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kidney and urinary
patho exam 2
| Question | Answer |
|---|---|
| urinary tract function | produces, stores, and eliminates urine |
| What is the urinary tract composed of? | bladder, two kidneys, two ureters, and the urethra |
| What are the kidneys responsible for? | homeostasis via urine production and elimination |
| body functions impacted by the kidneys | blood pressure, electrolyte acid base balance, RBC production, bone health |
| how do kidneys affect blood pressure? | secretes renin, which increases blood pressure |
| what is secondary hypertension caused by? | kidneys |
| acute kidney injury | rapid decrease in kidney function |
| chronic kidney disease | loss of kidney function over time, results from a failure of the body to remove waste products |
| end-stage renal disease | occurs if CKD is not treated, results from a failure of the body to remove waste products |
| main function of kidneys and urinary tract | elimination of waste products |
| What happens without blood flow to the kidneys? | decreased urine output |
| acid base balance | bicarbonate acts as a buffer to maintain acid-base balance |
| What happens in acidosis? | kidneys reabsorb bicarbonate |
| what happens in alkalosis? | kidneys excrete more bicarbonate |
| glomerulonephritis | inflammation of the glomeruli and capillaries |
| What is glomerulonephritis characterized by? | proteinuria, hematuria, and edema |
| What is the primary cause of AKI and CKD? | glomerulonephritis |
| glomerulonephritis etiology and pathogenesis | post infectious, systemic disease, toxin exposure, thrombosis, genetic |
| How does an infection lead to glomerulonephritis? | immune response- antigen-antibody complexes are deposited into the glomerular filtration membrane |
| 2 pathways of acute post infectious glomerulonephritis | nephritic, nephrotic |
| nephritic pathway after an infection | inflammation and attack on the glomerular membrane occurs by neutrophils and monocytes, enzymes are released that damage glomerular walls, increased membrane permeability permits the passage of protein and rbcs into urine |
| nephrotic pathway after an infection | coagulation system may be activated, leading to a proliferation of cells in the glomerular membrane, renal blood flow and glomerular filtration rate decreased, renal insufficiency; retention of sodium, water, and waste |
| nephritic syndrome | inflammation |
| nephritic syndrome clinical manifestations | hematuria, mild proteinuria, rbc casts/ dysmorphic RBCs |
| nephrotic syndrome clinical manifestations | hyperlipidemia, proteinuria, hypoalbuminuria, edema, urinary fatty casts |
| glomerular disorders diagnosis | biopsy |
| glomerular disorders treatment | blood pressure control, blood cholesterol control, control of rising creatinine: immunosuppression |
| Leading cause of end stage renal disease | diabetic nephropathy |
| diabetic nephropathy | CKD resulting from hyperglycemia, proteinuria and hyperfiltration |
| diabetic nephropathy risk factors | poor glycemic control, uncontrolled hypertension, obesity, smoking, genetic factors, race |
| what race is diabetic nephropathy more prevalent in? | african american, hispanic, american indian, and asians |
| what is nephropathy highly dependent on? | blood glucose |
| progression of diabetic nephropathy | hyperglycemia-> polyuria-> increased renal blood flow-> glomerular hypertrophy-> glomerular hypertension-> hyperfiltration |
| Clinical manifestations of diabetic nephropathy | albuminuria, hyperfiltration, hypertension |
| diabetic nephropathy diagnosis | renal biopsy may not be necessary; diabetes, hypertension, and albuminuria leads to diagnosis |
| diabetic nephropathy treatment | maintain BP <140/90 mmHg, blood cholesterol control, maintain A1C ,7% |
| maintain BP diabetic nephropathy | ACE inhibitors, ARBS |
| blood cholesterol control diabetic nephropathy | statins |
| maintain A1C <7% diabetic nephropathy | lifestyle modifications, glucose lowering modifications |
| Hypertensive nephropathy | CKD resulting from long-standing hypertension |
| What is the second leading cause of ESRD? | hypertensive nephropathy |
| What does hypertensive nephropathy affect? | glomerulus, tubules, and vasculature of kidneys |
| What does hypertensive nephropathy lead to? | nephrosclerosis |
| Hypertensive nephropathy risk factors | genetics, diabetes, previous renal disease, more prevalent in african americans |
| possible etiologies of essential hypertension (hypertensive nephropathy) | genetics, lifestyle choices, activation of the RAAS, arterial stiffness |
| etiology and pathogenesis of hypertensive nephropathy- activation of the RAAS | atherosclerosis, reduction of blood flow to the glomeruli, SNS stimulation, activation of the RAAS, renal renin production, increased systemic blood pressure |
| manifestations of hypertensive nephropathy | left ventricular hypertrophy, ophthalmic changes, mild proteinuria, increased BUN and creatinine over time |
| diagnosis hypertensive nephropathy | Past medical history, hypertension, increased BUN/ creatinine |
| hypertensive nephropathy treatment | maintain BP <140/90, blood cholesterol control, lifestlyle modifications |
| maintain BP hypertensive nephropathy | ACE inhibitors, ARBs |
| blood cholesterol control hypertensive nephropathy | statins |
| lifestyle modification hypertensive nephropathy | regular exercise, smoking cessation, maintain BMI <25, restrict dietary sodium to <2.4 grams/day |
| UTI | infection of lower urinary tract of the bladder, upper urinary tract, or the kidney |
| Cystitis | infection of the bladder |
| most common bacterial infection | cystitis |
| cystitis risk factors | diabetes mellitus, familial predisposition, obstruction, neurogenic bladder, use of spermicides and diaphragms |
| pyelonephritis | infection of the renal pelvis and parenchyma of the kidney |
| pyelonephritis risk factors | female gender- sexually active, use of spermicides or diaphragm, pregnancy; genitourinary tract abnormalities, neurogenic bladder, immunosuppression, diabetes |
| Etiology and pathogenesis of Urinary tract infections | ascending bacterial colonization from urethra to bladder |
| what type of bacteria are utis most often caused by? | e. coli |
| How can UTIs be classified as? | complicated or uncomplicated |
| Other causes of UTIs | obstruction in the flow of urine, residual urine retention, bacteremia (pyelonephritis), instrumentation, back flow of urine (VUR) |
| what can cause obstruction in the flow of urine? | stones, papillary necrosis |
| Cystitis clinical manifestations | dysuria, urgency, frequency, confusion |
| cystitis diagnosis | based on clinical symptoms, urinalysis, urine culture as needed |
| pyelonephritis clinical manifestations | costovertebral angle pain, fever, chills |
| pyelonephritis diagnosis | urine culture, CT scan |
| UTI diagnosis | based on clinical symptoms, urinalysis and culture |
| UTI treatment | antibiotic therapy |
Created by:
camrynfoster