein synthesis by the liver, what happens next? Hyperlipidemia to lipduria.
What does hypoalbumiemia do to antibodies? It causes a decrease in antibodies increasing risk of infection.
Can acute renal failure be reveresed? Yes it may be reversible.
What are the three Etiologies of Acute Renal Failure? Pre-renal, intra-renal, and post-renal.
Decreased Blood volume or decreased blood pressure from shock is an etiology of what type of Acute Renal Failure-- Pre-Renal,Intra-Renal, or Post Renal? Pre-Renal
Severe fluid loss from burns, the GI, or diuresis is an etiology of what type of Acute Renal Failure-- Pre-Renal,Intra-Renal, or Post Renal? Pre-Renal
What is azotemia? Abnormal urea and creatine in the blood due to insufficient filtering of the blood by the kidneys.
Azotemia is a sign and symptom of what type of disease? Abnormal urea and creatine in the blood due to insufficient filtering of the blood by the kidneys.
What is azotemia? Oliguria (inability to void), diuresis, and then recovery.
What is ATN and what does it cause. Acute Tubular Necrosis. It causes Acute Renal Failure and the Intra Renal level.
What is the GFR diagnostic indicator of glomerular function? 120 ml blood/min in females and 140 ml/min in males.
What is the creatinine diagnostic indicator of glomerular function? Normal is 0.6-1.2 (males) and 0.5-0.9 (females).
What is needed in high risk pt's since creatinine is not sensitive enough to diagnose glomerular fxn? A calculated GFR.
What is a normal BUN? 10-20 mg/dl
What pathologies other than kidney disease does urea increase in? Bleeding, dehyration, fever, protein intake.
Is urea by itself a specific indicator for kidney disease? No
What is the number one etiology of Chronic Renal Kidney Failure? Diabetes Mellitus
What is the prevalance of CRF in adults? 10-13% of US adults.
What other etiologies besides DM cause CRF? Polycystic Kidneys and Tuberculosis.
When is kidney disease considered Chronic Renal FAILURE? When the GFR is < 15ml/min (at Stage 5).
What is the GFR for Stage 1 & 2 kidney disease? GFR is normal or at a mild decrease.
CRF is the same as what stage in kidney disease? Stage 5
At what stage is chronic kidney disease when the GFR is 29-15 ml/min? Stage 4 with Renal Insufficiency and s/s of uremia.
At what stage is chronic kidney disease when the GFR is 59-30 ml/min? Stage 3 with Renal Insufficiency.
What stage is renal fxn at 50%? Stage 3
What is the GFR rate in Stage 5 CKD? < 15 ml/min
When is a pt considered to have CKD? When GFR < 60ml/min for >3 months OR kidney damage for > 3 months.
What type of diseases are CKD pts at risk for? Cardio Vascular Diseases
What populations are at HIGH RISK for CKD? Elderly, those with DM HTN CVD albuminuria family HX, Autoimmune Smokers
What data does the Cockcroft-Gault equation need? Age, gender, ht/wt, serum creatine
What data does the Levey equation need? Positive BUN, race, albumin
Is ESRF reversible? No it is IRREVERSIBLE.
What is needed inorder for a pt to live while in ESRF? Dialysis
When is chronic kidney disease considered renal failure? At Stage 5
What is a pt with ESRF unable to do? Excrete metabolic wastes, secrete/excrete or reabsorb certain electrolytes, excrete excess H2O.
What does the inability to excrete excess H2O put the pt at risk for? Increased risk for Left Ventricular Hypertrophy (LVH) leading to heart failure.
What level of creatinine do ESRF pt's have? 6 or >
What level of BUN do ESRF pt's have? 100 or >
In ESRF pt's, is uric acid decreased or increased? Increased Uric Acid
What are two urine ESRF manifestations? Oliguria (output < 400ml/day) and Anuria (< 100 ml/day)
This ESRF manifestation has increased creatinine and BUN, fatigue, anorexia, nausea, vomiting, pruritis, and neurological changes. Uremic Syndrome
This type of ESRF manifestation deals with fluid, what is it? FVE or fluid volume excess
Name the ESRF manifestations for electrolytes. ↑K, ↑ or ↓ Na, ↓Ca, ↑PO4
What does an ↑K put the pt at risk for? Dysrhytmia
What does a ↑ or ↓ Na put the pt at risk for? Seizures
Why does a ↓Ca occur in pts? B/c of ↓ Kidney activation of Vit D which ↓CA absorption from the GI.
What does a ↑PO4 do to Ca? It inhibits Ca absorption plus binds w/ Ca causing calcification's in soft tissues.
What causes ↑ or ↓ Na? Damage to the Loop of Henle and FVE.
What causes ↑PO4? ↓ secretion/excretion of PO4
What causes ↑K? ↓ secretion/excretion of K
What are some causes of Anemia? ↓ erythropoietin, ↑ Metabolic toxins that shorten RBC life, and Hgb < 10.
What does ↓ erythropoietin cause? Normocytic or normochromic RBC's.
What Hgb amount will be present in anemia if untreated? 7-8
What does a Hgb of < 10 cause? ↑ Heart rate causing LVH to heart failure.
In HTN r/t ESRF, what causes ↑ BP? FVE, ↑ vasoconstriction, ↑ H2O
In HTN r/t ESRF, what happens after ↓ renal perfusion? ↑ Renin causing ↑ angiotensinogen.
What does ↑ aldosterone cause? ↑ Na to ↑ H2O
Created by: jesusrvillarreal
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